皮质-皮质配对联合刺激促进脑卒中后运动恢复。

IF 10 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
EClinicalMedicine Pub Date : 2025-09-17 eCollection Date: 2025-10-01 DOI:10.1016/j.eclinm.2025.103473
Domiziana Falaschi, Charlotte Stagg, Alejandra Sel
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引用次数: 0

摘要

中风是最常见的神经系统疾病,是导致长期残疾的主要原因,也是导致死亡的第二大原因。卒中后运动症状严重影响和限制卒中幸存者的生活质量。康复旨在通过促进神经可塑性和神经元重组来恢复运动功能。一种很有前景的治疗方法是将非侵入性脑刺激(NIBS)与基于活动的训练相结合,以增强神经可塑性。NIBS被认为促进中风后功能相关网络的先天神经元重组。在NIBS技术中,一种开创性的方法,通常被称为皮质-皮质配对联想刺激(ccPAS),可以增强皮层网络中的神经可塑性。与传统方法不同,ccPAS能够操纵特定皮质通路内的区域间连接。特别是,ccPAS可以在功能相关的皮质-皮质途径中促进突触可塑性和连通性,从而使干预措施适应个体病变特异性网络的改变。在这种观点下,我们建议并批判性地评估ccPAS作为一种治疗工具的使用,并以上肢运动康复为主要例子,强调其在中风后康复中的潜力。我们总结了支持中风后使用ccPAS的有限和对比证据,并提出了克服当前局限性的建议,强调需要进一步的未来研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Promoting motor recovery after stroke using cortico-cortical paired associative stimulation.

Promoting motor recovery after stroke using cortico-cortical paired associative stimulation.

Promoting motor recovery after stroke using cortico-cortical paired associative stimulation.

Promoting motor recovery after stroke using cortico-cortical paired associative stimulation.

Stroke is the most prevalent neurological disorder, the primary cause of long-term disability, and the second leading cause of mortality. Post-stroke motor symptoms critically impact and limit stroke survivors' quality of life. Rehabilitation aims to restore motor function by promoting neuroplasticity and neuronal reorganisation. A promising therapeutic approach involves combining non-invasive brain stimulation (NIBS) with activity-based training to enhance neuroplasticity. NIBS are thought to promote the innate neuronal reorganisation of the functionally relevant networks after a stroke. Amongst NIBS techniques, a pioneering method, often referred to as cortico-cortical paired associative stimulation (ccPAS), allows to enhance neuroplasticity in cortical networks. Unlike traditional approaches, ccPAS enables the manipulation of interregional connectivity within specific cortical pathways. In particular, ccPAS can promote synaptic plasticity and connectivity in a functionally relevant cortico-cortical route tailoring the interventions to individual lesion-specific network alterations. In this viewpoint, we propose and critically evaluate the use of ccPAS as a therapeutic tool using upper-limb motor rehabilitation as a primary example, highlighting its potential for post-stroke recovery. We summarise the limited and contrasting evidence supporting the use of ccPAS after a stroke and make suggestions to overcome the current limitations emphasising the need for further future research.

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来源期刊
EClinicalMedicine
EClinicalMedicine Medicine-Medicine (all)
CiteScore
18.90
自引率
1.30%
发文量
506
审稿时长
22 days
期刊介绍: eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.
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