Shiferaw Barnabas T, Jin Max Y, Patel Milan, Henjum Lukas J, Abd-Elsayed Alaa
Department of Anesthesiology, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, B6/319 CSC, Madison, WI 53792, USA.
Biomedicines. 2025 Mar 5;13(3):631. doi: 10.3390/biomedicines13030631.
: Spinal cord injury (SCI) presents significant challenges in restoring motor function, with limited therapeutic options available. Recent advancements in neuromodulation technologies, such as brain-spine interface (BSI), epidural electrical stimulation (EES), and deep brain stimulation (DBS), offer promising solutions. This review article explores the integration of these approaches, focusing on their potential to restore function in SCI patients. : DBS has shown efficacy in SCI treatment with several stimulation sites identified, including the nucleus raphe magnus (NRM) and periaqueductal gray (PAG). However, transitioning from animal to human studies highlights challenges, including the technical risks of targeting the NRM in humans instead of rodent models. Additionally, several other regions have shown potential for motor rehabilitation, including the midbrain locomotor region (MLR) pathways, cuneiform nucleus (CnF), pedunculopontine nucleus (PPN), and lateral hypothalamic. DBS with EES further supports motor recovery in SCI; however, this approach requires high-DBS amplitude, serotonergic pharmacotherapy, and cortical activity decoding to attenuate stress-associated locomotion. BSI combined with EES has recently emerged as a promising novel therapy. Although human studies are limited, animal models have provided evidence supporting its potential. Despite these advancements, the effectiveness of DBS and combined systems remains limited in cases of complete central denervation. : The integration and combination of DBS, BSI, and EES represent a transformational approach to treating and restoring function in patients with SCI. While further research is needed to optimize these strategies, these advancements hold immense potential for improving the quality of life in SCI patients and advancing the field of neuromodulation.
脊髓损伤（SCI）在恢复运动功能方面面临重大挑战，可用的治疗选择有限。神经调节技术的最新进展，如脑-脊髓接口（BSI）、硬膜外电刺激（EES）和深部脑刺激（DBS），提供了有前景的解决方案。这篇综述文章探讨了这些方法的整合，重点关注它们在恢复SCI患者功能方面的潜力。：DBS已在SCI治疗中显示出疗效，确定了几个刺激部位，包括中缝大核（NRM）和导水管周围灰质（PAG）。然而，从动物研究向人体研究的转变凸显了挑战，包括在人体而非啮齿动物模型中靶向NRM的技术风险。此外，其他几个区域也显示出运动康复的潜力，包括中脑运动区（MLR）通路、楔形核（CnF）、脚桥核（PPN）和下丘脑外侧区。DBS与EES相结合进一步支持SCI患者的运动恢复；然而，这种方法需要高DBS振幅、血清素能药物治疗和皮质活动解码来减轻与压力相关的运动。BSI与EES相结合最近已成为一种有前景的新疗法。尽管人体研究有限，但动物模型已提供了支持其潜力的证据。尽管有这些进展，但在完全中枢去神经的情况下，DBS和联合系统的有效性仍然有限。：DBS、BSI和EES的整合与结合代表了一种治疗和恢复SCI患者功能的变革性方法。虽然需要进一步研究来优化这些策略，但这些进展对于改善SCI患者的生活质量和推动神经调节领域的发展具有巨大潜力。
