Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis.
Details
Serval ID
serval:BIB_8A46380C5B7D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis.
Journal
Nature medicine
ISSN
1546-170X (Electronic)
ISSN-L
1078-8956
Publication state
Published
Issued date
02/2022
Peer-reviewed
Oui
Volume
28
Number
2
Pages
260-271
Language
english
Notes
Publication types: Clinical Trial ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Epidural electrical stimulation (EES) targeting the dorsal roots of lumbosacral segments restores walking in people with spinal cord injury (SCI). However, EES is delivered with multielectrode paddle leads that were originally designed to target the dorsal column of the spinal cord. Here, we hypothesized that an arrangement of electrodes targeting the ensemble of dorsal roots involved in leg and trunk movements would result in superior efficacy, restoring more diverse motor activities after the most severe SCI. To test this hypothesis, we established a computational framework that informed the optimal arrangement of electrodes on a new paddle lead and guided its neurosurgical positioning. We also developed software supporting the rapid configuration of activity-specific stimulation programs that reproduced the natural activation of motor neurons underlying each activity. We tested these neurotechnologies in three individuals with complete sensorimotor paralysis as part of an ongoing clinical trial ( www.clinicaltrials.gov identifier NCT02936453). Within a single day, activity-specific stimulation programs enabled these three individuals to stand, walk, cycle, swim and control trunk movements. Neurorehabilitation mediated sufficient improvement to restore these activities in community settings, opening a realistic path to support everyday mobility with EES in people with SCI.
Keywords
Humans, Leg, Paralysis/rehabilitation, Spinal Cord/physiology, Spinal Cord Injuries/rehabilitation, Spinal Cord Stimulation, Walking/physiology
Pubmed
Web of science
Create date
12/02/2022 14:38
Last modification date
22/07/2022 5:38