| 余超超,张敏,彭轩,乌云塔娜,吴永超.硬膜外电刺激对脊髓损伤后神经环路重塑的研究进展[J].中国康复,2025,40(10):635-640 |
| 硬膜外电刺激对脊髓损伤后神经环路重塑的研究进展 |
| Neural circuit remodeling mediated by epidural electrical stimulation following spinal cord Injury: a research update |
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| DOI：10.3870/zgkf.2025.10.010 |
| 中文关键词: 脊髓损伤 硬膜外电刺激 神经环路 |
| 英文关键词: spinal cord injury epidural electrical stimulation neural circuit |
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| 摘要点击次数: 41 |
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| 中文摘要: |
| 脊髓损伤（SCI）发病率持续上升，高致残性导致严重功能障碍，给患者本身及社会带来沉重的负担。传统治疗面临瓶颈，硬膜外电刺激（EES）近年展现出突破性康复潜力，但其调控神经环路重塑的机制尚未系统阐明。本文检索PubMed、SinoMed、Web of Science、中国知网、万方等数据库建库至2024年文献，关键词包括"硬膜外电刺激"、"脊髓损伤"、"环路"、"epidural electrical stimulation"、"spinal cord injury"、"circuit "，筛选机制研究及临床报道，并综述EES通过重塑神经环路改善SCI功能障碍的作用机制，以期为临床转化及深入研究提供理论依据。EES可通过对SCI上行环路、下行环路、脊髓固有环路进行重塑，从而改善SCI后功能障碍。EES可能还通过多层级神经环路重组促进功能恢复，但仍需大样本RCT验证疗效。未来应结合单细胞测序、光遗传学技术精准解析神经元亚群机制，探索EES联合干细胞移植、脑机接口及多靶点神经调控的协同策略。 |
| 英文摘要: |
| The incidence of spinal cord injury (SCI) continues to rise globally. Its high disability rates result in severe functional impairments, imposing a substantial burden on both affected individuals and society. While conventional treatments face limitations, epidural electrical stimulation (EES) has demonstrated breakthrough potential for functional recovery in recent years. However, the precise mechanisms through which EES remodels neural circuits remain incompletely elucidated. This review aims to synthesize the mechanisms by which EES improves functional deficits following SCI through neural circuit remodeling, providing a theoretical foundation for clinical translation and further research. We systematically searched literature published from database inception to 2024 in PubMed, SinoMed, Web of Science, CNKI (China National Knowledge Infrastructure), and Wanfang Data. Key search terms included “epidural electrical stimulation,” “spinal cord injury,” “circuit,” and “neural circuit.” Studies focusing on mechanistic investigations and clinical reports were selected. EES can ameliorate post-SCI functional impairments by remodeling ascending sensory pathways, descending motor pathways, and intrinsic spinal cord circuits. EES promotes functional recovery via multi-level reorganization of neural circuits, although its efficacy requires validation in large-scale randomized controlled trials. Future research should integrate single-cell sequencing and optogenetics to precisely delineate neuron subtype-specific mechanisms and explore synergistic strategies combining EES with stem cell transplantation, brain-computer interfaces, and multi-target neuromodulation. |
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