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经颅直流电刺激治疗肌肉骨骼损伤所致中枢神经系统功能障碍的新方法:一项叙述性综述

A New Way to Treat Central Nervous System Dysfunction Caused by Musculoskeletal Injuries Using Transcranial Direct Current Stimulation: A Narrative Review.

作者信息

Perrey Stéphane

机构信息

EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, 34090 Montpellier, France.

出版信息

Brain Sci. 2025 Jan 21;15(2):101. doi: 10.3390/brainsci15020101.

Abstract

BACKGROUND

Musculoskeletal injuries can have far-reaching consequences on brain function, leading to reduced motor control, altered movement patterns, increased inhibition of the injured muscle and joint, and changes in neuroplasticity. These deficits, controlled in part by the central nervous system (CNS), might be alleviated with an appropriate adjuvant treatment. One possibly suited treatment at the CNS level is transcranial direct current stimulation (tDCS), which modulates cortical excitability and further neuroplasticity.

OBJECTIVES

The present review outlines the multifaceted repercussions of common musculo-skeletal injuries on CNS functions and presents original studies that mostly report beneficial effects regarding the use of the tDCS intervention in people who had experienced musculoskeletal injury rehabilitation.

RESULTS

The first evidence suggests that tDCS, targeting brain areas responsible for motor control or on sensory and pain-related brain regions, may offer significant benefits in the recovery of brain function and motor performance following musculoskeletal injuries. Key findings include enhanced motor function, altered CNS excitability and inhibition, and reduced pain perception, all contributing to improved rehabilitation outcomes. However, the paucity of studies and the heterogeneity of injuries render it challenging to ascertain the optimal treatment parameters. Furthermore, the variability regarding stimulation parameters is a crucial aspect that remains to be addressed and limits the possibility of generalizing these first findings.

CONCLUSIONS

It is concluded that well-powered trials with standardized protocols should be conducted to confirm these effects and establish clear clinical guidelines for the use of tDCS in sports injury rehabilitation.

摘要

背景

肌肉骨骼损伤可对脑功能产生深远影响,导致运动控制能力下降、运动模式改变、受伤肌肉和关节的抑制增加以及神经可塑性变化。这些缺陷部分由中枢神经系统(CNS)控制,可能通过适当的辅助治疗得到缓解。在中枢神经系统水平上一种可能合适的治疗方法是经颅直流电刺激(tDCS),它可调节皮质兴奋性和进一步的神经可塑性。

目的

本综述概述了常见肌肉骨骼损伤对中枢神经系统功能的多方面影响,并展示了一些原创研究,这些研究大多报告了tDCS干预对经历过肌肉骨骼损伤康复的人群的有益效果。

结果

初步证据表明,针对负责运动控制的脑区或感觉及疼痛相关脑区的tDCS,可能在肌肉骨骼损伤后的脑功能和运动表现恢复中带来显著益处。主要发现包括运动功能增强、中枢神经系统兴奋性和抑制改变以及疼痛感知减轻,所有这些都有助于改善康复结果。然而,研究数量不足以及损伤的异质性使得确定最佳治疗参数具有挑战性。此外,刺激参数的变异性是一个关键问题,仍有待解决,这限制了将这些初步发现推广的可能性。

结论

得出的结论是,应该进行采用标准化方案且样本量充足的试验,以证实这些效果,并为tDCS在运动损伤康复中的应用建立明确的临床指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d2d/11853165/304b3c4adbbe/brainsci-15-00101-g001.jpg

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