■脊髓损伤(SCI)通常会导致运动障碍和终身残疾。
■本系统综述,与PRISMA准则一致进行,旨在评估皮质脊髓配对联合刺激(PAS)对SCI患者运动结局的影响。PubMed,Scopus/EMBASE,Pedro和Cochrane数据库从成立到2023/01/12进行了咨询。
■关于1021篇文章,涉及84名患者的10项研究符合纳入标准,7个病例系列/研究和3个临床试验。尽管有轻微的差异,纳入的研究使用单次经颅磁刺激和高频外周神经电刺激进行了皮质-外周PAS,治疗次数一致(>20次).所有纳入的研究均报告了通过临床和/或神经生理学评估记录的运动结果的改善。
■现有证据表明PAS刺激后运动结果增加。的确,临床和神经生理学结果均表明,在慢性SCI患者中,大量PAS治疗的有效性.由于研究数量有限,研究设计不尽人意,需要精心设计的随机对照试验来确认这些方法的潜力,并阐明PAS在SCI人群中的适当剂量反应.
■该协议已在PROSPERO数据库(CRD42023485703)上注册。
UNASSIGNED: Spinal cord injuries (SCI) often result in motor impairment and lifelong disability.
UNASSIGNED: This systematic review, conducted in agreement with PRISMA guidelines, aimed to evaluate the effects of cortico-spinal paired associative stimulation (PAS) on motor outcomes in individuals with SCI. PubMed, Scopus/EMBASE, Pedro, and Cochrane databases were consulted from inception to 2023/01/12.
UNASSIGNED: In 1021 articles, 10 studies involving 84 patients meet the inclusion criteria, 7 case series/study, and 3 clinical trials. Despite light differences, the included studies performed a cortico-peripheral PAS using a single transcranial magnetic stimulation and high frequency electrical peripheral nerve stimulation for a consistent number of sessions (>20). All included studies reported improvement in motor outcomes recorded via clinical and/or neurophysiological assessment.
UNASSIGNED: Available evidence showed an increase in motor outcomes after PAS stimulation. Indeed, both clinical and neurophysiological outcomes suggest the effectiveness of a high number of PAS sessions in chronic individuals with SCI. Due to a limited number of studies and an unsatisfactory study design, well-designed RCTs are needed to confirm the potentiality of these approaches and clarify the adequate dose-response of PAS in the SCI population.
UNASSIGNED: The protocol was registered on the PROSPERO database (CRD42023485703).