临床实验证实硬脊膜外脊髓电刺激(ESCS)与减重步态疗法(PWBT)相结合,能明显提高患者脊髓损伤康复后的行走能力,对运动能量代谢产生显著影响,但相应的神经与生理机制目前尚不清楚。本研究开发研制一种小型低功耗的先进ESCS刺激仪,为ESCS机理的实验研究提供所需的刺激模式。基于印刷电路板工艺,采用聚酰亚胺对银电极触点进行绝缘封装,改进电极的设计。进行ESCS刺激仪性能的动物实验验证,改变电压幅值、频率和波宽等刺激参数,观察实验猫肌肉的抽搐情况。实验结果表明:所研制的小型低功耗ESCS刺激器能提供所需的多通道多模式刺激信号,电池供电和低功耗设计可提供使用安全性,ESCS电极满足柔韧性和生物兼容性要求,可为ESCS和PWBT组合疗法的机理研究提供先进实验手段。
Clinical research indicates that the combination of epidural spinal-cord stimulation (ESCS, T10-T12 vertebral levels) and partial weight bearing treadmill therapy (PWBT) can result in further improvement of the locomotion performance of the subjects with incomplete spinal cord injury (ISCl). The underlying neural and physiological mechanism of ESCS is remained undiscovered, The epidural spinal cord stimulator proposed in this paper was used to provide the versatile stimulation pattern for the ESCS experimental research. The advanced ESCS stimulator with small size and low power consumption was developed. Secondly the ESCS electrode consists of the silver contacts and the Polyimide substrate, manufactured by the flexible circuit board technique. During the animal experiments the stimulation intensity increases step by step and the induced muscle twitches synchronized with the ESCS is used for the effectiveness of stimulation. ESCS stimulator with small size and low power consumption could provide a versatile muhichannel output. With the battery power the ESCS stimulator could assure an intrinsic safety for the subjects, On the other hand, flexible muhicontact ESCS electrodes hold the necessary strength and biocompatibility. After testing a wide range of parameters, it was indicated that ESCS with larger voltage resulted in more significant muscle twitch, At a given voltage, the increase of pulse width and pulse rate could not enhance the effectiveness of stimulation. The stimulator for ESCS with small size provided necessary stimulation signal. Moreover, the operation of the apparatus is convenient. The battery power can ensure the safety of the experimental cats. In conclusion, the proposed stimulator can lay the apparatus foundation of the mechanism research of the combination of ESCS and PWBT.