Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy.
Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy.
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DOI：
10.1007/s13311-021-01087-6
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Edgerton VR
中科院分区：
文献类型：
--
作者：
Gad P;Hastings S;Zhong H;Seth G;Kandhari S;Edgerton VR
脊髓神经调节和基于活动的康复触发神经网络重组并增强涉及下肢、躯干和上肢的感觉运动性能。本研究报告了经皮电脊髓神经调节（SCONE™，SpineX Inc.）对12名被诊断患有脑瘫（CP）的个体（年龄2至50岁）进行了研究，粗大运动功能分类量表（GMFCS）水平范围为I至V。急性脊髓神经调节改善了12名患者中11名患者的姿势和运动能力，包括在一名无法行走的2岁儿童（GMFCS IV级）中产生双侧负重行走的能力。此外，我们观察了独立的头部控制和负重站立与刺激在10岁和4岁（GMFCS水平V）谁不能举行他们的头或站立没有支持在没有刺激。所有患者在踏车时，屈肌和伸肌运动池的协调性以及关节间和关节内角度均显著改善。虽然假设CP的破坏性功能的病因与脊髓上网络的损伤有关，但这些数据与脊髓神经调节和功能集中的基于活动的治疗可以形成脊髓-脊髓上连接重组的功能改善的慢性状态的假设一致。我们进一步认为，与神经调节的脊髓-脊髓上连接的重组水平有助于改善运动，通过调节的幅度和发放模式的EMG突发在步进过程中，通过改善屈肌和伸肌的协调模式。在线版本包含补充材料，可通过10.1007/s13311-021-01087-6获得。
Spinal neuromodulation and activity-based rehabilitation triggers neural network reorganization and enhances sensory-motor performances involving the lower limbs, the trunk, and the upper limbs. This study reports the acute effects of Transcutaneous Electrical Spinal Cord Neuromodulation (SCONE™, SpineX Inc.) on 12 individuals (ages 2 to 50) diagnosed with cerebral palsy (CP) with Gross Motor Function Classification Scale (GMFCS) levels ranging from I to V. Acute spinal neuromodulation improved the postural and locomotor abilities in 11 out of the 12 patients including the ability to generate bilateral weight bearing stepping in a 2-year-old (GMFCS level IV) who was unable to step. In addition, we observed independent head-control and weight bearing standing with stimulation in a 10-year-old and a 4-year old (GMFCS level V) who were unable to hold their head up or stand without support in the absence of stimulation. All patients significantly improved in coordination of flexor and extensor motor pools and inter and intralimb joint angles while stepping on a treadmill. While it is assumed that the etiologies of the disruptive functions of CP are associated with an injury to the supraspinal networks, these data are consistent with the hypothesis that spinal neuromodulation and functionally focused activity-based therapies can form a functionally improved chronic state of reorganization of the spinal-supraspinal connectivity. We further suggest that the level of reorganization of spinal-supraspinal connectivity with neuromodulation contributed to improved locomotion by improving the coordination patterns of flexor and extensor muscles by modulating the amplitude and firing patterns of EMG burst during stepping. The online version contains supplementary material available at 10.1007/s13311-021-01087-6.
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影响因子：
4.2
作者：
Gad, Parag;Lee, Sujin;Edgerton, V. Reggie
通讯作者：
Edgerton, V. Reggie
影响因子：
2.5
作者：
Gad, Parag;Kreydin, Evgeniy;Edgerton, V. Reggie
通讯作者：
Edgerton, V. Reggie
DOI：
10.1177/1073858416683681
发表时间：
2017-10
期刊：
The Neuroscientist : a review journal bringing neurobiology, neurology and psychiatry
影响因子：
--
作者：
Gerasimenko Y;Sayenko D;Gad P;Liu CT;Tillakaratne NJK;Roy RR;Kozlovskaya I;Edgerton VR
通讯作者：
Edgerton VR
影响因子：
--
作者：
Fong AJ;Roy RR;Ichiyama RM;Lavrov I;Courtine G;Gerasimenko Y;Tai YC;Burdick J;Edgerton VR
通讯作者：
Edgerton VR
DOI：
10.1111/j.1469-8749.2008.03190.x
发表时间：
2009-08-01
影响因子：
3.8
作者：
Kruse, Marie;Michelsen, Susan Ishoy;Uldall, Peter
通讯作者：
Uldall, Peter