He Le-Wei, Guo Xiao-Jun, Zhao Can, Rao Jia-Sheng
Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China.
Institute of Rehabilitation Engineering, China Rehabilitation Science Institute, Beijing 100068, China.
Biomedicines. 2023 Dec 22;12(1):41. doi: 10.3390/biomedicines12010041.
Spinal cord injury (SCI) is a serious neurological insult that disrupts the ascending and descending neural pathways between the peripheral nerves and the brain, leading to not only functional deficits in the injured area and below the level of the lesion but also morphological, structural, and functional reorganization of the brain. These changes introduce new challenges and uncertainties into the treatment of SCI. Rehabilitation training, a clinical intervention designed to promote functional recovery after spinal cord and brain injuries, has been reported to promote activation and functional reorganization of the cerebral cortex through multiple physiological mechanisms. In this review, we evaluate the potential mechanisms of exercise that affect the brain structure and function, as well as the rehabilitation training process for the brain after SCI. Additionally, we compare and discuss the principles, effects, and future directions of several rehabilitation training methods that facilitate cerebral cortex activation and recovery after SCI. Understanding the regulatory role of rehabilitation training at the supraspinal center is of great significance for clinicians to develop SCI treatment strategies and optimize rehabilitation plans.
脊髓损伤(SCI)是一种严重的神经损伤,它会破坏外周神经与大脑之间的上下行神经通路,不仅导致损伤部位及损伤平面以下出现功能缺陷,还会引起大脑的形态、结构和功能重组。这些变化给脊髓损伤的治疗带来了新的挑战和不确定性。康复训练是一种旨在促进脊髓和脑损伤后功能恢复的临床干预措施,据报道,它可通过多种生理机制促进大脑皮质的激活和功能重组。在本综述中,我们评估了运动影响脑结构和功能的潜在机制,以及脊髓损伤后脑的康复训练过程。此外,我们比较并讨论了几种促进脊髓损伤后大脑皮质激活和恢复的康复训练方法的原则、效果及未来方向。了解康复训练在脊髓上中枢的调节作用,对临床医生制定脊髓损伤治疗策略和优化康复计划具有重要意义。