Project Summary Efforts to promote recovery of function after human spinal cord injury (SCI) will likely require interventions targeting the corticospinal motor system, the most important pathway for voluntary motor control in humans. In a series of studies over the past 4 years we have found that corticospinal tract (CST) axons regenerate into spinal cord neural stem cell (NSC) grafts placed into sites of SCI in mice, rats and monkeys. These regenerating CST axons form synapses with the graft, and the graft in turn extends very large numbers of new axons from the injury site over long distances into the distal spinal cord. Neural relays across the injury are thereby formed, supporting functional improvement. This work is on a human translational path and IND-enabling work is in progress. This grant proposes two new directions that will be critically important in supporting human translation. First, we recently reported that injured adult mouse CST neurons revert to an embryonic transcriptional state that lasts for two weeks after SCI, a time during which CST axons can regenerate. This finding establishes a critical period for intervention after mouse SCI to support recovery. Does the same transcriptional reversion to a pro-growth embryonic state occur in the primate brain? If so, how long does it last? Work in Aim 1 will definitively answer this question, identifying for the first time what may be an optimal time window for therapeutic intervention of any type to support functional recovery in primates, including humans. We will perform RNA sequencing (RNAseq) specifically of CST neurons after SCI in rhesus monkeys using intersectional viral approaches, based on supportive preliminary data in monkeys. In Aim 2 we propose for the first time using novel viral vectors to anterogradely, trans-synaptically trace primate corticospinal projections to the spinal cord. Our preliminary studies demonstrate that rodent CST axons project nearly entirely to spinal cord interneurons, whereas in primates the vast preponderance of CST axons terminate directly on alpha motor neurons. Knowing the precise targets of CST projections to the spinal cord will both markedly extend our basic knowledge of motor system organization in primates, and will allow optimization of stem cell graft properties to enhance neural relay formation across sites of SCI. Unlike other neural stem cell programs for SCI, our work aims to directly re-form critical neural relays across a severe injury, rather than target spared axons through grafts of OPCs; knowledge gained from this aim could markedly improve relay formation across injury sites in the primate system.