School of Rehabilitation Medicine, Nanjing Medical University, Center of Rehabilitation Medicine, 1st affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland).
Department of Rehabilitation Medicine, Jiangsu Shengze Hospital, Nanjing Medical University, Suzhou, Jiangsu, China (mainland).
Med Sci Monit. 2021 Jul 25;27:e931601. doi: 10.12659/MSM.931601.
BACKGROUND This study aimed to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) and treadmill training (TT) on motor function recovery in rats with partial spinal cord injury (SCI). MATERIAL AND METHODS Sixty rats with moderate partial SCI at the 9th thoracic vertebral level induced by a Louisville Injury System Apparatus impactor were randomly allocated to 5 groups: Sham surgery (Intact); Sham rTMS without TT (S-rTMS/Non-TT); Sham rTMS with TT (S-rTMS/TT); rTMS without TT (rTMS/Non-TT); and rTMS with TT (rTMS/TT). Interventions commenced 8 days after SCI and continued for 8 weeks. Outcomes studied were Basso, Beattie, and Bresnahan locomotor scale scores, grid walking test, and biochemical analysis of the brain-derived neurotrophic factor (BDNF), synapsin I (SYN), and postsynaptic density protein-95 (PSD-95) in the motor cortex and spinal cord. RESULTS The rTMS/TT contributed to greater Basso, Beattie, and Bresnahan scores compared with the S-rTMS/Non-TT (P<0.01), S-rTMS/TT (P<0.05), and rTMS/Non-TT (P<0.05), and showed obviously reduced numbers of foot drops compared with the S-rTMS/Non-TT (P<0.05). The rTMS/TT significantly increased the expressions of BDNF, SYN, and PSD-95 compared with the S-rTMS/Non-TT, both in the motor cortex (P<0.01, P<0.01, P<0.001, respectively) and spinal cord (P<0.001, P<0.01, P<0.05, respectively). CONCLUSIONS In a modified rat model of SCI, combined rTMS with TT improved motor function, indicating that this combined approach promoted adaptive neuroplasticity between the motor cortex and the spinal cord. A combined app roach to improving motor function following SCI requires further evaluation to determine the possible clinical applications.
本研究旨在探讨重复经颅磁刺激(rTMS)和跑步机训练(TT)对部分脊髓损伤(SCI)大鼠运动功能恢复的影响。
采用 Louisville 损伤系统撞击器诱导 9 胸椎水平中度部分 SCI 的 60 只大鼠,随机分为 5 组:假手术(Intact);假 rTMS 无 TT(S-rTMS/Non-TT);假 rTMS 有 TT(S-rTMS/TT);rTMS 无 TT(rTMS/Non-TT);rTMS 有 TT(rTMS/TT)。干预措施在 SCI 后 8 天开始,持续 8 周。研究的结果是 Basso、Beattie 和 Bresnahan 运动评分、网格行走试验以及大脑源性神经营养因子(BDNF)、突触素 I(SYN)和突触后密度蛋白-95(PSD-95)在运动皮层和脊髓中的生化分析。
rTMS/TT 与 S-rTMS/Non-TT(P<0.01)、S-rTMS/TT(P<0.05)和 rTMS/Non-TT(P<0.05)相比,Basso、Beattie 和 Bresnahan 评分更高,且与 S-rTMS/Non-TT 相比,足下垂次数明显减少(P<0.05)。rTMS/TT 显著增加了 BDNF、SYN 和 PSD-95 的表达,与 S-rTMS/Non-TT 相比,在运动皮层(P<0.01、P<0.01、P<0.001)和脊髓(P<0.001、P<0.01、P<0.05)。
在改良的大鼠 SCI 模型中,rTMS 联合 TT 改善了运动功能,表明这种联合方法促进了运动皮层与脊髓之间的适应性神经可塑性。联合应用改善 SCI 后的运动功能需要进一步评估,以确定可能的临床应用。