首页|神经电刺激调控技术在脊髓损伤后康复治疗中的应用及效应机制

神经电刺激调控技术在脊髓损伤后康复治疗中的应用及效应机制

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脊髓损伤(SCI)是一种严重的神经系统疾病,常导致患者运动、感觉和自主神经功能的严重障碍.神经调控电刺激技术在SCI康复治疗中展现出了广阔的应用前景.本研究就神经电刺激调控技术在SCI后康复治疗中的应用及可能的作用机制进行综述.文章主要介绍脊髓电刺激(SCS)、深部脑刺激(DBS)等侵入性技术和周围神经电刺激(PNS)、经颅直流电刺激(tDCS)等非侵入性技术在SCI后康复治疗中的应用.神经电刺激调控技术治疗SCI的作用机制可能与调节突触可塑性、促进神经再生与修复,调节神经网络兴奋性、促进神经环路重建,调节神经递质系统、改善级联炎症反应有关.神经电刺激调控技术可在一定程度上改善SCI后运动、自主神经功能,但目前仍无法快速针对各种SCI类型提供最适合的个性化治疗方案;针对不同节段SCI的具体刺激频率、强度、持续时间和波形等参数尚未形成统一共识.下一步研究应持续分析不同干预手段对不同节段脊髓损伤后神经功能障碍的疗效与具体机制,采取多模态、个体化调控方案;探讨电信号对于恢复SCI后运动、感觉功能的关键原理,根据脊髓的节段损伤类型、年龄和性别等制订神经电刺激调控技术应用的专家共识,以期为神经电刺激调控技术在SCI患者康复治疗的应用提供参考依据.
Application and Mechanism of Electrical Neuromodulation Techniques for Rehabilitation of Spinal Cord Injury
Spinal cord injury(SCI)is a serious neurological disease,which often leads to severe impairments of motor,sensory and autonomic nervous functions.Electrical neuromodulation techniques have shown broad application prospects in the rehabilita-tion treatment of SCI.This study reviewed the applications and possible mechanisms of electrical neuromodulation techniques in the rehabilitation after SCI.It mainly introduced the applications of invasive techniques[spinal cord stimulation(SCS)and deep brain stimulation(DBS)]and non-invasive techniques[peripheral nerve stimulation(PNS)and transcranial direct current stimulation(tDCS)]in the rehabilitation after SCI.The mechanisms of electrical neuromodulation techniques in the treatment of SCI may be The mechanisms of electrical neuromodulation techniques in the treatment of SCI may be related to the regulation of synaptic plas-ticity to promote nerve regeneration and repair,the regulation of neurotransmitter system to improve the cascade of inflammatory response,and the regulation of neural network excitability to promote the reconstruction of neural circuits.Electrical neuromodula-tion techniques can improve motor and autonomic nervous functions after SCI to a certain extent,but they are still unable to quickly provide the most suitable personalized treatment plans for various types of SCI;there is no consensus on the specific parameters of stimulation frequency,intensity,duration and waveform for different levels of SCI.The future research should continue to analyze the efficacy and specific mechanisms of different interventions on neurological dysfunction after SCI at different levels,and adopt multi-modal and individualized regulation programs;explore the key principles of electrical signals in the recovery of motor and sensory functions after SCI,and formulate an expert consensus on the application of electrical neuromodulation techniques according to the type of spinal cord segment injury,age and gender,so as to provide a reference for the application of electrical neuromodulation tech-niques in the rehabilitation of patients with SCI.

spinal cord injuryneuromodulation techniqueselectrical stimulation therapyaxonal regenerative repairrehabili-tation therapyeffect and mechanism

刘文慧、孙文婷、胡耐翀、李彦丕、王正辉

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北京中医药大学中日友好医院,北京 100029

北京中医药大学东直门医院,北京 100700

新乡医学院第一附属医院,河南 新乡 453003

脊髓损伤 神经调控技术 电刺激疗法 轴突再生修复 康复治疗 效应机制

2024

康复学报
福建中医药大学

康复学报

CSTPCD
影响因子:0.545
ISSN:2096-0328
年,卷(期):2024.34(6)