PDF(Pubmed)
Abstract：
Neurorehabilitation is now one of the most exciting areas in neuroscience. Recognition that the central nervous system (CNS) remains plastic through life, new understanding of skilled behaviors (skills), and novel methods for engaging and guiding beneficial plasticity combine to provide unprecedented opportunities for restoring skills impaired by CNS injury or disease. The substrate of a skill is a distributed network of neurons and synapses that changes continually through life to ensure that skill performance remains satisfactory as new skills are acquired, and as growth, aging, and other life events occur. This substrate can extend from cortex to spinal cord. It has recently been given the name \"heksor.\" In this new context, the primary goal of rehabilitation is to enable damaged heksors to repair themselves so that their skills are once again performed well. Skill-specific practice, the mainstay of standard therapy, often fails to optimally engage the many sites and kinds of plasticity available in the damaged CNS. New noninvasive technology-based interventions can target beneficial plasticity to critical sites in damaged heksors; these interventions may thereby enable much wider beneficial plasticity that enhances skill recovery. Targeted-plasticity interventions include operant conditioning of a spinal reflex or corticospinal motor evoked potential (MEP), paired-pulse facilitation of corticospinal connections, and brain-computer interface (BCI)-based training of electroencephalographic (EEG) sensorimotor rhythms. Initial studies in people with spinal cord injury, stroke, or multiple sclerosis show that these interventions can enhance skill recovery beyond that achieved by skill-specific practice alone. After treatment ends, the repaired heksors maintain the benefits.
摘要：
神经康复现在是神经科学中最令人兴奋的领域之一。认识到中枢神经系统（CNS）在整个生命中保持可塑性，对熟练行为(技能)的新理解，以及用于参与和指导有益可塑性的新颖方法相结合，为恢复因CNS损伤或疾病而受损的技能提供了前所未有的机会。技能的基础是神经元和突触的分布式网络，它们在生活中不断变化，以确保技能表现在获得新技能时保持令人满意，随着增长，老化，和其他生活事件发生。这种底物可以从皮质延伸到脊髓。它最近被命名为“heksor”。\"在这个新的背景下，康复的主要目标是使受损的heksors能够自我修复，以便他们的技能再次得到很好的发挥。特定技能的实践，标准治疗的支柱,通常无法最佳地接合受损CNS中可用的许多部位和种类的可塑性。新的基于非侵入性技术的干预措施可以将有益的可塑性定位到受损HEKSORS的关键部位；这些干预措施可以因此实现更广泛的有益可塑性，从而增强技能恢复。有针对性的可塑性干预措施包括脊髓反射或皮质脊髓运动诱发电位（MEP）的操作性调节，皮质脊髓连接的成对脉冲促进，以及基于脑机接口（BCI）的脑电图（EEG）感觉运动节律训练。脊髓损伤患者的初步研究，中风,或多发性硬化症表明，这些干预措施可以增强技能恢复，而不仅仅是通过特定技能的实践。治疗结束后,修复后的heksors保持了收益。
