Poirrier Anne-Lise, Nyssen Yves, Scholtes Felix, Multon Sylvie, Rinkin Charline, Weber Géraldine, Bouhy Delphine, Brook Gary, Franzen Rachelle, Schoenen Jean
Research Centre for Cellular and Molecular Neurobiology, Neuroanatomy Laboratory, University of Liege, Belgium.
Department of Neurology, Aachen University Medical School, Aachen, Germany.
J Neurosci Res. 2004 Jan 15;75(2):253-261. doi: 10.1002/jnr.10852.
Electromagnetic fields are able to promote axonal regeneration in vitro and in vivo. Repetitive transcranial magnetic stimulation (rTMS) is used routinely in neuropsychiatric conditions and as an atraumatic method to activate descending motor pathways. After spinal cord injury, these pathways are disconnected from the spinal locomotor generator, resulting in most of the functional deficit. We have applied daily 10 Hz rTMS for 8 weeks immediately after an incomplete high (T4-5; n = 5) or low (T10-11; n = 6) thoracic closed spinal cord compression-injury in adult rats, using 6 high- and 6 low-lesioned non-stimulated animals as controls. Functional recovery of hindlimbs was assessed using the BBB locomotor rating scale. In the control group, the BBB score was significantly better from the 7th week post-injury in animals lesioned at T4-5 compared to those lesioned at T10-11. rTMS significantly improved locomotor recovery in T10-11-injured rats, but not in rats with a high thoracic injury. In rTMS-treated rats, there was significant positive correlation between final BBB score and grey matter density of serotonergic fibres in the spinal segment just caudal to the lesion. We propose that low thoracic lesions produce a greater functional deficit because they interfere with the locomotor centre and that rTMS is beneficial in such lesions because it activates this central pattern generator, presumably via descending serotonin pathways. The benefits of rTMS shown here suggest strongly that this non-invasive intervention strategy merits consideration for clinical trials in human paraplegics with low spinal cord lesions.
电磁场能够在体外和体内促进轴突再生。重复经颅磁刺激（rTMS）常用于神经精神疾病，并且作为一种无创方法来激活下行运动通路。脊髓损伤后，这些通路与脊髓运动发生器断开连接，导致大部分功能缺陷。我们在成年大鼠发生不完全性高位（T4 - 5；n = 5）或低位（T10 - 11；n = 6）胸段闭合性脊髓压迫性损伤后，立即每天施加10 Hz的rTMS，持续8周，使用6只高位和6只低位损伤未受刺激的动物作为对照。使用BBB运动评分量表评估后肢的功能恢复情况。在对照组中，与T10 - 11损伤的动物相比，T4 - 5损伤的动物在损伤后第7周起BBB评分明显更好。rTMS显著改善了T10 - 11损伤大鼠的运动恢复，但对高位胸段损伤的大鼠没有效果。在接受rTMS治疗的大鼠中，最终BBB评分与损伤部位尾侧脊髓节段中5-羟色胺能纤维的灰质密度之间存在显著正相关。我们认为低位胸段损伤产生更大的功能缺陷是因为它们干扰了运动中枢，而rTMS对这类损伤有益是因为它可能通过下行5-羟色胺通路激活了这个中枢模式发生器。此处显示的rTMS的益处强烈表明，这种非侵入性干预策略值得考虑用于低位脊髓损伤的人类截瘫患者的临床试验。
