Liu Mei, Meng Yijing, Ouyang Siguang, Zhai Meng'ai, Yang Likun, Yang Yang, Wang Yuhai
Department of Neurosurgery, Wuxi Clinical College of Anhui Medical University (The 904 Hospital of PLA), Wuxi, Jiangsu Province, China.
Department of Neurosurgery, The 904 Hospital of PLA, Jiangnan University, Wuxi, Jiangsu Province, China.
Neural Regen Res. 2026 Feb 1;21(2):506-520. doi: 10.4103/NRR.NRR-D-24-00652. Epub 2024 Dec 7.
Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited. This limited plasticity serves as a primary barrier to functional recovery after brain injury. Neuromodulation technologies represent one of the fastest-growing fields in medicine. These techniques utilize electricity, magnetism, sound, and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury. Therefore, this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury. Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury. However, studies report negative findings, potentially due to variations in stimulation protocols, differences in observation periods, and the severity of functional impairments among participants across different clinical trials. Additionally, we observed that different neuromodulation techniques share remarkably similar mechanisms, including promoting neuroplasticity, enhancing neurotrophic factor release, improving cerebral blood flow, suppressing neuroinflammation, and providing neuroprotection. Finally, considering the advantages and disadvantages of various neuromodulation techniques, we propose that future development should focus on closed-loop neural circuit stimulation, personalized treatment, interdisciplinary collaboration, and precision stimulation.
由于成年哺乳动物受损的中枢神经系统可塑性有限，自发恢复常常被证明是适应不良的或不充分的。这种有限的可塑性是脑损伤后功能恢复的主要障碍。神经调节技术是医学领域中发展最快的领域之一。这些技术利用电、磁、声和光，通过促进重组或长期变化来恢复或优化脑功能，以支持脑损伤患者的功能恢复。因此，本综述旨在全面概述神经调节技术在支持脑损伤后运动功能恢复方面的作用及潜在机制。这些技术中的许多已在临床实践中广泛应用，并在各种类型的脑损伤中显示出运动功能的显著改善。然而，研究报告了一些负面结果，这可能是由于刺激方案的差异、观察期的不同以及不同临床试验参与者之间功能障碍的严重程度不同所致。此外，我们观察到不同的神经调节技术具有非常相似的机制，包括促进神经可塑性、增强神经营养因子释放、改善脑血流量、抑制神经炎症以及提供神经保护。最后，考虑到各种神经调节技术的优缺点，我们建议未来的发展应侧重于闭环神经回路刺激、个性化治疗、跨学科合作和精准刺激。
