Recovery of motor function after paralysis by activity-dependent neuromodulation
2022
Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland(1)
Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland(2)
Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland(2)
Epidural electrical stimulation (EES), which targets the dorsal nerve roots of the lumbosacral segments, allows people with spinal cord injuries (SCI) to walk again. However, EES is performed with multielectrode paddle leads that were originally designed for the dorsal column of the spinal cord. In this study, it was hypothesized that an array of electrodes targeting the system of dorsal nerve roots involved in leg and trunk movements would result in better efficacy and restore a greater variety of motor activities after the most severe damage. To test this, a computerized system was developed to determine the optimal placement of electrodes on a new paddle lead and to guide neurosurgical positioning. Software assisted in the rapid configuration of activity-specific stimulation programs that reproduced the natural activation of motor neurons underlying each activity. As part of an ongoing clinical trial, these neurotechnologies were tested in three individuals with complete sensorimotor paralysis. Here, the activity-specific stimulation programs enabled the patients to stand, walk, bike, swim, and control trunk movements within one day. Accordingly, the method developed here resulted in sufficient improvement in activities, supporting people with SCI in their daily mobility.
Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis
Jocelyne Bloch(1), Grégoire Courtine(2)
Added on: 09-12-2022
[1] https://www.nature.com/articles/s41591-021-01663-5
