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

Wen-Yuan Li; Wen-Rui Qu; Yi Li; Shu-Ying Wang; Dong-Ming Liu; Ling-Xiao Deng; Ying Wang

doi:10.3389/fneur.2024.1442281

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

Front Neurol. 2024 Dec 4:15:1442281. doi: 10.3389/fneur.2024.1442281. eCollection 2024.

Authors

Wen-Yuan Li^#^{1

2}, Wen-Rui Qu^#³, Yi Li^{1

2}, Shu-Ying Wang^{1

2}, Dong-Ming Liu⁴, Ling-Xiao Deng⁵, Ying Wang^{1

2}

Affiliations

¹ Mudanjiang North Medicine Resource Development and Application Collaborative Innovation Center, Mudanjiang, China.
² Institute of Neural Tissue Engineering, Mudanjiang University of Medicine, Mudanjiang, China.
³ Department of Hand Surgery, The Second Hospital of Jilin University, Changchun, China.
⁴ Department of Neurology, Mudanjiang First People's Hospital, Mudanjiang, China.
⁵ Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States.

^# Contributed equally.

Abstract

The landscape of therapeutic deep brain stimulation (DBS) for locomotor function recovery is rapidly evolving. 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. We highlight research providing insight into underlying cellular and molecular mechanisms. A literature review via Web of Science and PubMed databases from 1990 to May 29, 2024, reveals a growing body of evidence for therapeutic DBS in SCI recovery. Advances in techniques like optogenetics and whole-brain tractogram have helped elucidate DBS mechanisms. Neuronal targets sites for SCI functional recovery include the mesencephalic locomotor region (MLR), cuneiform nucleus (CNF), and nucleus raphe magnus (NRG), with pedunculopontine nucleus (PPN), periaqueductal gray (PAG), and nucleus ventroposterolateral thalami (VPL) for post-injury functional recovery treatment. Radiologically guided DBS optimization and combination therapy with classical rehabilitation have become an effective therapeutic method, though ongoing interventional trials are needed to enhance understanding and validate DBS efficacy in SCI. On the pre-clinical front, standardization of pre-clinical approaches are essential to enhance the quality of evidence on DBS safety and efficacy. Mapping brain targets and optimizing DBS protocols, aided by combined DBS and medical imaging, are critical endeavors. Overall, DBS holds promise for neurological and functional recovery after SCI, akin to other electrical stimulation approaches.

Keywords: deep brain stimulation; motor function; neural circuits; neuromodulation; neuroplasticity; spinal cord injury.

Publication types

Review

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by the National Natural Science Foundation of China, No. 82371385 (to YW); Heilongjiang Natural Science Foundation of China, No. SS2022H001 (to W-yL); Mudanjiang Medical College Torch Plan Project of Science Foundation, No. 2022-MYHJ-012 (to W-yL); the Basic Research Operating Expenses Program of Heilongjiang provincial Universities, No. 2021-KYYWF-0469 (to W-yL); Doctoral scientific research foundation of Mudanjiang College of Medicine, No. 2021-MYBSKY-039 (to W-yL); IND DEPT HLTH No. 74247, 74244, 55051 (to L-xD); R21NS130241(to L-xD).