Journal ArticleDOI
Spinal Epidural Stimulation Strategies: Clinical Implications of Locomotor Studies in Spinal Rats.
Prithvi K. Shah,Igor Lavrov +1 more
TLDR
Insight is provided into addressing the translational gap, the design of relevant preclinical experiments are guided, and development of new approaches for motor recovery in patients with complete SCIs are facilitated.Abstract:
Significant advancements in spinal epidural stimulation (ES) strategies to enable volitional motor control in persons with a complete spinal cord injury (SCI) have generated much excitement in the field of neurorehabilitation. Still, an obvious gap lies in the ability of ES to effectively generate a robust locomotor stepping response after a complete SCI in rodents, but not in humans. In order to reveal potential discrepancies between rodent and human studies that account for this void, in this review, we summarize the findings of studies that have utilized ES strategies to enable successful hindlimb stepping in spinal rats. Recent clinical and preclinical evidence indicates that motor training with ES plays a crucial role in tuning spinal neural circuitry to generate meaningful motor output. Concurrently administered pharmacology can also facilitate the circuitry to provide near optimal motor performance in SCI rats. However, as of today, the evidence for pharmacological agents to enhance motor function in persons with complete SCI is insignificant. These and other recent findings discussed in this review provide insight into addressing the translational gap, guide the design of relevant preclinical experiments, and facilitate development of new approaches for motor recovery in patients with complete SCIs.read more
Citations
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Journal ArticleDOI
Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia
Megan L. Gill,Peter J. Grahn,Jonathan S. Calvert,Margaux B. Linde,Igor Lavrov,Igor Lavrov,Jeffrey A. Strommen,Lisa A. Beck,Dimitry G. Sayenko,Dimitry G. Sayenko,Meegan G. Van Straaten,Dina I. Drubach,Daniel D. Veith,Andrew R. Thoreson,Cesar Lopez,Yury Gerasimenko,Yury Gerasimenko,V. Reggie Edgerton,Kendall H. Lee,Kristin D. Zhao +19 more
TL;DR: 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.
Journal ArticleDOI
From cortex to cord: motor circuit plasticity after spinal cord injury
Andrew R. Brown,Marina Martinez +1 more
TL;DR: A perspective on harnessing neuroplasticity with therapeutic interventions to promote functional recovery is concluded, focusing mainly on the hindlimb motor cortex, its corticospinal projections, and the role of spinal mechanisms that support locomotor recovery.
Journal ArticleDOI
The Role of Functional Neuroanatomy of the Lumbar Spinal Cord in Effect of Epidural Stimulation.
Carlos A. Cuellar,Aldo A. Mendez,Riazul Islam,Jonathan S. Calvert,Peter J. Grahn,Bruce E. Knudsen,Tuan Pham,Kendall H. Lee,Igor Lavrov,Igor Lavrov +9 more
TL;DR: The influence of spinal cord anatomy on the effects of epidural stimulation and the role of specific orientation of electrodes on the dorsal surface of the dura mater in relation to the dorsal roots are presented for the first time.
Journal ArticleDOI
Regenerative rehabilitation with conductive biomaterials for spinal cord injury
TL;DR: Current regenerative medicine approaches in clinical trials and the rehabilitation, or neuromodulation, approaches for SCI, are discussed, along with their respective translational limitations, and the translational potential, in a surgical context, of conductive biomaterials as they pertain to SCI.
Journal ArticleDOI
Regenerative rehabilitation with conductive biomaterials for spinal cord injury
TL;DR: In this paper , the translational potential of conductive biomaterials (e.g., conductive polymers, carbon-based materials, metallic nanoparticle based materials) as they pertain to spinal cord injury (SCI) was discussed.
References
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Journal ArticleDOI
Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study
Susan J. Harkema,Susan J. Harkema,Yury Gerasimenko,Jonathan Hodes,Joel W. Burdick,Claudia A. Angeli,Claudia A. Angeli,Yangsheng Chen,Yangsheng Chen,Christie K. Ferreira,Christie K. Ferreira,Andrea Willhite,Andrea Willhite,Enrico Rejc,Robert G. Grossman,V. Reggie Edgerton +15 more
TL;DR: Task-specific training with epidural stimulation might reactivate previously silent spared neural circuits or promote plasticity and could be a viable clinical approach for functional recovery after severe paralysis.
Journal ArticleDOI
Locomotor circuits in the mammalian spinal cord
TL;DR: New advances in understanding the mammalian CPGs are discussed with a focus on experiments that address the overall network structure as well as the identification of CPG neurons.
Journal ArticleDOI
Evidence for a Spinal Central Pattern Generator in Humansa
TL;DR: It is shown that epidural spinal cord stimulation can elicit step‐like EMG activity and locomotor synergies in paraplegic subjects, and that externally controlled sustained electrical stimulation of the spinal cord can replace the tonic drive generated by the brain.
Journal ArticleDOI
Restoring Voluntary Control of Locomotion after Paralyzing Spinal Cord Injury
Rubia van den Brand,Janine Heutschi,Janine Heutschi,Quentin Barraud,Quentin Barraud,Jack DiGiovanna,Kay Bartholdi,Kay Bartholdi,Michèle Huerlimann,Lucia Friedli,Lucia Friedli,Isabel Vollenweider,Isabel Vollenweider,Eduardo Martin Moraud,Simone Duis,Simone Duis,Nadia Dominici,Nadia Dominici,Silvestro Micera,Pavel Musienko,Pavel Musienko,Grégoire Courtine,Grégoire Courtine +22 more
TL;DR: 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.
Journal ArticleDOI
Transformation of nonfunctional spinal circuits into functional states after the loss of brain input.
Grégoire Courtine,Yury Gerasimenko,Rubia van den Brand,Aileen Yew,Pavel Musienko,Hui Zhong,Bingbing Song,Yan Ao,Ronaldo M. Ichiyama,Igor Lavrov,Roland R. Roy,Michael V. Sofroniew,V. Reggie Edgerton +12 more
TL;DR: It is proposed that, in the absence of supraspinal input, spinal locomotion can emerge from a combination of central pattern-generating capability and the ability of these spinal circuits to use sensory afferent input to control stepping.
Related Papers (5)
Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study
Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia
Megan L. Gill,Peter J. Grahn,Jonathan S. Calvert,Margaux B. Linde,Igor Lavrov,Igor Lavrov,Jeffrey A. Strommen,Lisa A. Beck,Dimitry G. Sayenko,Dimitry G. Sayenko,Meegan G. Van Straaten,Dina I. Drubach,Daniel D. Veith,Andrew R. Thoreson,Cesar Lopez,Yury Gerasimenko,Yury Gerasimenko,V. Reggie Edgerton,Kendall H. Lee,Kristin D. Zhao +19 more