Targeted neurotechnology restores walking in humans with spinal cord injury.
Détails
ID Serval
serval:BIB_E3C65AD949FE
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Targeted neurotechnology restores walking in humans with spinal cord injury.
Périodique
Nature
ISSN
1476-4687 (Electronic)
ISSN-L
0028-0836
Statut éditorial
Publié
Date de publication
11/2018
Peer-reviewed
Oui
Volume
563
Numéro
7729
Pages
65-71
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
Spinal cord injury leads to severe locomotor deficits or even complete leg paralysis. Here we introduce targeted spinal cord stimulation neurotechnologies that enabled voluntary control of walking in individuals who had sustained a spinal cord injury more than four years ago and presented with permanent motor deficits or complete paralysis despite extensive rehabilitation. Using an implanted pulse generator with real-time triggering capabilities, we delivered trains of spatially selective stimulation to the lumbosacral spinal cord with timing that coincided with the intended movement. Within one week, this spatiotemporal stimulation had re-established adaptive control of paralysed muscles during overground walking. Locomotor performance improved during rehabilitation. After a few months, participants regained voluntary control over previously paralysed muscles without stimulation and could walk or cycle in ecological settings during spatiotemporal stimulation. These results establish a technological framework for improving neurological recovery and supporting the activities of daily living after spinal cord injury.
Mots-clé
Activities of Daily Living, Biomedical Technology, Computer Simulation, Electric Stimulation Therapy, Electromyography, Epidural Space, Humans, Leg/innervation, Leg/physiology, Leg/physiopathology, Locomotion/physiology, Male, Motor Neurons/physiology, Muscle, Skeletal/innervation, Muscle, Skeletal/physiology, Muscle, Skeletal/physiopathology, Paralysis/physiopathology, Paralysis/rehabilitation, Paralysis/surgery, Spinal Cord/cytology, Spinal Cord/physiology, Spinal Cord/physiopathology, Spinal Cord Injuries/physiopathology, Spinal Cord Injuries/rehabilitation, Spinal Cord Injuries/surgery, Walking/physiology
Pubmed
Web of science
Création de la notice
07/11/2018 12:37
Dernière modification de la notice
20/08/2019 16:07