Plasticity of interneuronal networks of the functionally isolated human spinal cord
Plasticity of interneuronal networks of the functionally isolated human spinal cord
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DOI：
10.1016/j.brainresrev.2007.07.012
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发表时间：
2008-01-01
影响因子：
--
通讯作者：
Harkema, Susan J.
中科院分区：
文献类型：
--
作者：
Harkema, Susan J.
人类脊髓损伤后行走能力的丧失被归因于脊髓上机制的优势。人类中枢模式产生的证据是有限的，因为无法最终将电路与下行和传入输入隔离开来。然而，研究脊髓损伤后的个体，从脊髓上中心对脊髓网络没有检测到的影响，可以提供他们与传入输入的相互作用的见解。这篇文章的重点是在运动模式的产生中感觉输入与人类脊髓网络的相互作用。功能性分离的人脊髓具有通过适当的传入输入产生运动模式的能力。运动训练是一种康复策略，它是从动物和人类研究中发展而来的，专注于脊髓的神经可塑性，并且对许多患有急性和慢性不完全脊髓损伤的人来说是成功的。然而，即使是那些临床上完全脊髓损伤的人，在跑步机上借助体重支撑的辅助下，在行走过程中产生适当的运动模式，也不能维持地上行走。这表明，虽然一个显着的控制运动可以发生在脊髓神经元间网络的水平，这些电路的可持续兴奋性的水平仍然受到损害。未来的研究应侧重于增加中枢兴奋性的方法，可能包括神经修复策略，药物干预或硬膜外刺激与运动训练相结合。(c)2007 Elsevier B.V.保留所有权利。
The loss of walking after human spinal cord injury has been attributed to the dominance of supraspinal over spinal mechanisms. The evidence for central pattern generation in humans is limited due to the inability to conclusively isolate the circuitry from descending and afferent input. However, studying individuals following spinal cord injury with no detectable influence on spinal networks from supraspinal centers can provide insight to their interaction with afferent input. The focus of this article is on the interaction of sensory input with human spinal networks in the generation of locomotor patterns. The functionally isolated human spinal cord has the capacity to generate locomotor patterns with appropriate afferent input. Locomotor Training is a rehabilitative strategy that has evolved from animal and humans studies focused on the neural plasticity of the spinal cord and has been successful for many people with acute and chronic incomplete spinal cord injury. However, even those individuals with clinically complete spinal cord injury that generate appropriate locomotor patterns during steppingwith assistance on a treadmill with body weight support cannot sustain overground walking. This suggests that although a significant control of locomotion can occur at the level of spinal interneuronal networks the level of sustainable excitability of these circuits is still compromised. Future studies should focus on approaches to increase the central state of excitability and may include neural repair strategies, pharmacological interventions or epidural stimulation in combination with Locomotor Training. (c) 2007 Elsevier B.V. All rights reserved.