在脊髓损伤的个体中,通过皮肤进行脊髓刺激后神经通路刺激的调节:系统性审查
Shirin Tajali1, Gustavo Balbinot1,2,3, Maureen Pakosh4
1KITE Research Institute - University Health Network, Toronto, ON, Canada.
Frontiers in neuroscience
|April 9, 2024
概括
通过皮肤进行脊髓刺激 (TSCS) 显示出改善脊髓损伤 (SCI) 中神经通路刺激性的前景. 然而,目前的证据质量不佳,需要进一步对TSCS影响进行高质量的研究.
科学领域:
- 神经科学是一个神经科学.
- 康复医学 康复医学 康复医学
- 脊髓损伤研究 脊髓损伤研究
背景情况:
- 穿皮脊髓刺激 (TSCS) 是一种调节神经活动的非侵入性方法.
- 它在脊髓损伤 (SCI) 中改善运动功能的潜力得到了认可.
- 然而,不同类型的TSCS电流对神经通路刺激性的影响仍然不清楚.
研究的目的:
- 系统地审查TSCS对非进展性SCI的成年人神经通路刺激性的影响.
- 为了研究直流 (DC-TSCS),交流电 (AC-TSCS) 和脊柱配对刺激的影响.
主要方法:
- 在多个数据库 (MEDLINE ALL,Embase,Web of Science,Cochrane Library,临床试验) 中进行了全面的搜索.
- 在4431个选摘要中,有23篇文章被纳入系统审查.
- 通过各种电生理学测量,评估了脊髓和皮质脊髓刺激能力.
主要成果:
- AC-TSCS降低了H反射和屈曲反射幅度,同时增加了SMEPs和CMEPs.
- 通过TSCS-TMS配对刺激抑制了脊柱反射.
- DC-TSCS和配对刺激增加了下肢肌肉的运动唤起潜力 (MEP).
- 证据质量通常很差.
结论:
- TSCS在SCI中显示出调节脊柱和脊柱上神经回路的潜力.
- 迫切需要更严格,高质量的研究来证实这些发现.
- 进一步的研究应侧重于优化TSCS参数和改进研究设计.
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