Wu Yu-Kuang, Wecht Jill M, Bloom Ona E, Panza Gino S, Harel Noam Y
Icahn School of Medicine at Mount Sinai.
James J. Peters VA Medical Center.
Curr Opin Neurol. 2023 Dec 1;36(6):523-530. doi: 10.1097/WCO.0000000000001216. Epub 2023 Sep 29.
Remote ischemic conditioning (RIC) involves transient blood flow restriction to one limb leading to systemic tissue-protective effects. RIC shares some potential underlying mechanisms with intermittent hypoxia (IH), in which brief bouts of systemic hypoxia trigger increases in growth factor expression and neural plasticity. RIC has shown promise in acute myocardial infarction and stroke but may be applicable toward chronic neuropathology as well. Consequently, this review discusses similarities and differences between RIC and IH and presents preliminary and ongoing research findings regarding RIC.
Several publications demonstrated that combining RIC with motor training may enhance motor learning in adults with intact nervous systems, though the precise mechanisms were unclear. Our own preliminary data has found that RIC, in conjunction with task specific exercise, can increase corticospinal excitability in a subset of people without neurological injury and in those with chronic cervical spinal cord injury or amyotrophic lateral sclerosis.
RIC is a low-cost intervention easy to deliver in a clinical or home setting. Its potential application to facilitate neural plasticity and motor learning during rehabilitation training for individuals with chronic neurological disorders is a novel concept requiring further investigation to characterize mechanisms, safety, and efficacy.
远程缺血预处理（RIC）涉及对一侧肢体进行短暂的血流限制，从而产生全身组织保护作用。RIC与间歇性缺氧（IH）具有一些潜在的共同机制，在间歇性缺氧中，短暂的全身性缺氧发作会触发生长因子表达增加和神经可塑性增强。RIC已在急性心肌梗死和中风中显示出前景，但也可能适用于慢性神经病理学。因此，本综述讨论了RIC和IH之间的异同，并介绍了有关RIC的初步和正在进行的研究结果。
一些出版物表明，将RIC与运动训练相结合可能会增强神经系统完好的成年人的运动学习能力，尽管确切机制尚不清楚。我们自己的初步数据发现，RIC与特定任务的运动相结合，可以增加一部分无神经损伤的人以及患有慢性颈脊髓损伤或肌萎缩侧索硬化症的人的皮质脊髓兴奋性。
RIC是一种低成本干预措施，易于在临床或家庭环境中实施。其在慢性神经疾病患者康复训练期间促进神经可塑性和运动学习的潜在应用是一个新颖的概念，需要进一步研究以确定其机制、安全性和有效性。
