DBS in the restoration of motor functional recovery following spinal cord injury

Frontiers in Neurology, 2024 · DOI: 10.3389/fneur.2024.1442281 · Published: December 4, 2024

Simple Explanation

This review discusses the use of deep brain stimulation (DBS) to help restore motor function after spinal cord injury (SCI). Despite standard treatments, complete recovery is often limited, and DBS is being explored as a way to improve motor function by targeting specific areas in the brain. DBS involves surgically implanting electrodes in the brain that connect to a generator under the skin. This stimulation can help to remodel neural circuits, potentially improving motor function. While DBS has been used for pain management in SCI, this review focuses on its potential to restore movement. The review highlights that ongoing clinical trials are crucial to validating DBS efficacy in SCI. Optimizing DBS techniques and combining it with rehabilitation methods may enhance motor recovery. Further research is needed to fully understand and refine the application of DBS for SCI.

Study Duration

Not specified

Participants

Human and animal models

Evidence Level

Review

Key Findings

1
DBS targeting specific brain regions like the mesencephalic locomotor region (MLR), cuneiform nucleus (CNF), and nucleus raphe magnus (NRG) shows promise for motor functional recovery after SCI.
2
Radiologically guided DBS optimization and combination therapy with classical rehabilitation have become an effective therapeutic method.
3
DBS-derived synaptic plasticity is mediated in part by elevations in brain derived neurotrophic factor (BDNF) and downstream synaptic proteins.

Research Summary

This review provides an overview of electrical neuromodulation effects on spinal cord injury (SCI), focusing on DBS for motor functional recovery in human and animal models. Advances in techniques like optogenetics and whole-brain tractogram have helped elucidate DBS mechanisms. Overall, DBS holds promise for neurological and functional recovery after SCI, akin to other electrical stimulation approaches.

Practical Implications

Therapeutic Target Identification

Identifying precise brain regions to target with DBS can maximize therapeutic efficacy and minimize off-target effects.

Personalized DBS Application

Mapping anatomical substrates with their maximal therapeutic response can help build predictive tools for clinical decision-making and personalized application of DBS.

Combined Therapy Potential

Combining DBS with other interventions, such as rehabilitation methods or EES, may enhance motor recovery after SCI.

Study Limitations

1
Limited clinical reports on DBS-related motor recovery in SCI patients.
2
Uncertainty of effective brain targets in animal models.
3
Lack of a comprehensive description of the macroanatomy and microanatomy of the human MLR.

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