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

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Serval ID
serval:BIB_06D7E96E24FC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Spatiotemporal neuromodulation therapies engaging muscle synergies improve motor control after spinal cord injury.
Journal
Nature Medicine
Author(s)
Wenger N., Moraud E.M., Gandar J., Musienko P., Capogrosso M., Baud L., Le Goff C.G., Barraud Q., Pavlova N., Dominici N., Minev I.R., Asboth L., Hirsch A., Duis S., Kreider J., Mortera A., Haverbeck O., Kraus S., Schmitz F., DiGiovanna J., van den Brand R., Bloch J., Detemple P., Lacour S.P., Bézard E., Micera S., Courtine G.
ISSN
1546-170X (Electronic)
ISSN-L
1078-8956
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
22
Number
2
Pages
138-145
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
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.
Keywords
Animals, Biomechanical Phenomena, Computer Simulation, Evoked Potentials, Motor/physiology, Feedback, Sensory/physiology, Female, Hindlimb/innervation, Hindlimb/physiopathology, Kinetics, Locomotion/physiology, Motor Neurons/physiology, Muscle, Skeletal/innervation, Muscle, Skeletal/physiopathology, Rats, Rats, Inbred Lew, Spinal Cord/physiology, Spinal Cord Injuries/pathology, Spinal Cord Injuries/physiopathology, Spinal Cord Stimulation, Spinal Nerve Roots/physiopathology, Time Factors, X-Ray Microtomography
Pubmed
Web of science
Create date
01/03/2016 18:39
Last modification date
30/04/2021 7:08
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