中国神经再生研究(英文版) ›› 2024, Vol. 19 ›› Issue (3): 503-504.doi: 10.4103/1673-5374.380895

• 观点:脊髓损伤修复保护与再生 • 上一篇    下一篇

脊髓硬膜内电极:机遇、挑战和临床应用

  

  • 出版日期:2024-03-15 发布日期:2023-09-02

Spinal intradural electrodes: opportunities, challenges and translation to the clinic

Bruce Harland, Chien Yew Kow, Darren Svirskis*#br#   

  1. School of Pharmacy, University of Auckland, Auckland, New Zealand (Harland B, Svirskis D) 
    Department of Neurosurgery, Auckland City Hospital, Auckland, New Zealand (Kow CY)
  • Online:2024-03-15 Published:2023-09-02
  • Contact: Darren Svirskis, PhD, d.svirskis@auckland.ac.nz.
  • Supported by:
    This work was supported by the CatWalk Spinal Cord Injury Trust and the Health Research Council of New Zealand (Project grant and HRC/Catwalk Partnership 19/895) (to DS).

摘要: https://orcid.org/0000-0001-9435-1773 (Darren Svirskis)

Abstract: Damage to the spinal cord disrupts the electrically active nerve cells which normally transmit afferent and efferent signals, resulting in loss of motor, sensory, and autonomic functions. Potential treatments for spinal cord injury utilizing implanted spinal electrodes can be broadly classified into three different categories. The first of these approaches is “spinal stimulation” where electrodes, usually positioned above the level of injury, provide electrical stimulation to target and disrupt pain signals before they reach the brain. The second approach uses “activity-dependent neuro-technologies”, in which electrodes positioned below the level of injury initiate a complex spatiotemporal pattern of stimulation at the lumbar spinal cord to generate a walking gait in the limbs (Minev et al., 2015; Wagner et al., 2018). The third treatment approach has been coined “electroceuticals”, in which a pair of electrodes positioned close to and either side of a spinal cord injury site generate a low-frequency electric field to promote regrowth and direct axons to reconnect across the damaged region (Shapiro, 2014). Most research studies or clinical applications utilizing these approaches use the epidural placement of the electrodes, in which the electrodes are placed in the epidural space (Figure 1). In contrast, our research group is developing an implant to deliver electroceutical treatments designed to be inserted underneath the dura mater, which is referred to as intradural or subdural positioning (Harland et al., 2022; Figure 1). We are currently using this implant to test different electrical field treatments in a preclinical model while looking ahead to how such a device may be translated to a clinical setting. Therefore, in this perspective, we will explore the advantages and challenges associated with intradural placement of electrodes in the spinal cord and discuss the current and future feasibility of clinical implantation of intradural electrodes and devices.