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慢性脑卒中神经调控的演变:从神经可塑性机制到脑机接口。

The evolution of neuromodulation for chronic stroke: From neuroplasticity mechanisms to brain-computer interfaces.

机构信息

Department of Neurosurgery, Medical University of South Carolina, SC 29425, USA.

Department of Psychiatry, Medical University of South Carolina, SC 29425, USA.

出版信息

Neurotherapeutics. 2024 Apr;21(3):e00337. doi: 10.1016/j.neurot.2024.e00337. Epub 2024 Feb 19.


DOI:10.1016/j.neurot.2024.e00337
PMID:38377638
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11103214/
Abstract

Stroke is one of the most common and debilitating neurological conditions worldwide. Those who survive experience motor, sensory, speech, vision, and/or cognitive deficits that severely limit remaining quality of life. While rehabilitation programs can help improve patients' symptoms, recovery is often limited, and patients frequently continue to experience impairments in functional status. In this review, invasive neuromodulation techniques to augment the effects of conventional rehabilitation methods are described, including vagus nerve stimulation (VNS), deep brain stimulation (DBS) and brain-computer interfaces (BCIs). In addition, the evidence base for each of these techniques, pivotal trials, and future directions are explored. Finally, emerging technologies such as functional near-infrared spectroscopy (fNIRS) and the shift to artificial intelligence-enabled implants and wearables are examined. While the field of implantable devices for chronic stroke recovery is still in a nascent stage, the data reviewed are suggestive of immense potential for reducing the impact and impairment from this globally prevalent disorder.

摘要

中风是全球最常见和致残的神经疾病之一。幸存者会出现运动、感觉、言语、视力和/或认知方面的缺陷,严重限制了他们的生活质量。虽然康复计划可以帮助改善患者的症状,但恢复往往是有限的,患者经常继续在功能状态上存在障碍。在这篇综述中,描述了增强常规康复方法效果的侵入性神经调节技术,包括迷走神经刺激(VNS)、深部脑刺激(DBS)和脑机接口(BCIs)。此外,还探讨了这些技术中的每一种的证据基础、关键试验和未来方向。最后,还研究了一些新兴技术,如功能性近红外光谱(fNIRS)以及向人工智能支持的植入物和可穿戴设备的转变。虽然用于慢性中风康复的植入式设备领域仍处于起步阶段,但所审查的数据表明,这些设备具有减轻这种全球普遍疾病的影响和障碍的巨大潜力。

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[7]
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[8]
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[9]
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[10]
Efficacy observation of combined transcutaneous vagus nerve stimulation and transcranial direct current stimulation on gait in 169 subacute stroke patients.

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本文引用的文献

[1]
Potentiation of cortico-spinal output via targeted electrical stimulation of the motor thalamus.

Nat Commun. 2024-10-1

[2]
tVNS in Stroke: A Narrative Review on the Current State and the Future.

Stroke. 2023-10

[3]
Neural Plasticity Changes Induced by Motor Robotic Rehabilitation in Stroke Patients: The Contribution of Functional Neuroimaging.

Bioengineering (Basel). 2023-8-21

[4]
A high-performance neuroprosthesis for speech decoding and avatar control.

Nature. 2023-8

[5]
A high-performance speech neuroprosthesis.

Nature. 2023-8

[6]
Cerebellar deep brain stimulation for chronic post-stroke motor rehabilitation: a phase I trial.

Nat Med. 2023-9

[7]
Artificial Intelligence and Machine Learning in the Diagnosis and Management of Stroke: A Narrative Review of United States Food and Drug Administration-Approved Technologies.

J Clin Med. 2023-5-30

[8]
Motor Activated Auricular Vagus Nerve Stimulation as a Potential Neuromodulation Approach for Post-Stroke Motor Rehabilitation: A Pilot Study.

Neurorehabil Neural Repair. 2023-6

[9]
On closed-loop brain stimulation systems for improving the quality of life of patients with neurological disorders.

Front Hum Neurosci. 2023-3-23

[10]
Assessment of Safety of a Fully Implanted Endovascular Brain-Computer Interface for Severe Paralysis in 4 Patients: The Stentrode With Thought-Controlled Digital Switch (SWITCH) Study.

JAMA Neurol. 2023-3-1

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