The Potential of Corticospinal-Motoneuronal Plasticity for Recovery after Spinal Cord Injury.
The Potential of Corticospinal-Motoneuronal Plasticity for Recovery after Spinal Cord Injury.
复制标题
皮质脊髓-运动神经元可塑性对脊髓损伤后恢复的潜力。
DOI：
10.1007/s40141-020-00272-6
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发表时间：
2020-09
影响因子：
1.1
通讯作者：
Perez MA
中科院分区：
文献类型：
--
作者：
Jo HJ;Richardson MSA;Oudega M;Perez MA
本综述重点关注一种相对较新的神经调节方法，其中对初级运动皮层的经颅磁刺激与对周围神经的经皮电刺激相结合，以诱导皮质脊髓运动神经元突触的可塑性。脊髓损伤后感觉运动功能的恢复很大程度上取决于皮质脊髓通路的传递。严重受损的皮质脊髓轴突无法再生并参与功能恢复。残余皮质脊髓轴突的传输可以使用非侵入性经颅磁刺激进行评估，该刺激与经皮电刺激相结合可用于改善自主运动输出，正如最近在患有慢性不完全脊髓损伤的人类的临床研究中所证明的那样。这两种刺激以精确的刺激间隔施加，以利用尖峰时间依赖性可塑性原理来加强皮质脊髓突触传递。我们讨论了这种神经调节技术的神经机制和应用及其对慢性脊髓损伤人类功能恢复的潜在治疗作用。
This review focuses on a relatively new neuromodulation method where transcranial magnetic stimulation over the primary motor cortex is paired with transcutaneous electrical stimulation over a peripheral nerve to induce plasticity at corticospinal-motoneuronal synapses. Recovery of sensorimotor function after spinal cord injury largely depends on transmission in the corticospinal pathway. Significantly damaged corticospinal axons fail to regenerate and participate in functional recovery. Transmission in residual corticospinal axons can be assessed using non-invasive transcranial magnetic stimulation which combined with transcutaneous electrical stimulation can be used to improve voluntary motor output, as was recently demonstrated in clinical studies in humans with chronic incomplete spinal cord injury. These two stimuli are applied at precise inter-stimulus intervals to reinforce corticospinal synaptic transmission using principles of spike-timing dependent plasticity. We discuss the neural mechanisms and application of this neuromodulation technique and its potential therapeutic effect on recovery of function in humans with chronic spinal cord injury.
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