School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
Prog Brain Res. 2011;192:181-97. doi: 10.1016/B978-0-444-53355-5.00012-9.
Given the inherent mechanical complexity of human bipedal locomotion, and that complete spinal cord lesions in human leads to paralysis with no recovery of gait, it is often suggested that the corticospinal tract (CST) has a more predominant role in the control of walking in humans than in other animals. However, what do we actually know about the contribution of the CST to the control of gait? This chapter will provide an overview of this topic based on the premise that a better understanding of the role of the CST in gait will be essential for the design of evidence-based approaches to rehabilitation therapy, which will enhance gait ability and recovery in patients with lesions to the central nervous system (CNS). We review evidence for the involvement of the primary motor cortex and the CST during normal and perturbed walking and during gait adaptation. We will also discuss knowledge on the CST that has been gained from studies involving CNS lesions, with a particular focus on recent data acquired in people with spinal cord injury.
鉴于人类双足运动固有的机械复杂性，以及人类完全性脊髓损伤会导致瘫痪而无法恢复步态，人们常认为皮质脊髓束（CST）在人类行走控制中的作用比在其他动物中更为重要。然而，我们对 CST 对步态控制的贡献到底了解多少呢？本章将基于以下前提对这一主题进行概述：更好地理解 CST 在步态中的作用对于基于证据的康复治疗方法的设计至关重要，这将增强中枢神经系统（CNS）损伤患者的步态能力和恢复能力。我们回顾了在正常和受扰行走以及步态适应过程中，初级运动皮层和 CST 的参与情况。我们还将讨论从涉及 CNS 损伤的研究中获得的关于 CST 的知识，特别关注最近在脊髓损伤患者中获得的数据。
