Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis.

Détails

ID Serval
serval:BIB_8A46380C5B7D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis.
Périodique
Nature medicine
Auteur⸱e⸱s
Rowald A., Komi S., Demesmaeker R., Baaklini E., Hernandez-Charpak S.D., Paoles E., Montanaro H., Cassara A., Becce F., Lloyd B., Newton T., Ravier J., Kinany N., D'Ercole M., Paley A., Hankov N., Varescon C., McCracken L., Vat M., Caban M., Watrin A., Jacquet C., Bole-Feysot L., Harte C., Lorach H., Galvez A., Tschopp M., Herrmann N., Wacker M., Geernaert L., Fodor I., Radevich V., Van Den Keybus K., Eberle G., Pralong E., Roulet M., Ledoux J.B., Fornari E., Mandija S., Mattera L., Martuzzi R., Nazarian B., Benkler S., Callegari S., Greiner N., Fuhrer B., Froeling M., Buse N., Denison T., Buschman R., Wende C., Ganty D., Bakker J., Delattre V., Lambert H., Minassian K., van den Berg CAT, Kavounoudias A., Micera S., Van De Ville D., Barraud Q., Kurt E., Kuster N., Neufeld E., Capogrosso M., Asboth L., Wagner F.B., Bloch J., Courtine G.
ISSN
1546-170X (Electronic)
ISSN-L
1078-8956
Statut éditorial
Publié
Date de publication
02/2022
Peer-reviewed
Oui
Volume
28
Numéro
2
Pages
260-271
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article
Publication Status: ppublish
Résumé
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.
Mots-clé
Humans, Leg, Paralysis/rehabilitation, Spinal Cord/physiology, Spinal Cord Injuries/rehabilitation, Spinal Cord Stimulation, Walking/physiology
Pubmed
Web of science
Création de la notice
12/02/2022 15:38
Dernière modification de la notice
22/07/2022 6:38
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