基于脊髓硬膜外电刺激的康复与能量代谢控制研究

项目名称： 基于脊髓硬膜外电刺激的康复与能量代谢控制研究

项目编号： No.60874035

项目类型： 面上项目

立项/批准年度： 2009

项目学科： 武器工业

项目作者： 徐琦

作者单位： 华中科技大学

项目金额： 34万元

中文摘要： 临床实验证实，脊髓硬膜外电刺激（ESCS）具有提高脊髓损伤康复后行走能力和调节运动能量代谢的功能，但其确切机制以及如何选择最佳刺激参数，目前尚不清楚。本研究构建ESCS和减重训练的组合新疗法用于控制不完全脊髓损伤（ISCI）后行走功能康复的动物实验研究平台并进行了动物实验，主要内容包括：开发了先进的全植入ESCS刺激系统，包括体内ESCS电极、多通道可编程ESCS刺激器和体外控制器，具有经皮无线供能和信息传输功能；开发了多功能动物减重训练跑台及其控制系统；开发了采用植入电极的EMG信号记录与分析系统；建立了基于视频的实验动物运动分析系统；利用改良allens打击法建立大鼠急性ISCI模型，完成ESCS 系统以及EMG记录电极的外科手术植入；融合运动视频和EMG信号对ISCI大鼠后肢进行运动功能评价，进而得到控制ISCI后运动功能康复的有效ESCS参数。上述结果不仅为医学研究提供了先进的实验手段，而且通过动物实验验证了ESCS临床疗效的可重复性，对于提高脊髓损伤患者的康复效率具有重要价值，促进了工程技术与医学研究的互动。

中文关键词： 脊髓硬膜外电刺激；脊髓损伤；行走功能康复；植入式器件；控制

英文摘要： The clinical research indicates that the epidural spinal cord stimulation (ESCS) can facilitate the locomotion performance of the patients with spinal cord injury (SCI) and modulate the energy metabolism during movement. However, it is unclear about the corresponding neural mechanism and how to select the optimal stimulation parameters. This project has built an animal experimental platform for the mechanism research on the combination therapy of ESCS and partial weight support training for the locomotion rehabilitation after incomplete spinal cord injury (ISCI). Furthermore, the animal experiments has been done to investigate the neural mechanism on the rehabilitation of motor dysfunction.The issues have addressed as follows. Firstly, a fully implantable ESCS system has been developed with transcutanuously wireless power transfer and information transmission. The stimulating system consists of an implanted electrode and a implanted multichannel programmable stimulator and an external controller. Secondly, a multifunctional treadmill for the animal training with partial weight bearing therapy has been developed. Thirdly, the electromyogram (EMG) signals detection and analysis system with an implantable recording electrode has been presented. Also, a video-based motion analysis system has been designed. Fourthly, Allen’ weight dropping has been used to make a rat model of acute imcomplete spinal cord injury (ISCI). After the developed ESCS system and the EMG recording electrode are implanted, the motor performance has been evaluated by fusing the motion video and EMG recording. AS a result, the effective ESCS parameters has been obtained for the improvement of the ambulation rehabilitation. These works have not only provided advanced experiment tools for medical researches, but also demonstrated the repeatable ESCS modulation and neural mechanism on locomotion performance after ISCI in acute animal experiments. This investigation is significant for the rehabilitation of SCI patients. Furthermore, the interdisciplinary research of engineering and rehabilitation medicine can be accelerated to a great extent.

英文关键词： Epidural spinal cord stimulation; Spinal cord injury; Ambulation rehabilitation; Implantable device; Control