Barss Trevor S, Parhizi Behdad, Porter Jane, Mushahwar Vivian K
Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB T6G 2R3, Canada.
Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada.
J Clin Med. 2022 Jan 27;11(3):639. doi: 10.3390/jcm11030639.
Transcutaneous spinal cord stimulation (tSCS) has the potential to promote improved sensorimotor rehabilitation by modulating the circuitry of the spinal cord non-invasively. Little is currently known about how cervical or lumbar tSCS influences the excitability of spinal and corticospinal networks, or whether the synergistic effects of multi-segmental tSCS occur between remote segments of the spinal cord. The aim of this review is to describe the emergence and development of tSCS as a novel method to modulate the spinal cord, while highlighting the effectiveness of tSCS in improving sensorimotor recovery after spinal cord injury. This review underscores the ability of single-site tSCS to alter excitability across multiple segments of the spinal cord, while multiple sites of tSCS converge to facilitate spinal reflex and corticospinal networks. Finally, the potential and current limitations for engaging cervical and lumbar spinal cord networks through tSCS to enhance the effectiveness of rehabilitation interventions are discussed. Further mechanistic work is needed in order to optimize targeted rehabilitation strategies and improve clinical outcomes.
经皮脊髓刺激（tSCS）有潜力通过非侵入性调节脊髓回路来促进感觉运动功能的改善性康复。目前对于颈段或腰段tSCS如何影响脊髓和皮质脊髓网络的兴奋性，或者多节段tSCS的协同效应是否会在脊髓的远端节段之间发生，了解甚少。本综述的目的是描述tSCS作为一种调节脊髓的新方法的出现和发展，同时强调tSCS在改善脊髓损伤后感觉运动恢复方面的有效性。本综述强调了单部位tSCS改变脊髓多个节段兴奋性的能力，而多部位tSCS汇聚以促进脊髓反射和皮质脊髓网络。最后，讨论了通过tSCS激活颈段和腰段脊髓网络以提高康复干预效果的潜力和当前局限性。为了优化有针对性的康复策略并改善临床结果，还需要进一步的机制研究。
