Optimization of Transspinal Stimulation Applications for Motor Recovery after Spinal Cord Injury: Scoping Review.
Optimization of Transspinal Stimulation Applications for Motor Recovery after Spinal Cord Injury: Scoping Review.
复制标题
脊髓损伤后运动恢复的经脊髓刺激应用优化：范围综述。
DOI：
10.3390/jcm12030854
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发表时间：
2023-01-20
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
--
作者：
脊髓损伤（SCI）是一种使人衰弱的疾病，会严重影响个人的生活，导致瘫痪、自主神经反射障碍和慢性疼痛。经脊髓刺激（TSS）是一种非侵入性的神经调节形式，可激活脊髓的潜在神经回路。TSS的应用可以通过多种刺激方案来实现，这些方案可能在电极的大小或位置以及刺激参数上有所不同，并且可能影响运动功能对刺激的响应。由于TSS的新颖性，总结现有证据以确定可能为运动反应提供最佳结果的参数范围是有益的。在PubMed和谷歌Scholar数据库中检索了有关TSS对肢体运动功能影响的研究。文献检索产生34项研究进行分析，其中电极放置和刺激参数变化很大。总结了各研究的刺激方案及其对肢体运动功能的影响。电极放置根据目标肢体的不同而不同。上肢的研究以颈椎扩大为目标，在颈椎区域解剖放置阴极。在下肢研究中，阴极放置在胸椎和腰椎椎体区域，以瞄准腰椎肿大。在这些研究中，载波频率的影响尚无定论。与单位点放置相比，多位点阴极放置产生了良好的运动响应结果。本文简要综述了目前关于TSS对脊髓损伤后运动反应影响的机制证据。我们的研究结果表明，优化增产参数将需要未来的随机对照研究，以独立评估不同增产参数在受控环境下的效果。
Spinal cord injury (SCI) is a debilitating condition that can significantly affect an individual’s life, causing paralysis, autonomic dysreflexia, and chronic pain. Transspinal stimulation (TSS) is a non-invasive form of neuromodulation that activates the underlying neural circuitries of the spinal cord. Application of TSS can be performed through multiple stimulation protocols, which may vary in the electrodes’ size or position as well as stimulation parameters, and which may influence the response of motor functions to the stimulation. Due to the novelty of TSS, it is beneficial to summarize the available evidence to identify the range of parameters that may provide the best outcomes for motor response. The PubMed and Google Scholar databases were searched for studies examining the effects of TSS on limb motor function. A literature search yielded 34 studies for analysis, in which electrode placement and stimulation parameters varied considerably. The stimulation protocols from each study and their impact on limb motor function were summarized. Electrode placement was variable based on the targeted limb. Studies for the upper limbs targeted the cervical enlargement with anatomical placement of the cathode over the cervical vertebral region. In lower-limb studies, the cathode(s) were placed over the thoracic and lumbar vertebral regions, to target the lumbar enlargement. The effects of carrier frequency were inconclusive across the studies. Multisite cathodal placements yielded favorable motor response results compared to single-site placement. This review briefly summarized the current mechanistic evidence of the effect of TSS on motor response after SCI. Our findings indicate that optimization of stimulation parameters will require future randomized controlled studies to independently assess the effects of different stimulation parameters under controlled circumstances.
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