Transcutaneous spinal stimulation alters cortical and subcortical activation patterns during mimicked-standing: A proof-of-concept fMRI study.
Transcutaneous spinal stimulation alters cortical and subcortical activation patterns during mimicked-standing: A proof-of-concept fMRI study.
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DOI：
10.1016/j.ynirp.2022.100090
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发表时间：
2022-06-01
期刊：
影响因子：
--
通讯作者：
Sayenko, Dimitry G
中科院分区：
文献类型：
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作者：
Manson, Gerome;Atkinson, Darryn A;Sayenko, Dimitry G
经皮脊髓刺激（TSS）是一种非侵入性神经调节技术，已用于促进脊髓损伤患者自主运动功能的表现，如躯干控制和自助站立。虽然有人假设TSS放大了来自脊髓上运动控制网络的信号，但TSS对脊髓上激活模式的影响目前尚不清楚。本研究的目的是调查TSS引起的活动在脊髓上感觉运动区在下肢运动任务。功能性磁共振成像（fMRI）被用来评估神经激活模式的变化，因为11名参与者在扫描仪中进行模仿站立运动。在没有刺激的情况下以及在存在（1）TSS、（2）施加于背部肌肉的刺激、（3）感觉异常刺激和（4）神经肌肉电刺激的情况下进行运动。TSS与皮质下和皮质感觉运动区的更大激活相关，这些感觉运动区参与运动相关体感信息的中继和处理（例如，丘脑、尾状核、苍白球、壳核）。TSS也导致失活在两个脑桥核和后顶叶皮层，这表明向体感反馈为基础的机制和更多的反射运动控制的转变。总之，这些研究结果表明，脊髓刺激可以改变脊髓上感觉运动网络内的活动，并促进使用体感反馈，从而提供了一个合理的神经机制，刺激引起的改善感觉运动功能的参与者与神经损伤和障碍。
Transcutaneous spinal stimulation (TSS) is a non-invasive neuromodulation technique that has been used to facilitate the performance of voluntary motor functions such as trunk control and self-assisted standing in individuals with spinal cord injury. Although it is hypothesized that TSS amplifies signals from supraspinal motor control networks, the effect of TSS on supraspinal activation patterns is presently unknown. The purpose of this study was to investigate TSS-induced activity in supraspinal sensorimotor regions during a lower-limb motor task. Functional magnetic resonance imaging (fMRI) was used to assess changes in neural activation patterns as eleven participants performed mimicked-standing movements in the scanner. Movements were performed without stimulation, as well as in the presence of (1) TSS, (2) stimulation applied to the back muscle, (3) paresthesia stimulation, and (4) neuromuscular electrical stimulation. TSS was associated with greater activation in subcortical and cortical sensorimotor regions involved in relay and processing of movement-related somatosensory information (e.g., thalamus, caudate, pallidum, putamen), as compared to the other stimulation paradigms. TSS also resulted in deactivation in both nucleus accumbens and posterior parietal cortex, suggesting a shift toward somatosensory feedback-based mechanisms and more reflexive motor control. Together, these findings demonstrate that spinal stimulation can alter the activity within supraspinal sensorimotor networks and promote the use of somatosensory feedback, thus providing a plausible neural mechanism for the stimulation-induced improvements of sensorimotor function observed in participants with neurological injuries and disorders.