Long-term Connectivity between Spinal Cord Tissue Transplants and the Injured Phrenic Motor Network

Restoring vital motor functions after spinal cord injury (SCI) remains a central challenge in neuroscience and regenerative medicine. Cervical SCI can cause life-threatening respiratory deficits by damaging the phrenic motor network that controls the diaphragm. Cellular transplantation offers a viable means to improve function by providing new neurons that can relay supraspinal drive to denervated spinal phrenic networks, yet the long-term stability of transplants is poorly defined. Here, we examine donor-host neuronal synaptic connectivity in a respiratory model of cervical SCI, 1-year post-transplantation in adult rats. Embryonically-derived spinal cord tissue was transplanted into the lesion cavity one-week post-SCI, and transplant integration and diaphragm function were assessed at 1-month and 1-year post-transplantation. At 1-month, transplant-recipients exhibited significantly greater diaphragm output than injured, vehicle control animals. The extent of recovery at 1-year, however, was significantly less, coinciding with anatomical changes in graft neuronal density and donor-host connectivity, revealed by transneuronal tracing (pseudorabies virus). These results demonstrate that embryonic spinal cord transplants can improve phrenic motor activity after cervical SCI, but that long-term efficacy may be limited by reduced donor-host connectivity.