Characterizing neurological status in individuals with tetraplegia using transcutaneous spinal stimulation.
Characterizing neurological status in individuals with tetraplegia using transcutaneous spinal stimulation.
复制标题
用经皮脊髓刺激研究四肢瘫痪患者的神经状态。
DOI：
10.1038/s41598-023-48811-0
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发表时间：
2023-12-06
影响因子：
4.6
通讯作者：
中科院分区：
文献类型：
--
作者：
经皮脊髓电刺激（TSS）正在成为一种有价值的工具，电生理和临床评估。本研究的目的是通过在脊髓病变上方和下方输送TSS来检查上肢（UL）运动池的募集模式。本研究还旨在探讨脊髓损伤（SCI）后UL运动池的募集模式与神经和功能状态之间的关系。在8名因颈椎脊髓损伤导致四肢瘫痪的参与者中，将TSS递送到C3-C4和C7-T1椎骨棘突之间的颈脊髓，并表征UL肌肉中的脊髓诱发运动电位。我们发现，在UL肌肉运动池神经支配的损伤水平以下的反应表现出相对较低的敏感性TSS相比，以上的病变，是不对称的，在大多数肌肉，并依赖于水平，程度和侧SCI。总的来说，我们的研究结果表明，通过TSS获得的电生理数据可以提供洞察UL功能不对称的程度，神经通路的中断，以及SCI后运动控制的变化。这项研究表明，这样的电生理数据可以补充临床和功能评估，并提供进一步的见解与SCI的个人残余运动功能。
Transcutaneous spinal stimulation (TSS) is emerging as a valuable tool for electrophysiological and clinical assessment. This study had the objective of examining the recruitment patterns of upper limb (UL) motor pools through the delivery of TSS above and below a spinal lesion. It also aimed to explore the connection between the recruitment pattern of UL motor pools and the neurological and functional status following spinal cord injury (SCI). In eight participants with tetraplegia due to cervical SCI, TSS was delivered to the cervical spinal cord between the spinous processes of C3–C4 and C7–T1 vertebrae, and spinally evoked motor potentials in UL muscles were characterized. We found that responses observed in UL muscles innervated by motor pools below the level of injury demonstrated relatively reduced sensitivity to TSS compared to those above the lesion, were asymmetrical in the majority of muscles, and were dependent on the level, extent, and side of SCI. Overall, our findings indicate that electrophysiological data acquired through TSS can offer insights into the extent of UL functional asymmetry, disruptions in neural pathways, and changes in motor control following SCI. This study suggests that such electrophysiological data can supplement clinical and functional assessment and provide further insight regarding residual motor function in individuals with SCI.
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