中国神经再生研究(英文版) ›› 2020, Vol. 15 ›› Issue (8): 1437-1450.doi: 10.4103/1673-5374.274332

• 综述:脊髓损伤修复保护与再生 • 上一篇    下一篇

脊髓损伤多模态治疗:神经调控后的神经再生之剑

  

  • 出版日期:2020-08-15 发布日期:2020-09-16

Multimodal treatment for spinal cord injury: a sword of neuroregeneration upon neuromodulation

Ya Zheng1 , Ye-Ran Mao1 , Ti-Fei Yuan2, 3, * , Dong-Sheng Xu1, 4, * , Li-Ming Cheng4, 5, *   

  1. 1 Rehabilitation Section, Spine Surgery Division of Department of Orthopedics, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, China 2 Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China 3 Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China 4 Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education of the People’s Republic of China, Tongji University, Shanghai, China 5 Spine Surgery Division of Department of Orthopedics, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
  • Online:2020-08-15 Published:2020-09-16
  • Contact: Ti-Fei Yuan, PhD, ytf0707@126.com; Dong-Sheng Xu, MD, dxu0927@tongji.edu.cn; Li-Ming Cheng, MD, PhD, limingcheng@tongji.edu.cn.
  • Supported by:
    This work was supported by the Major International (Regional) Joint Research Project of the National Natural Science Foundation of China, No. 81820108013 (to LMC); the General Research Project of the National Natural Science Foundation of China, No. 81772453 (to DSX); the National Key Research and Development Program of China, No. 2016YFA0100800 (to LMC).

摘要:

orcid: 0000-0003-0510-715X (Ti-Fei Yuan) 

          0000-0002-8477-5377 (Dong-Sheng Xu) 

          0000-0003-3396-4300 (Li-Ming Cheng)

Abstract: Spinal cord injury is linked to the interruption of neural pathways, which results in irreversible neural dysfunction. Neural repair and neuroregeneration are critical goals and issues for rehabilitation in spinal cord injury, which require neural stem cell repair and multimodal neuromodulation techniques involving personalized rehabilitation strategies. Besides the involvement of endogenous stem cells in neurogenesis and neural repair, exogenous neural stem cell transplantation is an emerging effective method for repairing and replacing damaged tissues in central nervous system diseases. However, to ensure that endogenous or exogenous neural stem cells truly participate in neural repair following spinal cord injury, appropriate interventional measures (e.g., neuromodulation) should be adopted. Neuromodulation techniques, such as noninvasive magnetic stimulation and electrical stimulation, have been safely applied in many neuropsychiatric diseases. There is increasing evidence to suggest that neuromagnetic/electrical modulation promotes neuroregeneration and neural repair by affecting signaling in the nervous system; namely, by exciting, inhibiting, or regulating neuronal and neural network activities to improve motor function and motor learning following spinal cord injury. Several studies have indicated that fine motor skill rehabilitation training makes use of residual nerve fibers for collateral growth, encourages the formation of new synaptic connections to promote neural plasticity, and improves motor function recovery in patients with spinal cord injury. With the development of biomaterial technology and biomechanical engineering, several emerging treatments have been developed, such as robots, brain-computer interfaces, and nanomaterials. These treatments have the potential to help millions of patients suffering from motor dysfunction caused by spinal cord injury. However, large-scale clinical trials need to be conducted to validate their efficacy. This review evaluated the efficacy of neural stem cells and magnetic or electrical stimulation combined with rehabilitation training and intelligent therapies for spinal cord injury according to existing evidence, to build up a multimodal treatment strategy of spinal cord injury to enhance nerve repair and regeneration.

Key words: brain-computer interface technology, multimodal rehabilitation, nerve regeneration, neural circuit reconstruction, neural regeneration, neuromodulation, rehabilitation training, spinal cord injury, stem cells, transcranial direct current stimulation, transcranial magnetic stimulation