Recovery of motoneuron and locomotor function after spinal cord injury depends on constitutive activity in 5-HT2C receptors

Katherine C. Murray, Aya Nakae, Marilee J. Stephens, Michelle Rank, Jessica D'Amico, Philip J. Harvey, Xiaole Li, R. Luke W Harris, Edward W. Ballou, Roberta Anelli, Charles J. Heckman, Takashi Mashimo, Romana Vavrek, Leo Sanelli, Monica A. Gorassini, David J. Bennett, Karim Fouad

Research output: Contribution to journalArticlepeer-review

263 Scopus citations


Muscle paralysis after spinal cord injury is partly caused by a loss of brainstem-derived serotonin (5-HT), which normally maintains motoneuron excitability by regulating crucial persistent calcium currents. Here we examine how over time motoneurons compensate for lost 5-HT to regain excitability. We find that, months after a spinal transection in rats, changes in posttranscriptional editing of 5-HT2C receptor mRNA lead to increased expression of 5-HT2C receptor isoforms that are spontaneously active (constitutively active) without 5-HT. Such constitutive receptor activity restores large persistent calcium currents in motoneurons in the absence of 5-HT. We show that this helps motoneurons recover their ability to produce sustained muscle contractions and ultimately enables recovery of motor functions such as locomotion. However, without regulation from the brain, these sustained contractions can also cause debilitating muscle spasms. Accordingly, blocking constitutively active 5-HT2C receptors with SB206553 or cyproheptadine, in both rats and humans, largely eliminates these calcium currents and muscle spasms, providing a new rationale for antispastic drug therapy.

Original languageEnglish (US)
Pages (from-to)694-700
Number of pages7
JournalNature Medicine
Issue number6
StatePublished - Jun 2010

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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