皮质脊髓运动神经元可塑性在脊髓损伤后恢复中的潜力
The Potential of Corticospinal-Motoneuronal Plasticity for Recovery after Spinal Cord Injury.
作者信息
Jo Hang Jin, Richardson Michael S A, Oudega Martin, Perez Monica A
机构信息
Edward Jr. Hines VA Medical Center, Northwestern University, Chicago, USA.
Shirley Ryan AbilityLab, Northwestern University, Chicago, USA.
出版信息
Curr Phys Med Rehabil Rep. 2020 Sep;8(3):293-298. doi: 10.1007/s40141-020-00272-6. Epub 2020 Aug 4.
PURPOSE OF REVIEW
This review focuses on a relatively new neuromodulation method where transcranial magnetic stimulation over the primary motor cortex is paired with transcutaneous electrical stimulation over a peripheral nerve to induce plasticity at corticospinal-motoneuronal synapses.
RECENT FINDINGS
Recovery of sensorimotor function after spinal cord injury largely depends on transmission in the corticospinal pathway. Significantly damaged corticospinal axons fail to regenerate and participate in functional recovery. Transmission in residual corticospinal axons can be assessed using non-invasive transcranial magnetic stimulation which combined with transcutaneous electrical stimulation can be used to improve voluntary motor output, as was recently demonstrated in clinical studies in humans with chronic incomplete spinal cord injury. These two stimuli are applied at precise inter-stimulus intervals to reinforce corticospinal synaptic transmission using principles of spike-timing dependent plasticity.
SUMMARY
We discuss the neural mechanisms and application of this neuromodulation technique and its potential therapeutic effect on recovery of function in humans with chronic spinal cord injury.
综述目的
本综述聚焦于一种相对较新的神经调节方法，即对初级运动皮层进行经颅磁刺激，并与对周围神经进行经皮电刺激相结合，以诱导皮质脊髓运动神经元突触的可塑性。
最新发现
脊髓损伤后感觉运动功能的恢复很大程度上取决于皮质脊髓通路的传导。严重受损的皮质脊髓轴突无法再生并参与功能恢复。残余皮质脊髓轴突的传导可通过非侵入性经颅磁刺激进行评估，该刺激与经皮电刺激相结合可用于改善自主运动输出，最近在慢性不完全性脊髓损伤患者的临床研究中得到了证实。这两种刺激以精确的刺激间隔施加，利用尖峰时间依赖性可塑性原理增强皮质脊髓突触传递。
总结
我们讨论了这种神经调节技术的神经机制、应用及其对慢性脊髓损伤患者功能恢复的潜在治疗效果。
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