Electrical spinal cord stimulation must preserve proprioception to enable locomotion in humans with spinal cord injury.

Détails

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Etat: Public
Version: Author's accepted manuscript
Licence: Non spécifiée
ID Serval
serval:BIB_F80544F3A538
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Electrical spinal cord stimulation must preserve proprioception to enable locomotion in humans with spinal cord injury.
Périodique
Nature neuroscience
Auteur(s)
Formento E., Minassian K., Wagner F., Mignardot J.B., Le Goff-Mignardot C.G., Rowald A., Bloch J., Micera S., Capogrosso M., Courtine G.
ISSN
1546-1726 (Electronic)
ISSN-L
1097-6256
Statut éditorial
Publié
Date de publication
12/2018
Peer-reviewed
Oui
Volume
21
Numéro
12
Pages
1728-1741
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
Epidural electrical stimulation (EES) of the spinal cord restores locomotion in animal models of spinal cord injury but is less effective in humans. Here we hypothesized that this interspecies discrepancy is due to interference between EES and proprioceptive information in humans. Computational simulations and preclinical and clinical experiments reveal that EES blocks a significant amount of proprioceptive input in humans, but not in rats. This transient deafferentation prevents modulation of reciprocal inhibitory networks involved in locomotion and reduces or abolishes the conscious perception of leg position. Consequently, continuous EES can only facilitate locomotion within a narrow range of stimulation parameters and is unable to provide meaningful locomotor improvements in humans without rehabilitation. Simulations showed that burst stimulation and spatiotemporal stimulation profiles mitigate the cancellation of proprioceptive information, enabling robust control over motor neuron activity. This demonstrates the importance of stimulation protocols that preserve proprioceptive information to facilitate walking with EES.
Mots-clé
Animals, Biomechanical Phenomena/physiology, Computer Simulation, Feedback, Physiological/physiology, Female, Humans, Locomotion/physiology, Models, Biological, Muscle, Skeletal/physiopathology, Proprioception/physiology, Rats, Spinal Cord/physiopathology, Spinal Cord Injuries/physiopathology, Spinal Cord Injuries/therapy, Spinal Cord Stimulation/methods, Walking/physiology
Pubmed
Web of science
Création de la notice
07/11/2018 12:07
Dernière modification de la notice
30/04/2021 6:16
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