Anti-Nogo-A Antibody Therapy Improves Functional Outcome Following Traumatic Brain Injury

Neurorehabil Neural Repair. 2023 Oct;37(10):682-693. doi: 10.1177/15459683231203194. Epub 2023 Oct 14.

Abstract

Background: Traumatic brain injury (TBI) can cause sensorimotor deficits, and recovery is slow and incomplete. There are no effective pharmacological treatments for recovery from TBI, but research indicates potential for anti-Nogo-A antibody (Ab) therapy. This Ab neutralizes Nogo-A, an endogenous transmembrane protein that inhibits neuronal plasticity and regeneration.

Objective: We hypothesized that anti-Nogo-A Ab treatment following TBI results in disinhibited axonal growth from the contralesional cortex, the establishment of new compensatory neuronal connections, and improved function.

Methods: We modeled TBI in rats using the controlled cortical impact method, resulting in focal brain damage and motor deficits like those observed in humans with a moderate cortical TBI. Rats were trained on the skilled forelimb reaching task and the horizontal ladder rung walking task. They were then given a TBI, targeting the caudal forelimb motor cortex, and randomly divided into 3 groups: TBI-only, TBI + Anti-Nogo-A Ab, and TBI + Control Ab. Testing resumed 3 days after TBI and continued for 8 weeks, when rats received an injection of the anterograde neuronal tracer, biotinylated dextran amine (BDA), into the corresponding area contralateral to the TBI.

Results: We observed significant improvement in rats that received anti-Nogo-A Ab treatment post-TBI compared to controls. Analysis of BDA-positive axons revealed that anti-Nogo-A Ab treatment resulted in cortico-rubral plasticity to the deafferented red nucleus. Conclusions. Anti-Nogo-A Ab treatment may improve functional recovery via neuronal plasticity to brain areas important for skilled movements, and this treatment shows promise to improve outcomes in humans who have suffered a TBI.

Keywords: Nogo-A; motor function; neuroplasticity; traumatic brain injury.

MeSH terms

  • Animals
  • Axons / physiology
  • Brain Injuries*
  • Brain Injuries, Traumatic* / drug therapy
  • Disease Models, Animal
  • Humans
  • Nogo Proteins
  • Rats
  • Recovery of Function / physiology

Substances

  • Nogo Proteins