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

@article{Rowald2022ActivitydependentSC,
  title={Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis.},
  author={Andreas Rowald and Salif Komi and Robin Demesmaeker and Edeny Baaklini and Sergio D. Hernandez-Charpak and Edoardo Paoles and Hazael Montanaro and Antonino Mario Cassar{\`a} and Fabio Becce and Bryn A. Lloyd and Taylor Newton and Jimmy Ravier and Nawal Kinany and Marina D'Ercole and Aur{\'e}lie Paley and Nicolas Hankov and Camille Varescon and Laura A. McCracken and Molywan Vat and Miroslav Caban and Anne Watrin and Charlotte Jacquet and L{\'e}a Bole-Feysot and Cathal Harte and Henri Lorach and Andrea G{\'a}lvez and Manon Tschopp and Natacha Herrmann and Mo{\"i}ra Wacker and Lionel Geernaert and Isabelle Fodor and Valentin Radevich and Katrien Van Den Keybus and Gr{\'e}goire Eberle and Etienne Pralong and Maxime Roulet and J. B. Ledoux and Eleonora Fornari and Stefano Mandija and Loan Mattera and Roberto Martuzzi and Bruno Nazarian and Stefan Benkler and Simone Callegari and Nathan Greiner and Benjamin Fuhrer and M. Froeling and Nik Buse and Tim Denison and Rik Buschman and Christian Wende and Damien Ganty and J. Wangand A. Bakker and Vincent Delattre and Hendrik Lambert and Karen Minassian and Cornelis A. T. van den Berg and Anne Kavounoudias and Silvestro Micera and Dimitri Van de Ville and Quentin Barraud and Erkan Kurt and Niels Kuster and Esra Neufeld and Marco Capogrosso and Leonie Asboth and Fabien B. Wagner and Jocelyne Bloch and Gr{\'e}goire Courtine},
  journal={Nature medicine},
  year={2022}
}
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… 

The Impact of Spinal Cord Neuromodulation on Restoration of Walking Ability After Spinal Cord Injury

TLDR
A multinational multidisciplinary team led by Swiss neuroscientist Gregoire Courtine and neurosurgeon Jocelyne Bloch report the restoration of walking in 3 paraplegic individuals using a unique neuromodulatory approach.

Targeted transcutaneous cervical spinal cord stimulation promotes upper limb recovery in spinal cord and peripheral nerve injury

TLDR
Targeted transcutaneous stimulation of the cervical spinal cord can substantially and rapidly improve volitionally evoked muscle activity and force, even with minimal physical therapy, in two individuals with SCI.

Spatiotemporal Distribution of Electrically Evoked Spinal Compound Action Potentials During Spinal Cord Stimulation.

Epidural stimulation restores muscle synergies by modulating neural drives in participants with motor/sensory complete spinal cord injuries.

TLDR
It is found that SCS restores muscle movements and muscle synergies that are distinct from healthy, able-bodied controls and supporting the neural hypothesis of Muscle synergies.

Spinal cord bioelectronic interfaces: opportunities in neural recording and clinical challenges

TLDR
The vision of bi-directional closed-loop spinal cord bioelectronic bypass interfaces that enable the communication of disrupted sensory signals and restoration of motor function in SCI is established.

Preferential activation of proprioceptive and cutaneous sensory fibers compared to motor fibers during cervical transcutaneous spinal cord stimulation: a computational study

TLDR
These findings suggest high proprioceptive and cutaneous contributions to neural activations during cervical tSCS, which inform the underlying mechanisms of upper-limb functional motor recovery.

Restoration of complex movement in the paralyzed upper limb

TLDR
The range of movements that can be produced with this approach is virtually unlimited, and this system could greatly expand the repertoire of movements available to individuals with high level paralysis.

High-Frequency Stimulation Does Not Improve Comfort of Transcutaneous Spinal Cord Stimulation

TLDR
High-frequency tSCS is equally as comfortable as conventional stimulation at amplitudes required to stimulate spinal dorsal roots, and is less efficient in recruiting neural activity in spinal roots.

References

SHOWING 1-10 OF 75 REFERENCES

Epidural Electrical Stimulation Of The Cervical Dorsal Roots Restores Voluntary Arm Control In Paralyzed Monkeys

TLDR
The neural function of surviving spinal circuits is exploited to restore voluntary arm and hand control in three monkeys with spinal cord injury using spinal cord stimulation, and the efficacy and reliability of the approach hold realistic promises of clinical translation.

Epidural Electrical Stimulation of the Cervical Dorsal Roots Restores Voluntary Upper Limb Control in Paralyzed Monkeys

TLDR
The neural function of surviving spinal circuits is exploited to restore voluntary arm and hand control in three monkeys with spinal cord injury using spinal cord stimulation, and the efficacy and reliability of the approach hold realistic promises of clinical translation.

Targeted neurotechnology restores walking in humans with spinal cord injury

TLDR
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 are introduced.

Recruitment of upper-limb motoneurons with epidural electrical stimulation of the cervical spinal cord

TLDR
It is shown that lateral electrodes produce a segmental recruitment of arm motoneurons mediated by the direct activation of sensory afferents, and that muscle responses to EES are modulated during movement, which can be applied for the development of neurotechnologies designed for the improvement of arm and hand control in humans with quadriplegia.

Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia

TLDR
In a human subject with chronic paraplegia, a combination of epidural electrical stimulation and long-term rehabilitative training have culminated in the first report of unassisted, voluntary independent stepping in a paralyzed individual.

A Brain–Spinal Interface Alleviating Gait Deficits after Spinal Cord Injury in Primates

TLDR
The implantable components integrated in the brain–spine interface have all been approved for investigational applications in similar human research, suggesting a practical translational pathway for proof-of-concept studies in people with spinal cord injury.

Restoring Voluntary Control of Locomotion after Paralyzing Spinal Cord Injury

TLDR
An electrochemical neuroprosthesis and a robotic postural interface designed to encourage supraspinally mediated movements in rats with paralyzing lesions triggered a cortex-dependent recovery that may improve function after similar injuries in humans.

Spatiotemporal neuromodulation therapies engaging muscle synergies improve motor control after spinal cord injury

TLDR
Spatiotemporal neuromodulation therapies improved gait quality, weight-bearing capacity, endurance and skilled locomotion in several rodent models of spinal cord injury and are directly translatable to strategies to improve motor control in humans.
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