Rupp Rüdiger
Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany.
Handb Clin Neurol. 2020;168:51-65. doi: 10.1016/B978-0-444-63934-9.00006-8.
A spinal cord injury (SCI) may result in impairments of motor, sensory, and autonomous functions below the injury level. Worldwide, the prevalence of SCI is 1:1000 and the incidence is between 4 and 9 new cases per 100,000 people per year. Most common causes for traumatic SCI are traffic accidents, falls, and violence. Nowadays, the proportion of patients with tetraplegia and paraplegia is equal. In industrialized countries, the percentage of nontraumatic injuries increases together with age. Most patients with initially preserved motor functions below the injury level show a substantial functional recovery, while three quarters of patients with initially complete SCI remain that way. In SCI, brain-computer interfaces (BCIs) may be used in the subacute phase as part of a restorative therapy program and, later, for control of assistive devices most needed by individuals with high cervical lesions. Research on structural and functional reorganization of the deefferented and deafferented brain after SCI is inconclusive mainly because of varying methods of analysis and the heterogeneity of the investigated populations. A better characterization of study participants with SCI together with documentation of confounding factors such as antispasticity medication or neuropathic pain is indicated.
脊髓损伤(SCI)可能导致损伤平面以下的运动、感觉和自主功能障碍。在全球范围内,SCI的患病率为1:1000,发病率为每年每10万人中有4至9例新病例。创伤性SCI最常见的原因是交通事故、跌倒和暴力。如今,四肢瘫痪和截瘫患者的比例相等。在工业化国家,非创伤性损伤的百分比随年龄增长而增加。大多数损伤平面以下最初保留运动功能的患者显示出显著的功能恢复,而四分之三最初完全性SCI的患者仍保持原状。在SCI中,脑机接口(BCI)可在亚急性期作为恢复性治疗方案的一部分使用,随后用于控制高颈段损伤患者最需要的辅助设备。关于SCI后去传入和去神经支配大脑的结构和功能重组的研究尚无定论,主要是因为分析方法不同以及所研究人群的异质性。建议更好地描述SCI研究参与者的特征,并记录诸如抗痉挛药物或神经性疼痛等混杂因素。