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

Neural Regen Res, 2020 · DOI: 10.4103/1673-5374.274332 · Published: January 28, 2020

Spinal Cord Injury Regenerative Medicine Neurology

Simple Explanation

Spinal cord injury (SCI) is a severe neural trauma that, depending on the damaged segment and severity (Tanabe et al., 2019), is classified into complete and incomplete SCI. 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. 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.

Study Duration

Not specified

Participants

Patients with SCI/animal models of SCI

Evidence Level

Review

Key Findings

1
Neuromodulation techniques, such as noninvasive magnetic stimulation and electrical stimulation, have been safely applied in many neuropsychiatric diseases.
2
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.
3
Several emerging treatments have been developed, such as robots, brain-computer interfaces, and nanomaterials, which have the potential to help millions of patients suffering from motor dysfunction caused by spinal cord injury.

Research Summary

Spinal cord injury is linked to the interruption of neural pathways, which results in irreversible neural dysfunction. 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. 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.

Practical Implications

Clinical Translation

Brain-computer interface technology is very likely to advance in the realm of deep neural network decoders.

Multimodal Progressive Repetitive Intervention

More multi-target, multimodal progressive repetitive intervention is needed for sensorimotor circuit reconstruction.

Surgical-Rehabilitation Integration

Integrating rehabilitation into the entire surgical procedure, including before and after surgery.

Study Limitations

1
Large-scale clinical trials need to be conducted to validate their efficacy.
2
The underlying mechanisms of neural circuit reconstruction following magnetic/electrical neuromodulation remain unknown.
3
The most effective source of NSCs and creating a microenvironment that can neutralize inhibitory effects of neuroregeneration following nerve injury have yet to be identified

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