Edgerton V Reggie, Hastings Susan, Gad Parag N
Department of Neurobiology, University of California, Los Angeles, Los Angeles, CA, United States.
Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States.
Front Neurosci. 2021 Apr 12;15:643463. doi: 10.3389/fnins.2021.643463. eCollection 2021.
Although children with cerebral palsy seem to have the neural networks necessary to generate most movements, they are markedly dysfunctional, largely attributable to abnormal patterns of muscle activation, often characterized as spasticity, largely reflecting a functionally abnormal spinal-supraspinal connectivity. While it is generally assumed that the etiologies of the disruptive functions associated with cerebral palsy can be attributed primarily to supraspinal networks, we propose that the more normal connectivity that persists between peripheral proprioception-cutaneous input to the spinal networks can be used to guide the reorganization of a more normal spinal-supraspinal connectivity. The level of plasticity necessary to achieve the required reorganization within and among different neural networks can be achieved with a combination of spinal neuromodulation and specific activity-dependent mechanisms. By engaging these two concepts, we hypothesize that bidirectional reorganization of proprioception-spinal cord-brain connectivity to higher levels of functionality can be achieved without invasive surgery.
尽管患有脑瘫的儿童似乎具备产生大多数运动所需的神经网络，但这些网络明显功能失调，这在很大程度上归因于肌肉激活模式异常，通常表现为痉挛，这在很大程度上反映了功能异常的脊髓-脊髓上连接。虽然一般认为与脑瘫相关的功能破坏的病因主要可归因于脊髓上网络，但我们提出，脊髓网络的外周本体感觉-皮肤输入之间持续存在的更正常连接可用于指导更正常的脊髓-脊髓上连接的重组。通过脊髓神经调节和特定的活动依赖机制相结合，可以实现不同神经网络内部和之间实现所需重组所需的可塑性水平。通过运用这两个概念，我们假设无需进行侵入性手术就能实现本体感觉-脊髓-脑连接向更高功能水平的双向重组。
