Neuroprosthetic baroreflex controls haemodynamics after spinal cord injury.

Details

Serval ID
serval:BIB_7E16A50CBFB9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Neuroprosthetic baroreflex controls haemodynamics after spinal cord injury.
Journal
Nature
Author(s)
Squair J.W., Gautier M., Mahe L., Soriano J.E., Rowald A., Bichat A., Cho N., Anderson M.A., James N.D., Gandar J., Incognito A.V., Schiavone G., Sarafis Z.K., Laskaratos A., Bartholdi K., Demesmaeker R., Komi S., Moerman C., Vaseghi B., Scott B., Rosentreter R., Kathe C., Ravier J., McCracken L., Kang X., Vachicouras N., Fallegger F., Jelescu I., Cheng Y., Li Q., Buschman R., Buse N., Denison T., Dukelow S., Charbonneau R., Rigby I., Boyd S.K., Millar P.J., Moraud E.M., Capogrosso M., Wagner F.B., Barraud Q., Bezard E., Lacour S.P., Bloch J., Courtine G., Phillips A.A.
ISSN
1476-4687 (Electronic)
ISSN-L
0028-0836
Publication state
Published
Issued date
02/2021
Peer-reviewed
Oui
Volume
590
Number
7845
Pages
308-314
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Spinal cord injury (SCI) induces haemodynamic instability that threatens survival <sup>1-3</sup> , impairs neurological recovery <sup>4,5</sup> , increases the risk of cardiovascular disease <sup>6,7</sup> , and reduces quality of life <sup>8,9</sup> . Haemodynamic instability in this context is due to the interruption of supraspinal efferent commands to sympathetic circuits located in the spinal cord <sup>10</sup> , which prevents the natural baroreflex from controlling these circuits to adjust peripheral vascular resistance. Epidural electrical stimulation (EES) of the spinal cord has been shown to compensate for interrupted supraspinal commands to motor circuits below the injury <sup>11</sup> , and restored walking after paralysis <sup>12</sup> . Here, we leveraged these concepts to develop EES protocols that restored haemodynamic stability after SCI. We established a preclinical model that enabled us to dissect the topology and dynamics of the sympathetic circuits, and to understand how EES can engage these circuits. We incorporated these spatial and temporal features into stimulation protocols to conceive a clinical-grade biomimetic haemodynamic regulator that operates in a closed loop. This 'neuroprosthetic baroreflex' controlled haemodynamics for extended periods of time in rodents, non-human primates and humans, after both acute and chronic SCI. We will now conduct clinical trials to turn the neuroprosthetic baroreflex into a commonly available therapy for people with SCI.
Pubmed
Web of science
Create date
09/02/2021 16:30
Last modification date
08/07/2021 6:37
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