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脊髓刺激治疗脑卒中后偏瘫:范围综述。

Spinal Cord Stimulation for Poststroke Hemiparesis: A Scoping Review.

机构信息

Jonathan R. Allen, OTD, OTR/L, is Occupational Therapist, Corewell Health, Grand Rapids, MI. At the time of the study, Allen was Doctoral Student, Department of Occupational Therapy, College of Health Sciences, University of Michigan-Flint;

Swathi R. Karri, is Osteopathic Medical Student II, Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL.

出版信息

Am J Occup Ther. 2024 Mar 1;78(2). doi: 10.5014/ajot.2024.050533.

Abstract

IMPORTANCE

Spinal cord stimulation (SCS) is a neuromodulation technique that can improve paresis in individuals with spinal cord injury. SCS is emerging as a technique that can address upper and lower limb hemiparesis. Little is understood about its effectiveness with the poststroke population.

OBJECTIVE

To summarize the evidence for SCS after stroke and any changes in upper extremity and lower extremity motor function.

DATA SOURCES

PubMed, Web of Science, Embase, and CINAHL. The reviewers used hand searches and reference searches of retrieved articles. There were no limitations regarding publication year.

STUDY SELECTION AND DATA COLLECTION

This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The inclusion and exclusion criteria included a broad range of study characteristics. Studies were excluded if the intervention did not meet the definition of SCS intervention, used only animals or healthy participants, did not address upper or lower limb motor function, or examined neurological conditions other than stroke.

FINDINGS

Fourteen articles met the criteria for this review. Seven studies found a significant improvement in motor function in groups receiving SCS.

CONCLUSIONS AND RELEVANCE

Results indicate that SCS may provide an alternative means to improve motor function in the poststroke population. Plain-Language Summary: The results of this study show that spinal cord stimulation may provide an alternative way to improve motor function after stroke. Previous neuromodulation methods have targeted the impaired supraspinal circuitry after stroke. Although downregulated, spinal cord circuitry is largely intact and offers new possibilities for motor recovery.

摘要

重要性

脊髓刺激 (SCS) 是一种神经调节技术,可改善脊髓损伤患者的轻瘫。SCS 作为一种可治疗上下肢偏瘫的技术正在兴起。但对于脑卒中患者人群,其疗效知之甚少。

目的

总结脑卒中后 SCS 的证据,以及上肢和下肢运动功能的任何变化。

数据来源

PubMed、Web of Science、Embase 和 CINAHL。审查员使用手工搜索和检索文章的参考文献搜索。对出版物年份没有限制。

研究选择和数据收集

本综述遵循了系统评价和荟萃分析扩展的首选报告项目(PRISMA-ScR)清单。纳入和排除标准包括广泛的研究特征。如果干预措施不符合 SCS 干预的定义、仅使用动物或健康参与者、不解决上肢或下肢运动功能问题、或检查除中风以外的神经疾病,则将研究排除在外。

发现

符合本综述标准的有 14 篇文章。7 项研究发现接受 SCS 治疗的组运动功能有显著改善。

结论和相关性

结果表明,SCS 可能为改善脑卒中后人群的运动功能提供一种替代方法。先前的神经调节方法针对的是脑卒中后的受损皮质下回路。尽管下调,但脊髓回路基本完整,为运动恢复提供了新的可能性。

相似文献

1
Spinal Cord Stimulation for Poststroke Hemiparesis: A Scoping Review.
Am J Occup Ther. 2024 Mar 1;78(2). doi: 10.5014/ajot.2024.050533.
2
Sensory-Based Priming for Upper Extremity Hemiparesis After Stroke: A Scoping Review.
OTJR (Thorofare N J). 2022 Jan;42(1):65-78. doi: 10.1177/15394492211032606. Epub 2021 Jul 26.
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Poststroke arm and hand paresis: should we target the cervical spinal cord?
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J Stroke Cerebrovasc Dis. 2014 Apr;23(4):655-61. doi: 10.1016/j.jstrokecerebrovasdis.2013.06.017. Epub 2013 Jul 16.

本文引用的文献

1
Epidural stimulation of the cervical spinal cord for post-stroke upper-limb paresis.
Nat Med. 2023 Mar;29(3):689-699. doi: 10.1038/s41591-022-02202-6. Epub 2023 Feb 20.
2
A New Technology for Recovery of Locomotion in Patients after a Stroke.
Dokl Biochem Biophys. 2022 Dec;507(1):353-356. doi: 10.1134/S1607672922340087. Epub 2023 Feb 14.
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Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association.
Circulation. 2023 Feb 21;147(8):e93-e621. doi: 10.1161/CIR.0000000000001123. Epub 2023 Jan 25.
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A Review of Functional Restoration From Spinal Cord Stimulation in Patients With Spinal Cord Injury.
Neurospine. 2022 Sep;19(3):703-734. doi: 10.14245/ns.2244652.326. Epub 2022 Sep 30.
6
Poststroke arm and hand paresis: should we target the cervical spinal cord?
Trends Neurosci. 2022 Aug;45(8):568-578. doi: 10.1016/j.tins.2022.05.002. Epub 2022 May 31.
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Transcutaneous spinal cord stimulation and motor responses in individuals with spinal cord injury: A methodological review.
PLoS One. 2021 Nov 18;16(11):e0260166. doi: 10.1371/journal.pone.0260166. eCollection 2021.
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Corticospinal recruitment of spinal motor neurons in human stroke survivors.
J Physiol. 2021 Sep;599(18):4357-4373. doi: 10.1113/JP281311. Epub 2021 Jun 18.

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