Benavides Francisco, Shine Mary Grace, Stefanovic Filip, Chen Robert, Jo Hang Jin
Department of Rehabilitation Science, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States.
Department of Biomedical Engineering, School of Engineering and Applied Sciences, University at Buffalo, Buffalo, NY, United States.
Front Neurol. 2025 Jul 2;16:1587060. doi: 10.3389/fneur.2025.1587060. eCollection 2025.
Spinal cord injury (SCI) often leads to disabilities that significantly impact quality of life, highlighting the need for effective rehabilitation strategies. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising neuromodulatory approach to enhance neuronal plasticity and promote motor recovery following SCI. This narrative review examines the current state of evidence regarding the therapeutic use of rTMS for motor function recovery after SCI and outlines key methodological considerations to guide future research. To address these aims, we summarize various rTMS techniques and evaluate their overall efficacy in improving motor function in individuals with SCI. Among the fourteen studies reviewed, early rTMS protocols primarily utilized low-frequency stimulation, whereas more recent approaches have adopted higher frequencies and more complex patterned protocols. Despite considerable heterogeneity in stimulation parameters, most studies reported beneficial effects of rTMS, including reduction in spasticity and improvements in voluntary motor function of both upper and lower limbs. These findings demonstrate that rTMS holds promise as an effective tool for SCI rehabilitation, with limited to moderate evidence supporting reductions in spasticity, increased muscle strength, and enhanced functional outcomes. However, many of these findings are derived from small sample sizes, varied protocols, and studies lacking rigorous control conditions. The review emphasizes the need for standardized functional and electrophysiological assessments to systematically evaluate motor outcomes following rTMS interventions. Additionally, larger, well-controlled clinical trials incorporating consistent physical therapy protocols are essential to confirm the efficacy of rTMS.
脊髓损伤（SCI）常导致严重影响生活质量的残疾，这凸显了有效康复策略的必要性。重复经颅磁刺激（rTMS）已成为一种有前景的神经调节方法，可增强神经元可塑性并促进脊髓损伤后的运动恢复。本叙述性综述考察了rTMS用于脊髓损伤后运动功能恢复治疗的现有证据状况，并概述了指导未来研究的关键方法学考量。为实现这些目标，我们总结了各种rTMS技术，并评估了它们在改善脊髓损伤个体运动功能方面的总体疗效。在所综述的14项研究中，早期的rTMS方案主要采用低频刺激，而最近的方法则采用了更高频率和更复杂的模式化方案。尽管刺激参数存在相当大的异质性，但大多数研究报告了rTMS的有益效果，包括痉挛减轻以及上肢和下肢自主运动功能改善。这些发现表明，rTMS有望成为脊髓损伤康复的有效工具，有有限到中等程度的证据支持痉挛减轻、肌肉力量增加和功能结果改善。然而，这些发现大多来自小样本量、多样的方案以及缺乏严格对照条件的研究。该综述强调需要标准化的功能和电生理评估，以系统评估rTMS干预后的运动结果。此外，纳入一致物理治疗方案的更大规模、严格对照的临床试验对于确认rTMS的疗效至关重要。
