Brihmat Nabila, Allexandre Didier, Saleh Soha, Zhong Jian, Yue Guang H, Forrest Gail F
Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West Orange, NJ, United States.
Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, NJ, United States.
Front Hum Neurosci. 2022 Apr 7;16:800349. doi: 10.3389/fnhum.2022.800349. eCollection 2022.
There is a growing interest in non-invasive stimulation interventions as treatment strategies to improve functional outcomes and recovery after spinal cord injury (SCI). Repetitive transcranial magnetic stimulation (rTMS) is a neuromodulatory intervention which has the potential to reinforce the residual spinal and supraspinal pathways and induce plasticity. Recent reviews have highlighted the therapeutic potential and the beneficial effects of rTMS on motor function, spasticity, and corticospinal excitability modulation in SCI individuals. For this scoping review, we focus on the stimulation parameters used in 20 rTMS protocols. We extracted the rTMS parameters from 16 published rTMS studies involving SCI individuals and were able to infer preliminary associations between specific parameters and the effects observed. Future investigations will need to consider timing, intervention duration and dosage (in terms of number of sessions and number of pulses) that may depend on the stage, the level, and the severity of the injury. There is a need for more real vs. sham rTMS studies, reporting similar designs with sufficient information for replication, to achieve a significant level of evidence regarding the use of rTMS in SCI.
作为改善脊髓损伤（SCI）后功能结局和恢复的治疗策略，非侵入性刺激干预正受到越来越多的关注。重复经颅磁刺激（rTMS）是一种神经调节干预措施，具有增强脊髓和脊髓上残留通路并诱导可塑性的潜力。最近的综述强调了rTMS对SCI个体运动功能、痉挛和皮质脊髓兴奋性调节的治疗潜力和有益效果。在本次范围综述中，我们重点关注20种rTMS方案中使用的刺激参数。我们从16项涉及SCI个体的已发表rTMS研究中提取了rTMS参数，并能够推断特定参数与观察到的效果之间的初步关联。未来的研究需要考虑可能取决于损伤阶段、损伤水平和严重程度的时机、干预持续时间和剂量（就疗程数和脉冲数而言）。需要进行更多真实与假rTMS对比研究，报告具有足够信息以便重复的相似设计，以获得关于rTMS在SCI中应用的显著证据水平。
