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Shukla PD, Burke JF, Kunwar N, Presbrey K, Balakid J, Yaroshinsky M, Louie K, Jacques L, Shirvalkar P, Wang DD. Human Cervical Epidural Spinal Electrogram Topographically Maps Distinct Volitional Movements. J Neurosci 2024; 44:e2258232024. [PMID: 38960719 PMCID: PMC11308355 DOI: 10.1523/jneurosci.2258-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/22/2024] [Accepted: 06/06/2024] [Indexed: 07/05/2024] Open
Abstract
Little is known about the electrophysiologic activity of the intact human spinal cord during volitional movement. We analyzed epidural spinal recordings from a total of five human subjects of both sexes during a variety of upper extremity movements and found that these spinal epidural electrograms contain spectral information distinguishing periods of movement, rest, and sensation. Cervical epidural electrograms also contained spectral changes time-locked with movement. We found that these changes were primarily associated with increased power in the theta (4-8 Hz) band and feature increased theta phase to gamma amplitude coupling, and this increase in theta power can be used to topographically map distinct upper extremity movements onto the cervical spinal cord in accordance with established myotome maps of the upper extremity. Our findings have implications for the development of neurostimulation protocols and devices focused on motor rehabilitation for the upper extremity, and the approach presented here may facilitate spatiotemporal mapping of naturalistic movements.
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Affiliation(s)
- Poojan D Shukla
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California 94143
| | - John F Burke
- Department of Neurosurgery, University of Oklahoma, Oklahoma City, Oklahoma 73104
| | - Nikhita Kunwar
- School of Medicine, University of California San Diego, San Diego, California 92093
| | - Kara Presbrey
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California 94143
| | - Jannine Balakid
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California 94143
| | - Maria Yaroshinsky
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California 94143
| | - Kenneth Louie
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California 94143
| | - Line Jacques
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California 94143
| | - Prasad Shirvalkar
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California 94143
- Department of Anesthesia and Pain Management, University of California, San Francisco, California 94143
- Department of Neurology, University of California, San Francisco, San Francisco, California 94143
| | - Doris D Wang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California 94143
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Rejc E, Zaccaron S, Bowersock C, Pisolkar T, Ugiliweneza B, Forrest GF, Agrawal S, Harkema SJ, Angeli CA. Effects of Robotic Postural Stand Training with Epidural Stimulation on Sitting Postural Control in Individuals with Spinal Cord Injury: A Pilot Study. J Clin Med 2024; 13:4309. [PMID: 39124576 PMCID: PMC11313204 DOI: 10.3390/jcm13154309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/18/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024] Open
Abstract
(1) Background. High-level spinal cord injury (SCI) disrupts trunk control, leading to an impaired performance of upright postural tasks in sitting and standing. We previously showed that a novel robotic postural stand training with spinal cord epidural stimulation targeted at facilitating standing (Stand-scES) largely improved standing trunk control in individuals with high-level motor complete SCI. Here, we aimed at assessing the effects of robotic postural stand training with Stand-scES on sitting postural control in the same population. (2) Methods. Individuals with cervical (n = 5) or high-thoracic (n = 1) motor complete SCI underwent approximately 80 sessions (1 h/day; 5 days/week) of robotic postural stand training with Stand-scES, which was performed with free hands (i.e., without using handlebars) and included periods of standing with steady trunk control, self-initiated trunk and arm movements, and trunk perturbations. Sitting postural control was assessed on a standard therapy mat, with and without scES targeted at facilitating sitting (Sit-scES), before and after robotic postural stand training. Independent sit time and trunk center of mass (CM) displacement were assessed during a 5 min time window to evaluate steady sitting control. Self-initiated antero-posterior and medial-lateral trunk movements were also attempted from a sitting position, with the goal of covering the largest distance in the respective cardinal directions. Finally, the four Neuromuscular Recovery Scale items focused on sitting trunk control (Sit, Sit-up, Trunk extension in sitting, Reverse sit-up) were assessed. (3) Results. In summary, neither statistically significant differences nor large Effect Size were promoted by robotic postural stand training for the sitting outcomes considered for analysis. (4) Conclusions. The findings of the present study, together with previous observations, may suggest that robotic postural stand training with Stand-scES promoted trunk motor learning that was posture- and/or task-specific and, by itself, was not sufficient to significantly impact sitting postural control.
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Affiliation(s)
- Enrico Rejc
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ 07052, USA; (G.F.F.); (C.A.A.)
- Department of Medicine, University of Udine, P.le Kolbe 4, 33100 Udine (UD), Italy;
- Kentucky Spinal Cord Injury Research Center, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA; (C.B.); (T.P.); (B.U.); (S.J.H.)
| | - Simone Zaccaron
- Department of Medicine, University of Udine, P.le Kolbe 4, 33100 Udine (UD), Italy;
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Collin Bowersock
- Kentucky Spinal Cord Injury Research Center, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA; (C.B.); (T.P.); (B.U.); (S.J.H.)
- Biomechatronics Lab, Department of Mechanical Engineering, Northern Arizona University, S San Francisco St, Flagstaff, AZ 86011, USA
| | - Tanvi Pisolkar
- Kentucky Spinal Cord Injury Research Center, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA; (C.B.); (T.P.); (B.U.); (S.J.H.)
| | - Beatrice Ugiliweneza
- Kentucky Spinal Cord Injury Research Center, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA; (C.B.); (T.P.); (B.U.); (S.J.H.)
- Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA
| | - Gail F. Forrest
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ 07052, USA; (G.F.F.); (C.A.A.)
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ 07103, USA
| | - Sunil Agrawal
- Department of Mechanical Engineering, Columbia University, 220 S. W. Mudd Building, 500 West 120th Street, New York, NY 10027, USA;
- Department of Rehabilitation and Regenerative Medicine, Columbia University, New York, NY 10032, USA
| | - Susan J. Harkema
- Kentucky Spinal Cord Injury Research Center, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA; (C.B.); (T.P.); (B.U.); (S.J.H.)
- Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA
| | - Claudia A. Angeli
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ 07052, USA; (G.F.F.); (C.A.A.)
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Song D, Tresch MC. Prediction of isometric forces from combined epidural spinal cord and neuromuscular electrical stimulation in the rat lower limb. Sci Rep 2024; 14:15871. [PMID: 38982137 PMCID: PMC11233659 DOI: 10.1038/s41598-024-66773-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 07/03/2024] [Indexed: 07/11/2024] Open
Abstract
Although epidural spinal cord and muscle stimulation have each been separately used for restoration of movement after spinal cord injury, their combined use has not been widely explored. Using both approaches in combination could provide more flexible control compared to using either approach alone, but whether responses evoked from such combined stimulation can be easily predicted is unknown. We evaluate whether responses evoked by combined spinal and muscle stimulation can be predicted simply, as the linear summation of responses produced by each type of stimulation individually. Should this be true, it would simplify the prediction of co-stimulation responses and the development of control schemes for spinal cord injury rehabilitation. In healthy anesthetized rats, we measured hindlimb isometric forces in response to spinal and muscle stimulation. Force prediction errors were calculated as the difference between predicted and observed co-stimulation forces. We found that spinal and muscle co-stimulation could be closely predicted as the linear summation of the individual spinal and muscle responses and that the errors were relatively low. We discuss the implications of these results to the use of combined muscle and spinal stimulation for the restoration of movement following spinal cord injury.
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Affiliation(s)
- Daniel Song
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, 60611, USA.
| | - Matthew C Tresch
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, 60611, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, 60611, USA
- Shirley Ryan AbilityLab, Chicago, IL, 60611, USA
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Alazzam AM, Ballance WB, Smith AC, Rejc E, Weber KA, Trainer R, Gorgey AS. Peak Slope Ratio of the Recruitment Curves Compared to Muscle Evoked Potentials to Optimize Standing Configurations with Percutaneous Epidural Stimulation after Spinal Cord Injury. J Clin Med 2024; 13:1344. [PMID: 38592158 PMCID: PMC10932170 DOI: 10.3390/jcm13051344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Percutaneous spinal cord epidural stimulation (pSCES) has effectively restored varying levels of motor control in persons with motor complete spinal cord injury (SCI). Studying and standardizing the pSCES configurations may yield specific motor improvements. Previously, reliance on the amplitude of the SCES-evoked potentials (EPs) was used to determine the correct stimulation configurations. Methods: We, hereby, retrospectively examined the effects of wide and narrow-field configurations on establishing the motor recruitment curves of motor units of three different agonist-antagonist muscle groups. Magnetic resonance imaging was also used to individualize SCI participants (n = 4) according to their lesion characteristics. The slope of the recruitment curves using a six-degree polynomial function was calculated to derive the slope ratio for the agonist-antagonist muscle groups responsible for standing. Results: Axial damage ratios of the spinal cord ranged from 0.80 to 0.92, indicating at least some level of supraspinal connectivity for all participants. Despite the close range of these ratios, standing motor performance was enhanced using different stimulation configurations in the four persons with SCI. A slope ratio of ≥1 was considered for the recommended configurations necessary to achieve standing. The retrospectively identified configurations using the supine slope ratio of the recruitment curves of the motor units agreed with that visually inspected muscle EPs amplitude of the extensor relative to the flexor muscles in two of the four participants. Two participants managed to advance the selected configurations into independent standing performance after using tonic stimulation. The other two participants required different levels of assistance to attain standing performance. Conclusions: The findings suggest that the peak slope ratio of the muscle agonists-antagonists recruitment curves may potentially identify the pSCES configurations necessary to achieve standing in persons with SCI.
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Affiliation(s)
- Ahmad M. Alazzam
- Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, VA 23249, USA; (A.M.A.); (W.B.B.)
| | - William B. Ballance
- Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, VA 23249, USA; (A.M.A.); (W.B.B.)
| | - Andrew C. Smith
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO 80045, USA;
| | - Enrico Rejc
- Department of Medicine, University of Udine, 33100 Udine, Italy;
| | - Kenneth A. Weber
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA;
| | - Robert Trainer
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23284, USA;
- Physical Medicine and Rehabilitation, Richmond VA Medical Center, Richmond, VA 23249, USA
| | - Ashraf S. Gorgey
- Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, VA 23249, USA; (A.M.A.); (W.B.B.)
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23284, USA;
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Miller T, Hosseinzadeh A, Thordarson T, Kalimullina T, Samejima S, Shackleton C, Malik R, Calderón-Juárez M, Sachdeva R, Krassioukov A. Web-Based Information on Spinal Cord Stimulation: Qualitative Assessment of Publicly Accessible Online Resources. JMIR Public Health Surveill 2024; 10:e50031. [PMID: 38393781 PMCID: PMC10924266 DOI: 10.2196/50031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 12/26/2023] [Accepted: 01/08/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Despite the growing accessibility of web-based information related to spinal cord stimulation (SCS), the content and quality of commonly encountered websites remain unknown. OBJECTIVE This study aimed to assess the content and quality of web-based information on SCS. METHODS This qualitative study was prospectively registered in Open Science Framework. Google Trends was used to identify the top trending, SCS-related search queries from 2012 to 2022. Top queried terms were then entered into separate search engines. Information found on websites within the first 2 pages of results was extracted and assessed for quality using the DISCERN instrument, the Journal of the American Medical Association benchmark criteria, and the Health on the Net Foundation code of conduct certification. Website readability and SCS-related information were also assessed. RESULTS After exclusions, 42 unique sites were identified (scientific resources: n=6, nonprofit: n=12, for-profit: n=20, news or media: n=2, and personal or blog: n=2). Overall, information quality was moderate (DISCERN). Few sites met all the Journal of the American Medical Association benchmark criteria (n=3, 7%) or had Health on the Net Foundation certification (n=7, 16%). On average, information was difficult to read, requiring a 9th- to 10th-grade level of reading comprehension. Sites described SCS subcategories (n=14, 33%), indications (n=38, 90%), contraindications (n=14, 33%), side effects or risks (n=28, 66%), device considerations (n=25, 59%), follow-up (n=22, 52%), expected outcomes (n=31, 73%), provided authorship details (n=20, 47%), and publication dates (n=19, 45%). The proportion of for-profit sites reporting authorship information was comparatively less than other site types (n=3, 15%). Almost all sites focused on surgically implanted SCS (n=37, 88%). On average, nonprofit sites contained the greatest number of peer-reviewed reference citations (n=6, 50%). For-profit sites showed the highest proportion of physician or clinical referrals among site types (n=17, 85%) indicating implicit bias (ie, auto-referral). CONCLUSIONS Overall, our findings suggest the public may be exposed to incomplete or dated information from unidentifiable sources that could put consumers and patient groups at risk.
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Affiliation(s)
- Tiev Miller
- International Collaboration on Repair Discoveries, The University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Ali Hosseinzadeh
- International Collaboration on Repair Discoveries, The University of British Columbia, Vancouver, BC, Canada
| | - Thomas Thordarson
- International Collaboration on Repair Discoveries, The University of British Columbia, Vancouver, BC, Canada
| | - Tamila Kalimullina
- International Collaboration on Repair Discoveries, The University of British Columbia, Vancouver, BC, Canada
| | - Soshi Samejima
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Claire Shackleton
- International Collaboration on Repair Discoveries, The University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Raza Malik
- International Collaboration on Repair Discoveries, The University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Martín Calderón-Juárez
- International Collaboration on Repair Discoveries, The University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Rahul Sachdeva
- International Collaboration on Repair Discoveries, The University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Andrei Krassioukov
- International Collaboration on Repair Discoveries, The University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
- Spinal Cord Program, GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
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Pedrocchiguest A, Guanziroli E. Guest Editorial Special Section on Functional Recovery and Brain Plasticity. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2024; 4:275-277. [PMID: 38196974 PMCID: PMC10776091 DOI: 10.1109/ojemb.2023.3339954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024] Open
Abstract
The aim of rehabilitation after neurological damage is functional recovery, which includes motor, sensory, and cognitive aspects, which are closely interrelated [22].
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Affiliation(s)
- Alessandra Pedrocchiguest
- NEARLAB, Neuroengineering and Medical Robotics Laboratory, AND WE-COBOT, Wearable Collaborative Laboratory, Department of Electronics, Information and BioengineeringPolitecnico di MilanoMilanItaly
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Gorgey AS, Venigalla S, Rehman MU, George B, Rejc E, Gouda JJ. Interleaved configurations of percutaneous epidural stimulation enhanced overground stepping in a person with chronic paraplegia. Front Neurosci 2023; 17:1284581. [PMID: 38144208 PMCID: PMC10740173 DOI: 10.3389/fnins.2023.1284581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023] Open
Abstract
Descending motor signals are disrupted after complete spinal cord injury (SCI) resulting in loss of standing and walking. We previously restored standing and trunk control in a person with a T3 complete SCI following implantation of percutaneous spinal cord epidural stimulation (SCES). We, hereby, present a step-by-step procedure on configuring the SCES leads to initiate rhythmic lower limb activation (rhythmic-SCES) resulting in independent overground stepping in parallel bars and using a standard walker. Initially, SCES was examined in supine lying at 2 Hz before initiating stepping-like activity in parallel bars using 20 or 30 Hz; however, single lead configuration (+2, -5) resulted in lower limb adduction and crossing of limbs, impairing the initiation of overground stepping. After 6 months, interleaving the original rhythmic-SCES with an additional configuration (-12, +15) on the opposite lead, resulted in a decrease of the extensive adduction tone and allowed the participant to initiate overground stepping up to 16 consecutive steps. The current paradigm suggests that interleaving two rhythmic-SCES configurations may improve the excitability of the spinal circuitry to better interpret the residual descending supraspinal signals with the ascending proprioceptive inputs, resulting in a stepping-like motor behavior after complete SCI.
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Affiliation(s)
- Ashraf S. Gorgey
- Spinal Cord Injury and Disorders, Richmond VA Medical Center, Richmond, VA, United States
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, United States
| | - Siddharth Venigalla
- Spinal Cord Injury and Disorders, Richmond VA Medical Center, Richmond, VA, United States
| | - Muhammad Uzair Rehman
- Spinal Cord Injury and Disorders, Richmond VA Medical Center, Richmond, VA, United States
| | - Botros George
- ELAGI Center for Physical Therapy and Rehabilitation, Giza, Egypt
| | - Enrico Rejc
- Department of Medicine, University of Udine, Udine, Italy
| | - Jan J. Gouda
- Neurosurgery Department, Louran Hospital, Alexandria, Egypt
- Department of Surgery, Wright State University, Dayton, OH, United States
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Guo XJ, Zhao Z, Chang JQ, He LW, Su WN, Feng T, Zhao C, Xu M, Rao JS. Epidural combined optical and electrical stimulation induces high-specificity activation of target muscles in spinal cord injured rats. Front Neurosci 2023; 17:1282558. [PMID: 38027482 PMCID: PMC10667474 DOI: 10.3389/fnins.2023.1282558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Epidural electrical stimulation (EES) has been shown to improve motor dysfunction after spinal cord injury (SCI) by activating residual locomotor neural networks. However, the stimulation current often spreads excessively, leading to activation of non-target muscles and reducing the accuracy of stimulation regulation. Objectives Near-infrared nerve stimulation (nINS) was combined with EES to explore its regulatory effect on lower limb muscle activity in spinal-cord-transected rats. Methods In this study, stimulation electrodes were implanted into the rats' L3-L6 spinal cord segment with T8 cord transected. Firstly, a series of EES parameters (0.2-0.6 mA and 20-60 Hz) were tested to determine those that specifically regulate the tibialis anterior (TA) and medial gastrocnemius (MG). Subsequently, to determine the effect of combined optical and electrical stimulation, near-infrared laser with a wavelength of 808 nm was used to irradiate the L3-L6 spinal cord segment while EES was performed. The amplitude of electromyography (EMG), the specific activation intensity of the target muscle, and the minimum stimulus current intensity to induce joint movement (motor threshold) under a series of optical stimulation parameters (power: 0.0-2.0 W; pulse width: 0-10 ms) were investigated and analyzed. Results EES stimulation with 40 Hz at the L3 and L6 spinal cord segments specifically activated TA and MG, respectively. High stimulation intensity (>2 × motor threshold) activated non-target muscles, while low stimulation frequency (<20 Hz) produced intermittent contraction. Compared to electrical stimulation alone (0.577 ± 0.081 mV), the combined stimulation strategy could induce stronger EMG amplitude of MG (1.426 ± 0.365 mV) after spinal cord injury (p < 0.01). The combined application of nINS effectively decreased the EES-induced motor threshold of MG (from 0.237 ± 0.001 mA to 0.166 ± 0.028 mA, p < 0.001). Additionally, the pulse width (PW) of nINS had a slight impact on the regulation of muscle activity. The EMG amplitude of MG only increased by ~70% (from 3.978 ± 0.240 mV to 6.753 ± 0.263 mV) when the PW increased by 10-fold (from 1 to 10 ms). Conclusion The study demonstrates the feasibility of epidural combined electrical and optical stimulation for highly specific regulation of muscle activity after SCI, and provides a new strategy for improving motor dysfunction caused by SCI.
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Affiliation(s)
- Xiao-Jun Guo
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Ziyi Zhao
- Department of Orthopedics, The First Medical Center of PLA General Hospital, Beijing, China
| | - Jia-Qi Chang
- Smart Fluid Equipment and Manufacture Lab, School of Automation Science and Electrical Engineering, Beihang Univeristy, Beijing, China
| | - Le-Wei He
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Wen-Nan Su
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Ting Feng
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Can Zhao
- Institute of Rehabilitation Engineering, China Rehabilitation Science Institute, Beijing, China
| | - Meng Xu
- Department of Orthopedics, The First Medical Center of PLA General Hospital, Beijing, China
| | - Jia-Sheng Rao
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
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