Significant advancements in spinal epidural stimulation (ES) strategies to enable volitional motor control in persons with a complete spinal cord injury (SCI) have generated much excitement in the field of neurorehabilitation. Still, an obvious gap lies in the ability of ES to effectively generate a robust locomotor stepping response after a complete SCI in rodents, but not in humans. In order to reveal potential discrepancies between rodent and human studies that account for this void, in this review, we summarize the findings of studies that have utilized ES strategies to enable successful hindlimb stepping in spinal rats. Recent clinical and preclinical evidence indicates that motor training with ES plays a crucial role in tuning spinal neural circuitry to generate meaningful motor output. Concurrently administered pharmacology can also facilitate the circuitry to provide near optimal motor performance in SCI rats. However, as of today, the evidence for pharmacological agents to enhance motor function in persons with complete SCI is insignificant. These and other recent findings discussed in this review provide insight into addressing the translational gap, guide the design of relevant preclinical experiments, and facilitate development of new approaches for motor recovery in patients with complete SCIs.

中文翻译：

---

脊髓硬膜外刺激策略：脊髓大鼠运动研究的临床意义。

脊髓硬膜外刺激（ES）策略的显着进步使得能够对完全脊髓损伤（SCI）的人进行自主运动控制，在神经康复领域引起了极大的兴趣。仍然存在明显的差距，那就是ES在啮齿动物中完成SCI后有效产生强大的运动步进反应的能力，但在人类中却没有。为了揭示啮齿类动物和人体研究之间可能存在的差异，在本综述中，我们总结了利用ES策略成功实现后足踩踏大鼠的研究结果。最近的临床和临床前证据表明，ES进行运动训练在调节脊髓神经回路以产生有意义的运动输出中起着至关重要的作用。同时给药的药理学也可以促进电路，以在SCI大鼠中提供接近最佳的运动表现。然而，到目前为止，药理学证据可增强患有完全SCI的人的运动功能的证据还很少。本综述中讨论的这些和其他近期发现提供了对解决翻译缺口的见解，指导了相关的临床前实验的设计，并促进了具有完全SCI的患者运动恢复的新方法的开发。