Aparición de la Estimulación Eléctrica Epidural para Facilitar la Funcionalidad de la Red Sensoriomotora Luego de Daño Espinal.: Publicado originalmente en la Revista Neuromodulation 2019; 22: 244-252. Traducción: Juan Carlos Andreani.

Jonathan S. Calvert; Peter J. Grahn; Kristin D. Zhao; Kendall H. Lee

doi:10.47924/neurotarget202179

Autores/as

Jonathan S. Calvert Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, USA
Peter J. Grahn Department of Neurologic Surgery, Rochester, MN, USA
Kristin D. Zhao Department of Physical Medicine and Rehabilitation, Rehabilitation Medicine Research Center, Rochester, MN, USA.
Kendall H. Lee Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, USA.

DOI:

https://doi.org/10.47924/neurotarget202179

Palabras clave:

Daño Medular Espinal, Estimulación de la Médula Espinal, Estimulación Eléctrica epidural, Neuromodulación, Respuestas Motoras Evocadas

Resumen

Antecedentes: El daño espinal traumático (DET) destruye los caminos de las señales entre el cerebro y las redes espinales por debajo del nivel lesionado. En casos de DET severo, puede ocurrir pérdida permanente de las funciones sensoriomotoras y autonómicas. El estándar de cuidado para DET grave utiliza estrategias de compensación para maximizar la independencia durante las actividades de la vida diaria mientras se vive con esas disfunciones crónicas relacionadas con DET. En los últimos años, el campo de investigación de la neuromodulación espinal ha generado resultados prometedores que tienen potencial para permitir la recuperación de funciones a través de la estimulación eléctrica epidural (EEE).
Métodos: Esta revisión proporciona una descripción histórica de los esfuerzos de investigación traslacional que llevaron a la aparición de EEE en la médula espinal para permitir el control intencional de las funciones motoras que se perdieron después de un DET. También destacamos las principales limitaciones asociado con EEE después de DET y proponemos direcciones futuras de investigación de la neuromodulación espinal.
Resultados: Múltiples estudios independientes han demostrado el retorno de la función motora a través de EES en individuos con LME crónica. Estas funciones motoras rehabilitadas incluyen movimiento intencional y controlado de extremidades previamente paralizadas, posición de pie y pasos independientes, mayor fuerza de agarre podal, además, mejoras en la salud cardiovascular, la función respiratoria y asimismo se han informado mejoras de la bioquímica corporal y en la función urológica.
Conclusiones: la EEE promete habilitar funciones que se suponían perdidas permanentemente debido a DET, pero la EEE está actualmente restringida sólo a la investigación científica en humanos con DET y requiere una mayor validación de su seguridad y eficacia antes de su empleo clínico.

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