Hultborn Hans
Department of Medical Physiology, The Panum Institute, University of Copenhagen, Copenhagen, Denmark.
J Rehabil Med. 2003 May(41 Suppl):46-55. doi: 10.1080/16501960310010142.
It is a well-known fact that spinal reflexes may gradually change and often become enhanced following spinal cord lesions. Although these phenomena are known, the underlying mechanisms are still unknown and under investigation, mainly in animal models. Over the last twenty years, new methods have been developed that can reliably estimate the activity of specific spinal pathways in humans at rest and during voluntary movement. These methods now make it possible to describe components of the spinal pathophysiology in spasticity in humans following spinal lesions or stroke. We now know that spinal networks are capable of generating the basic pattern of locomotion in a large number of vertebrates, including the monkey--and in all likelihood, humans. Although spinal networks are capable of generating locomotor-like activity in the absence of afferent signals, functional gait is not possible without sensory feedback. The results of animal studies on the sensory control of and the transmitter systems involved in the spinal locomotor centers are now being used to improve rehabilitation of walking in persons with spinal cord injury and hemiplegia.
众所周知，脊髓反射可能会逐渐变化，并且在脊髓损伤后常常会增强。尽管这些现象是已知的，但其潜在机制仍然未知，并且主要在动物模型中进行研究。在过去的二十年中，已经开发出了新的方法，这些方法能够可靠地估计人类在休息和自主运动期间特定脊髓通路的活动。现在，这些方法使得描述脊髓损伤或中风后人类痉挛状态下脊髓病理生理学的组成部分成为可能。我们现在知道，脊髓网络能够在包括猴子在内的大量脊椎动物中产生基本的运动模式，而且很可能在人类中也能如此。尽管脊髓网络在没有传入信号的情况下能够产生类似运动的活动，但没有感觉反馈就不可能有功能性步态。目前，关于脊髓运动中枢的感觉控制和所涉及的递质系统的动物研究结果正被用于改善脊髓损伤和偏瘫患者的步行康复。
