Guo Xiao-Jun, He Le-Wei, Chang Jia-Qi, Su Wen-Nan, Feng Ting, Gao Yi-Meng, Wu Yuan-Yuan, 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.
School of Automation Science and Electrical Engineering, Beihang University, Beijing 100191, China.
Exp Neurol. 2025 Mar;385:115112. doi: 10.1016/j.expneurol.2024.115112. Epub 2024 Dec 10.
Epidural electrical stimulation (EES) could restore motor function of paralyzed limbs of patients with spinal cord injury (SCI). However, its invasiveness limits its application in early stage of injury. Photobiomodulation (PBM) utilizes infrared light for percutaneous irradiation of the spinal cord to protect nerve tissue, delay muscle atrophy, and can be applied in early stage of SCI due to its non-invasiveness. This study tested the effect of the combination of EES and PBM on promoting motor function recovery in SCI rats. Severe contusion was induced at the T9 spinal segment in female rats, EES (applied to the L2 and S1 spinal cord segments) with treadmill training was conducted one week after the injury, and PBM percutaneous irradiation started at the injured segment on the day of surgery. In the third week post-injury, electromyographic and gait performance during training were recorded. Besides, the muscles of the hind limbs and the spinal cord on the caudal side of the injured segment were extracted. The results demonstrate that compared to the EES- or PBM-only group, this combined therapy led to several indicators returning to intact levels, including behavioral and electrophysiological, the gait patterns was also closer to intact rats. Additionally, the combined treatment group showed minimal muscle atrophy and maximal preservation of the injured spinal cord on the caudal side, with this histological improvement correlated with motor function recovery. Taken together, our results showed that this combined therapy was a more effective treatment for improving motor dysfunction after SCI which could protect the damaged spinal cord and promote the recovery of motor function in rats with SCI.
硬膜外电刺激（EES）可恢复脊髓损伤（SCI）患者瘫痪肢体的运动功能。然而，其侵入性限制了它在损伤早期的应用。光生物调节（PBM）利用红外光经皮照射脊髓，以保护神经组织、延缓肌肉萎缩，并且由于其非侵入性可应用于SCI早期。本研究测试了EES与PBM联合应用对促进SCI大鼠运动功能恢复的效果。在雌性大鼠的T9脊髓节段诱导严重挫伤，损伤后1周对L2和S1脊髓节段进行EES并结合跑步机训练，在手术当天开始对损伤节段进行PBM经皮照射。在损伤后第三周，记录训练期间的肌电图和步态表现。此外，提取后肢肌肉和损伤节段尾侧的脊髓。结果表明，与单独使用EES或PBM的组相比，这种联合治疗使包括行为和电生理在内的几个指标恢复到完整水平，步态模式也更接近正常大鼠。此外，联合治疗组的肌肉萎缩最小，损伤节段尾侧的脊髓保存最大，这种组织学改善与运动功能恢复相关。综上所述，我们的结果表明，这种联合治疗是改善SCI后运动功能障碍的更有效治疗方法，可保护受损脊髓并促进SCI大鼠运动功能的恢复。
