학술논문

Spatiotemporal neuromodulation therapies engaging muscle synergies improve motor control after spinal cord injury
Document Type
Report
Source
Nature Medicine. February 1, 2016, p138, 12 p.
Subject
Spinal cord injuries -- Care and treatment -- Physiological aspects
Neural stimulation -- Physiological aspects
Biological sciences
Health
Language
English
ISSN
1078-8956
Abstract
Electrical neuromodulation of lumbar segments improves motor control after spinal cord injury in animal models and humans. However, the physiological principles underlying the effect of this intervention remain poorly understood, which has limited the therapeutic approach to continuous stimulation applied to restricted spinal cord locations. Here we developed stimulation protocols that reproduce the natural dynamics of motoneuron activation during locomotion. For this, we computed the spatiotemporal activation pattern of muscle synergies during locomotion in healthy rats. Computer simulations identified optimal electrode locations to target each synergy through the recruitment of proprioceptive feedback circuits. This framework steered the design of spatially selective spinal implants and real-time control software that modulate extensor and flexor synergies with precise temporal resolution. Spatiotemporal neuromodulation therapies improved gait quality, weight-bearing capacity, endurance and skilled locomotion in several rodent models of spinal cord injury. These new concepts are directly translatable to strategies to improve motor control in humans.
Spinal cord injury (SCI) disrupts communication between supraspinal centers and spinal circuits, which leads to a range of motor disabilities. Neuromodulation strategies provide access to surviving circuits and pathways to [...]