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非侵入性脑刺激能否改善中风后的运动恢复?

Can Motor Recovery in Stroke Be Improved by Non-invasive Brain Stimulation?

作者信息

Rothwell John C

机构信息

Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK.

出版信息

Adv Exp Med Biol. 2016;957:313-323. doi: 10.1007/978-3-319-47313-0_17.

Abstract

At the present time, there is enormous interest in methods of non-invasive brain stimulation. These interact with ongoing neural activity, mainly in cerebral cortex, and have measureable effects on behaviours in healthy people. More intriguingly, they appear to have effects on synaptic plasticity that persist even after stimulation has ceased. This has led, as might be expected, to the proposal that brain stimulation methods might be therapeutically useful in rehabilitation. The rationale is that physical therapy involves learning new patterns of activity to compensate for those lost to the stroke. Enhanced "plasticity" produced by brain stimulation might increase the ability to learn and enhance therapy. However, if things really were as simple as this, brain stimulation would be on its way to becoming a standard addition to treatment in all departments of rehabilitation. The fact that this has not happened means that something is not quite correct. Is the theory untenable, or are the methods of stimulation suboptimal?

摘要

目前,人们对非侵入性脑刺激方法有着极大的兴趣。这些方法与正在进行的神经活动相互作用,主要作用于大脑皮层,并且对健康人的行为有可测量的影响。更有趣的是,它们似乎对突触可塑性有影响,即使在刺激停止后这种影响仍会持续。不出所料,这导致了一种提议,即脑刺激方法在康复治疗中可能具有治疗作用。其基本原理是,物理治疗涉及学习新的活动模式以补偿因中风而丧失的模式。脑刺激产生的增强的“可塑性”可能会提高学习能力并加强治疗效果。然而,如果事情真的如此简单,脑刺激将很快成为所有康复科室治疗的标准补充手段。但事实并非如此,这意味着有些地方不太正确。是该理论站不住脚,还是刺激方法不够理想呢?

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