Field-Fote Edelle C
Crawford Research Institute, Shepherd Center, Atlanta, GA, USA.
Prog Brain Res. 2015;218:103-26. doi: 10.1016/bs.pbr.2014.12.006. Epub 2015 Mar 29.
The discovery that the nervous system is plastic even in adulthood has been a great benefit to people with spinal cord injury (SCI) and other disorders of the central nervous system. Currently, practice and training provide the best opportunities to reverse the maladaptive plasticity associated with neuropathology and to promote adaptive plasticity that is supportive of function. Evidence suggests that several noninvasive, clinically accessible forms of stimulus energy, such as electrical, magnetic, and vibration stimuli may augment the effects of training. In essence, stimulation activates the same neural circuits that are activated by training, and when used in combination with training, stimulation has the potential to promote neuroplasticity beyond that achieved by practice or training alone. Studies involving neurologically healthy individuals have shown these approaches to enhance neural excitability and motor performance. Noninvasive, clinically available forms of stimulation may be used to modulate neural excitability as an adjuvant to programs designed to improve hand/arm function or to improve walking function in persons with neurological disorders. This chapter focuses on studies involving individuals with SCI and provides insights regarding how stimulation may be used to augment to training in this population.
神经系统即使在成年期也是可塑的这一发现，对脊髓损伤（SCI）患者和其他中枢神经系统疾病患者大有裨益。目前，实践和训练提供了最佳机会，以扭转与神经病理学相关的适应不良可塑性，并促进支持功能的适应性可塑性。有证据表明，几种非侵入性、临床上可获取的刺激能量形式，如电刺激、磁刺激和振动刺激，可能会增强训练效果。从本质上讲，刺激激活的神经回路与训练激活的神经回路相同，当与训练结合使用时，刺激有可能促进神经可塑性，其效果超过单纯通过实践或训练所能达到的程度。涉及神经功能正常个体的研究表明，这些方法可增强神经兴奋性和运动表现。非侵入性、临床上可用的刺激形式可用于调节神经兴奋性，作为旨在改善神经疾病患者手/臂功能或行走功能的方案的辅助手段。本章重点介绍涉及脊髓损伤个体的研究，并提供有关如何在这一人群中使用刺激来增强训练效果的见解。
