Journal of Neural Transmission

, Volume 122, Issue 2, pp 279–295 | Cite as

Serotonergic transmission after spinal cord injury

  • Raffaele Nardone
  • Yvonne Höller
  • Aljoscha Thomschewski
  • Peter Höller
  • Piergiorgio Lochner
  • Stefan Golaszewski
  • Francesco Brigo
  • Eugen Trinka
Neurology and Preclinical Neurological Studies - Review Article


Changes in descending serotonergic innervation of spinal neural activity have been implicated in symptoms of paralysis, spasticity, sensory disturbances and pain following spinal cord injury (SCI). Serotonergic neurons possess an enhanced ability to regenerate or sprout after many types of injury, including SCI. Current research suggests that serotonine (5-HT) release within the ventral horn of the spinal cord plays a critical role in motor function, and activation of 5-HT receptors mediates locomotor control. 5-HT originating from the brain stem inhibits sensory afferent transmission and associated spinal reflexes; by abolishing 5-HT innervation SCI leads to a disinhibition of sensory transmission. 5-HT denervation supersensitivity is one of the key mechanisms underlying the increased motoneuron excitability that occurs after SCI, and this hyperexcitability has been demonstrated to underlie the pathogenesis of spasticity after SCI. Moreover, emerging evidence implicates serotonergic descending facilitatory pathways from the brainstem to the spinal cord in the maintenance of pathologic pain. There are functional relevant connections between the descending serotonergic system from the rostral ventromedial medulla in the brainstem, the 5-HT receptors in the spinal dorsal horn, and the descending pain facilitation after tissue and nerve injury. This narrative review focussed on the most important studies that have investigated the above-mentioned effects of impaired 5-HT-transmission in humans after SCI. We also briefly discussed the promising therapeutical approaches with serotonergic drugs, monoclonal antibodies and intraspinal cell transplantation.


Serotonin Spinal cord injury Motor function Locomotion Spasticity Pain Monoclonal antibodies Cell therapy 


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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Raffaele Nardone
    • 1
    • 2
    • 3
  • Yvonne Höller
    • 1
    • 3
  • Aljoscha Thomschewski
    • 1
    • 3
  • Peter Höller
    • 1
    • 3
  • Piergiorgio Lochner
    • 2
  • Stefan Golaszewski
    • 1
  • Francesco Brigo
    • 2
    • 4
  • Eugen Trinka
    • 1
    • 3
  1. 1.Department of NeurologyChristian Doppler Klinik, Paracelsus Medical University and Center for Cognitive NeuroscienceSalzburgAustria
  2. 2.Department of NeurologyFranz Tappeiner HospitalMerano (BZ)Italy
  3. 3.Spinal Cord Injury and Tissue Regeneration CenterParacelsus Medical UniversitySalzburgAustria
  4. 4.Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical NeurologyUniversity of VeronaVeronaItaly

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