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Sharma P, Du Y, Singapuri K, Delafraz DM, Shah PK. Novel comprehensive analysis of skilled reaching and grasping behavior in adult rats. J Neurosci Methods 2024; 411:110271. [PMID: 39218256 DOI: 10.1016/j.jneumeth.2024.110271] [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: 06/05/2024] [Revised: 08/19/2024] [Accepted: 08/25/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Reaching and grasping (R&G) in rats is commonly used as an outcome measure to investigate the effectiveness of rehabilitation or treatment strategies to recover forelimb function post spinal cord injury. Kinematic analysis has been limited to the wrist and digit movements. Kinematic profiles of the more proximal body segments that play an equally crucial role in successfully executing the task remain unexplored. Additionally, understanding of different forelimb muscle activity, their interactions, and their correlation with the kinematics of R&G movement is scarce. NEW METHOD In this work, novel methodologies to comprehensively assess and quantify the 3D kinematics of the proximal and distal forelimb joints along with associated muscle activity during R&G movements in adult rats are developed and discussed. RESULTS Our data show that different phases of R&G identified using the novel kinematic and EMG-based approach correlate with the well-established descriptors of R&G stages derived from the Whishaw scoring system. Additionally, the developed methodology allows describing the temporal activity of individual muscles and associated mechanical and physiological properties during different phases of the motor task. COMPARISON WITH EXISTING METHOD(S) R&G phases and their sub-components are identified and quantified using the developed kinematic and EMG-based approach. Importantly, the identified R&G phases closely match the well-established qualitative descriptors of the R&G task proposed by Whishaw and colleagues. CONCLUSIONS The present work provides an in-depth objective analysis of kinematics and EMG activity of R&G behavior, paving the way to a standardized approach to assessing this critical rodent motor function in future studies.
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Affiliation(s)
- Pawan Sharma
- Division of Rehabilitation Sciences, Department of Physical Therapy, School of Health Technology and Management, USA.
| | - Yixuan Du
- Undergraduate Biology, Stony Brook University, Stony Brook, New York 11727, USA
| | - Kripi Singapuri
- Undergraduate Biology, Stony Brook University, Stony Brook, New York 11727, USA
| | | | - Prithvi K Shah
- Division of Rehabilitation Sciences, Department of Physical Therapy, School of Health Technology and Management, USA
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Wang L, Liu S, Zhao W, Li J, Zeng H, Kang S, Sheng X, Wang L, Fan Y, Yin L. Recent Advances in Implantable Neural Interfaces for Multimodal Electrical Neuromodulation. Adv Healthc Mater 2024; 13:e2303316. [PMID: 38323711 DOI: 10.1002/adhm.202303316] [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: 09/29/2023] [Revised: 01/29/2024] [Indexed: 02/08/2024]
Abstract
Electrical neuromodulation plays a pivotal role in enhancing patient outcomes among individuals suffering from neurological disorders. Implantable neural interfaces are vital components of the electrical neuromodulation system to ensure desirable performance; However, conventional devices are limited to a single function and are constructed with bulky and rigid materials, which often leads to mechanical incompatibility with soft tissue and an inability to adapt to the dynamic and complex 3D structures of biological systems. In addition, current implantable neural interfaces utilized in clinical settings primarily rely on wire-based techniques, which are associated with complications such as increased risk of infection, limited positioning options, and movement restrictions. Here, the state-of-art applications of electrical neuromodulation are presented. Material schemes and device structures that can be employed to develop robust and multifunctional neural interfaces, including flexibility, stretchability, biodegradability, self-healing, self-rolling, or morphing are discussed. Furthermore, multimodal wireless neuromodulation techniques, including optoelectronics, mechano-electrics, magnetoelectrics, inductive coupling, and electrochemically based self-powered devices are reviewed. In the end, future perspectives are given.
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Affiliation(s)
- Liu Wang
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100083, P. R. China
| | - Shengnan Liu
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing, 100084, P. R. China
| | - Wentai Zhao
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100083, P. R. China
| | - Jiakun Li
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100083, P. R. China
| | - Haoxuan Zeng
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100083, P. R. China
| | - Shaoyang Kang
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100083, P. R. China
| | - Xing Sheng
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, Institute for Precision Medicine, Laboratory of Flexible Electronics Technology, IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, 100084, China
| | - Lizhen Wang
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100083, P. R. China
| | - Yubo Fan
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100083, P. R. China
| | - Lan Yin
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing, 100084, P. R. China
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3
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Huang Y, Yao K, Zhang Q, Huang X, Chen Z, Zhou Y, Yu X. Bioelectronics for electrical stimulation: materials, devices and biomedical applications. Chem Soc Rev 2024; 53:8632-8712. [PMID: 39132912 DOI: 10.1039/d4cs00413b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Bioelectronics is a hot research topic, yet an important tool, as it facilitates the creation of advanced medical devices that interact with biological systems to effectively diagnose, monitor and treat a broad spectrum of health conditions. Electrical stimulation (ES) is a pivotal technique in bioelectronics, offering a precise, non-pharmacological means to modulate and control biological processes across molecular, cellular, tissue, and organ levels. This method holds the potential to restore or enhance physiological functions compromised by diseases or injuries by integrating sophisticated electrical signals, device interfaces, and designs tailored to specific biological mechanisms. This review explains the mechanisms by which ES influences cellular behaviors, introduces the essential stimulation principles, discusses the performance requirements for optimal ES systems, and highlights the representative applications. From this review, we can realize the potential of ES based bioelectronics in therapy, regenerative medicine and rehabilitation engineering technologies, ranging from tissue engineering to neurological technologies, and the modulation of cardiovascular and cognitive functions. This review underscores the versatility of ES in various biomedical contexts and emphasizes the need to adapt to complex biological and clinical landscapes it addresses.
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Affiliation(s)
- Ya Huang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Kuanming Yao
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Qiang Zhang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Xingcan Huang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Zhenlin Chen
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Yu Zhou
- Department of Electronic and Computer Engineering, The Hong Kong University of Science and Technology, Hong Kong, China.
| | - Xinge Yu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
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Sun P, Li C, Yang C, Sun M, Hou H, Guan Y, Chen J, Liu S, Chen K, Ma Y, Huang Y, Li X, Wang H, Wang L, Chen S, Cheng H, Xiong W, Sheng X, Zhang M, Peng J, Wang S, Wang Y, Yin L. A biodegradable and flexible neural interface for transdermal optoelectronic modulation and regeneration of peripheral nerves. Nat Commun 2024; 15:4721. [PMID: 38830884 PMCID: PMC11148186 DOI: 10.1038/s41467-024-49166-4] [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: 08/02/2023] [Accepted: 05/23/2024] [Indexed: 06/05/2024] Open
Abstract
Optoelectronic neural interfaces can leverage the photovoltaic effect to convert light into electrical current, inducing charge redistribution and enabling nerve stimulation. This method offers a non-genetic and remote approach for neuromodulation. Developing biodegradable and efficient optoelectronic neural interfaces is important for achieving transdermal stimulation while minimizing infection risks associated with device retrieval, thereby maximizing therapeutic outcomes. We propose a biodegradable, flexible, and miniaturized silicon-based neural interface capable of transdermal optoelectronic stimulation for neural modulation and nerve regeneration. Enhancing the device interface with thin-film molybdenum significantly improves the efficacy of neural stimulation. Our study demonstrates successful activation of the sciatic nerve in rodents and the facial nerve in rabbits. Moreover, transdermal optoelectronic stimulation accelerates the functional recovery of injured facial nerves.
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Affiliation(s)
- Pengcheng Sun
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing, 100084, P. R. China
| | - Chaochao Li
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and Injuries PLA, No. 28 Fuxing Road, Beijing, 100853, P. R. China
| | - Can Yang
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing, 100084, P. R. China
| | - Mengchun Sun
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and Injuries PLA, No. 28 Fuxing Road, Beijing, 100853, P. R. China
| | - Hanqing Hou
- School of Life Sciences, Tsinghua University, Beijing, 100084, P. R. China
| | - Yanjun Guan
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and Injuries PLA, No. 28 Fuxing Road, Beijing, 100853, P. R. China
| | - Jinger Chen
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing, 100084, P. R. China
| | - Shangbin Liu
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing, 100084, P. R. China
| | - Kuntao Chen
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing, 100084, P. R. China
| | - Yuan Ma
- Department of Electronic Engineering, Tsinghua University, Beijing, 100084, P. R. China
| | - Yunxiang Huang
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA
| | - Xiangling Li
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and Injuries PLA, No. 28 Fuxing Road, Beijing, 100853, P. R. China
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P. R. China
| | - Huachun Wang
- School of Integrated Circuits, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, P. R. China
| | - Liu Wang
- School of Biological Science and Medical Engineering, Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, 100083, P. R. China
- School of Engineering Medicine, Beihang University, Beijing, 100083, P. R. China
| | - Shengfeng Chen
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and Injuries PLA, No. 28 Fuxing Road, Beijing, 100853, P. R. China
| | - Haofeng Cheng
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and Injuries PLA, No. 28 Fuxing Road, Beijing, 100853, P. R. China
| | - Wei Xiong
- Chinese Institute for Brain Research, Beijing, 102206, P. R. China
| | - Xing Sheng
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing, 100084, P. R. China
- Institute for Precision Medicine, Tsinghua University, Beijing, 100084, P. R. China
- IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, 100084, P. R. China
| | - Milin Zhang
- Department of Electronic Engineering, Tsinghua University, Beijing, 100084, P. R. China
| | - Jiang Peng
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and Injuries PLA, No. 28 Fuxing Road, Beijing, 100853, P. R. China
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, 226007, P. R. China
| | - Shirong Wang
- MegaRobo Technologies Co. ltd, Beijing, 100085, P. R. China.
| | - Yu Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and Injuries PLA, No. 28 Fuxing Road, Beijing, 100853, P. R. China.
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, 226007, P. R. China.
| | - Lan Yin
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing, 100084, P. R. China.
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Sun Y, Xiao Z, Chen B, Zhao Y, Dai J. Advances in Material-Assisted Electromagnetic Neural Stimulation. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2400346. [PMID: 38594598 DOI: 10.1002/adma.202400346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/26/2024] [Indexed: 04/11/2024]
Abstract
Bioelectricity plays a crucial role in organisms, being closely connected to neural activity and physiological processes. Disruptions in the nervous system can lead to chaotic ionic currents at the injured site, causing disturbances in the local cellular microenvironment, impairing biological pathways, and resulting in a loss of neural functions. Electromagnetic stimulation has the ability to generate internal currents, which can be utilized to counter tissue damage and aid in the restoration of movement in paralyzed limbs. By incorporating implanted materials, electromagnetic stimulation can be targeted more accurately, thereby significantly improving the effectiveness and safety of such interventions. Currently, there have been significant advancements in the development of numerous promising electromagnetic stimulation strategies with diverse materials. This review provides a comprehensive summary of the fundamental theories, neural stimulation modulating materials, material application strategies, and pre-clinical therapeutic effects associated with electromagnetic stimulation for neural repair. It offers a thorough analysis of current techniques that employ materials to enhance electromagnetic stimulation, as well as potential therapeutic strategies for future applications.
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Affiliation(s)
- Yuting Sun
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhifeng Xiao
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Bing Chen
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Yannan Zhao
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Jianwu Dai
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
- Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300192, China
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6
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Moritz C, Field-Fote EC, Tefertiller C, van Nes I, Trumbower R, Kalsi-Ryan S, Purcell M, Janssen TWJ, Krassioukov A, Morse LR, Zhao KD, Guest J, Marino RJ, Murray LM, Wecht JM, Rieger M, Pradarelli J, Turner A, D'Amico J, Squair JW, Courtine G. Non-invasive spinal cord electrical stimulation for arm and hand function in chronic tetraplegia: a safety and efficacy trial. Nat Med 2024; 30:1276-1283. [PMID: 38769431 PMCID: PMC11108781 DOI: 10.1038/s41591-024-02940-9] [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: 12/01/2023] [Accepted: 03/22/2024] [Indexed: 05/22/2024]
Abstract
Cervical spinal cord injury (SCI) leads to permanent impairment of arm and hand functions. Here we conducted a prospective, single-arm, multicenter, open-label, non-significant risk trial that evaluated the safety and efficacy of ARCEX Therapy to improve arm and hand functions in people with chronic SCI. ARCEX Therapy involves the delivery of externally applied electrical stimulation over the cervical spinal cord during structured rehabilitation. The primary endpoints were safety and efficacy as measured by whether the majority of participants exhibited significant improvement in both strength and functional performance in response to ARCEX Therapy compared to the end of an equivalent period of rehabilitation alone. Sixty participants completed the protocol. No serious adverse events related to ARCEX Therapy were reported, and the primary effectiveness endpoint was met. Seventy-two percent of participants demonstrated improvements greater than the minimally important difference criteria for both strength and functional domains. Secondary endpoint analysis revealed significant improvements in fingertip pinch force, hand prehension and strength, upper extremity motor and sensory abilities and self-reported increases in quality of life. These results demonstrate the safety and efficacy of ARCEX Therapy to improve hand and arm functions in people living with cervical SCI. ClinicalTrials.gov identifier: NCT04697472 .
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Affiliation(s)
- Chet Moritz
- Departments of Rehabilitation Medicine, Electrical & Computer Engineering, Physiology & Biophysics and Center for Neurotechnology, University of Washington, Seattle, WA, USA
| | - Edelle C Field-Fote
- Shepherd Center, Crawford Research Institute and Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Ilse van Nes
- Sint Maartenskliniek, Revalidatiegeneeskunde, Nijmegen, The Netherlands
| | - Randy Trumbower
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Spaulding Rehabilitation Hospital, Charlestown, MA, USA
| | - Sukhvinder Kalsi-Ryan
- KITE Research Institute|Toronto Rehab, University Health Network, Toronto, Ontario, Canada
| | - Mariel Purcell
- Scottish Centre for Innovation in Spinal Cord Injury, Queen Elizabeth National Spinal Injuries Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Thomas W J Janssen
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
- Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Andrei Krassioukov
- ICORD and Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie R Morse
- Department of Rehabilitation Medicine, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - Kristin D Zhao
- Department of Physical Medicine and Rehabilitation, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA
| | - James Guest
- Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
- Miami Project to Cure Paralysis, Miami, FL, USA
| | - Ralph J Marino
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Lynda M Murray
- Departments of Rehabilitation and Human Performance and Medicine, James J. Peters VA Medical Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Research and Development, James J. Peters VA Medical Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jill M Wecht
- Department of Research and Development, James J. Peters VA Medical Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | - Jessica D'Amico
- ONWARD Medical, Lausanne, Switzerland
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta, Canada
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Jordan W Squair
- NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
- NeuroRestore, NeuroX Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Gregoire Courtine
- NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland.
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
- Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland.
- NeuroRestore, NeuroX Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
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Jiménez-García AM, Bonnel G, Álvarez-Mota A, Arias N. Current perspectives on neuromodulation in ALS patients: A systematic review and meta-analysis. PLoS One 2024; 19:e0300671. [PMID: 38551974 PMCID: PMC10980254 DOI: 10.1371/journal.pone.0300671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/01/2024] [Indexed: 04/01/2024] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease that affects motor neurons, resulting in muscle weakness, paralysis, and eventually patient mortality. In recent years, neuromodulation techniques have emerged as promising potential therapeutic approaches to slow disease progression and improve the quality of life of ALS patients. A systematic review was conducted until August 8, 2023, to evaluate the neuromodulation methods used and their potential in the treatment of ALS. The search strategy was applied in the Cochrane Central database, incorporating results from other databases such as PubMed, Embase, CTgov, CINAHL, and ICTRP. Following the exclusion of papers that did not fulfil the inclusion criteria, a total of 2090 records were found, leaving a total of 10 studies. R software was used to conduct meta-analyses based on the effect sizes between the experimental and control groups. This revealed differences in muscle stretch measures with manual muscle testing (p = 0.012) and resting motor threshold (p = 0.0457), but not with voluntary isometric contraction (p = 0.1883). The functionality of ALS was also different (p = 0.007), but not the quality of life. Although intracortical facilitation was not seen in motor cortex 1 (M1) (p = 0.1338), short-interval intracortical inhibition of M1 was significant (p = 0.0001). BDNF showed no differences that were statistically significant (p = 0.2297). Neuromodulation-based treatments are proposed as a promising therapeutic approach for ALS that can produce effects on muscle function, spasticity, and intracortical connections through electrical, magnetic, and photonic stimulation. Photobiomodulation stands out as an innovative approach that uses specific wavelengths to influence mitochondria, with the aim of improving mitochondrial function and reducing excitotoxicity. The lack of reliable placebo controls and the variation in stimulation frequency are some of the drawbacks of neuromodulation.
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Affiliation(s)
- Ana M. Jiménez-García
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, University of Nebrija, Madrid, Spain
| | - Gaspard Bonnel
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, University of Nebrija, Madrid, Spain
| | - Alicia Álvarez-Mota
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, University of Nebrija, Madrid, Spain
| | - Natalia Arias
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, University of Nebrija, Madrid, Spain
- Health Research Institute of the Principality of Asturias (Instituto de Investigación Universitaria del Principado de Asturias), Oviedo, Spain
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Plaza Feijoo, Oviedo, Spain
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Liu J, Chen Z, Wu R, Yu H, Yang S, Xu J, Wu C, Guo Y, Hua N, Zeng X, Ma Y, Li G, Zhang L, Chen Y, Zeng Y, Ding Y, Lai B. Effects of tail nerve electrical stimulation on the activation and plasticity of the lumbar locomotor circuits and the prevention of skeletal muscle atrophy after spinal cord transection in rats. CNS Neurosci Ther 2024; 30:e14445. [PMID: 37752787 PMCID: PMC10916423 DOI: 10.1111/cns.14445] [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: 12/23/2022] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION Severe spinal cord injury results in the loss of neurons in the relatively intact spinal cord below the injury area and skeletal muscle atrophy in the paralyzed limbs. These pathological processes are significant obstacles for motor function reconstruction. OBJECTIVE We performed tail nerve electrical stimulation (TNES) to activate the motor neural circuits below the injury site of the spinal cord to elucidate the regulatory mechanisms of the excitatory afferent neurons in promoting the reconstruction of locomotor function. METHODS Eight days after T10 spinal cord transection in rats, TNES was performed for 7 weeks. Behavioral scores were assessed weekly. Electrophysiological tests and double retrograde tracings were performed at week 8. RESULTS After 7 weeks of TNES treatment, there was restoration in innervation, the number of stem cells, and mitochondrial metabolism in the rats' hindlimb muscles. Double retrograde tracings of the tail nerve and sciatic nerve further confirmed the presence of synaptic connections between the tail nerve and central pattern generator (CPG) neurons in the lumbar spinal cord, as well as motor neurons innervating the hindlimb muscles. CONCLUSION The mechanisms of TNES induced by the stimulation of primary afferent nerve fibers involves efficient activation of the motor neural circuits in the lumbosacral segment, alterations of synaptic plasticity, and the improvement of muscle and nerve regeneration, which provides the structural and functional foundation for the future use of cutting-edge biological treatment strategies to restore voluntary movement of paralyzed hindlimbs.
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Affiliation(s)
- Jia‐Lin Liu
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
| | - Zheng‐Hong Chen
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Rehabilitation Medicine DepartmentThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Rong‐Jie Wu
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Shantou University Medical CollegeShantouGuangdongChina
- Department of OrthopedicsGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
| | - Hai‐Yang Yu
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Department of OrthopedicsGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
| | - Shang‐Bin Yang
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Department of Histology and EmbryologyZhongshan School of Medicine, Sun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Jing Xu
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Department of Histology and EmbryologyZhongshan School of Medicine, Sun Yat‐sen UniversityGuangzhouGuangdongChina
- Guangdong Provincial Key Laboratory of Brain Function and DiseaseZhongshan School of Medicine, Sun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Chuang‐Ran Wu
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Department of OrthopedicsGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
| | - Yi‐Nan Guo
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Department of Histology and EmbryologyZhongshan School of Medicine, Sun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Nan Hua
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
| | - Xiang Zeng
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Department of Histology and EmbryologyZhongshan School of Medicine, Sun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Yuan‐Huan Ma
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Guangzhou First People's Hospital, Guangzhou Institute of Clinical Medicine, South China University of TechnologyGuangzhouGuangdongChina
| | - Ge Li
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Guangdong Provincial Key Laboratory of Pathogenesis, Targeted Prevention and Treatment of Heart DiseaseGuangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangzhouGuangdongChina
| | - Ling Zhang
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Rehabilitation Medicine DepartmentThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Yuan‐Feng Chen
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Department of OrthopedicsGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
| | - Yuan‐Shan Zeng
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Department of Histology and EmbryologyZhongshan School of Medicine, Sun Yat‐sen UniversityGuangzhouGuangdongChina
- Guangdong Provincial Key Laboratory of Brain Function and DiseaseZhongshan School of Medicine, Sun Yat‐sen UniversityGuangzhouGuangdongChina
- Co‐innovation Center of NeuroregenerationNantong UniversityNantongJiangsuChina
| | - Ying Ding
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Department of Histology and EmbryologyZhongshan School of Medicine, Sun Yat‐sen UniversityGuangzhouGuangdongChina
- Guangdong Provincial Key Laboratory of Brain Function and DiseaseZhongshan School of Medicine, Sun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Bi‐Qin Lai
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat‐sen University), Ministry of EducationGuangzhouGuangdongChina
- Department of Histology and EmbryologyZhongshan School of Medicine, Sun Yat‐sen UniversityGuangzhouGuangdongChina
- Guangdong Provincial Key Laboratory of Brain Function and DiseaseZhongshan School of Medicine, Sun Yat‐sen UniversityGuangzhouGuangdongChina
- Co‐innovation Center of NeuroregenerationNantong UniversityNantongJiangsuChina
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9
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Jung Y, Breitbart S, Malvea A, Bhatia A, Ibrahim GM, Gorodetsky C. Epidural Spinal Cord Stimulation for Spasticity: a Systematic Review of the Literature. World Neurosurg 2024; 183:227-238.e5. [PMID: 38181878 DOI: 10.1016/j.wneu.2023.12.158] [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: 10/10/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/07/2024]
Abstract
OBJECTIVE Spasticity is a form of muscle hypertonia secondary to various diseases, including traumatic brain injury, spinal cord injury, cerebral palsy, and multiple sclerosis. Medical treatments are available; however, these often result in insufficient clinical response. This review evaluates the role of epidural spinal cord stimulation (SCS) in the treatment of spasticity and associated functional outcomes. METHODS A systematic review of the literature was performed using the Embase, CENTRAL, and MEDLINE databases. We included studies that used epidural SCS to treat spasticity. Studies investigating functional electric stimulation, transcutaneous SCS, and animal models of spasticity were excluded. We also excluded studies that used SCS to treat other symptoms such as pain. RESULTS Thirty-four studies were included in the final analysis. The pooled rate of subjective improvement in spasticity was 78% (95% confidence interval, 64%-91%; I2 = 77%), 40% (95% confidence interval, 7%-73%; I2 = 88%) for increased H-reflex threshold or decreased Hoffman reflex/muscle response wave ratio, and 73% (65%-80%; I2 = 50%) for improved ambulation. Patients with spinal causes had better outcomes compared with patients with cerebral causes. Up to 10% of patients experienced complications including infections and hardware malfunction. CONCLUSIONS Our review of the literature suggests that SCS may be a safe and useful tool for the management of spasticity; however, there is significant heterogeneity among studies. The quality of studies is also low. Further studies are needed to fully evaluate the usefulness of this technology, including various stimulation paradigms across different causes of spasticity.
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Affiliation(s)
- Youngkyung Jung
- Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada.
| | - Sara Breitbart
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anahita Malvea
- Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Anuj Bhatia
- Department of Anesthesia and Pain Medicine, University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - George M Ibrahim
- Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada; Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Carolina Gorodetsky
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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10
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Lemieux M, Karimi N, Bretzner F. Functional plasticity of glutamatergic neurons of medullary reticular nuclei after spinal cord injury in mice. Nat Commun 2024; 15:1542. [PMID: 38378819 PMCID: PMC10879492 DOI: 10.1038/s41467-024-45300-4] [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: 07/26/2023] [Accepted: 01/17/2024] [Indexed: 02/22/2024] Open
Abstract
Spinal cord injury disrupts the descending command from the brain and causes a range of motor deficits. Here, we use optogenetic tools to investigate the functional plasticity of the glutamatergic reticulospinal drive of the medullary reticular formation after a lateral thoracic hemisection in female mice. Sites evoking stronger excitatory descending drive in intact conditions are the most impaired after injury, whereas those associated with a weaker drive are potentiated. After lesion, pro- and anti-locomotor activities (that is, initiation/acceleration versus stop/deceleration) are overall preserved. Activating the descending reticulospinal drive improves stepping ability on a flat surface of chronically impaired injured mice, and its priming enhances recovery of skilled locomotion on a horizontal ladder. This study highlights the resilience and capacity for reorganization of the glutamatergic reticulospinal command after injury, along with its suitability as a therapeutical target to promote functional recovery.
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Affiliation(s)
- Maxime Lemieux
- Centre de Recherche du CHU de Québec, CHUL-Neurosciences, 2705 Boul. Laurier, Québec, QC, G1V 4G2, Canada
| | - Narges Karimi
- Centre de Recherche du CHU de Québec, CHUL-Neurosciences, 2705 Boul. Laurier, Québec, QC, G1V 4G2, Canada
- Faculty of Medicine, Department of Psychiatry and Neurosciences, Université Laval, Québec, QC, G1V 4G2, Canada
| | - Frederic Bretzner
- Centre de Recherche du CHU de Québec, CHUL-Neurosciences, 2705 Boul. Laurier, Québec, QC, G1V 4G2, Canada.
- Faculty of Medicine, Department of Psychiatry and Neurosciences, Université Laval, Québec, QC, G1V 4G2, Canada.
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11
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Zhou K, Wei W, Yang D, Zhang H, Yang W, Zhang Y, Nie Y, Hao M, Wang P, Ruan H, Zhang T, Wang S, Liu Y. Dual electrical stimulation at spinal-muscular interface reconstructs spinal sensorimotor circuits after spinal cord injury. Nat Commun 2024; 15:619. [PMID: 38242904 PMCID: PMC10799086 DOI: 10.1038/s41467-024-44898-9] [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: 01/12/2023] [Accepted: 01/09/2024] [Indexed: 01/21/2024] Open
Abstract
The neural signals produced by varying electrical stimulation parameters lead to characteristic neural circuit responses. However, the characteristics of neural circuits reconstructed by electrical signals remain poorly understood, which greatly limits the application of such electrical neuromodulation techniques for the treatment of spinal cord injury. Here, we develop a dual electrical stimulation system that combines epidural electrical and muscle stimulation to mimic feedforward and feedback electrical signals in spinal sensorimotor circuits. We demonstrate that a stimulus frequency of 10-20 Hz under dual stimulation conditions is required for structural and functional reconstruction of spinal sensorimotor circuits, which not only activates genes associated with axonal regeneration of motoneurons, but also improves the excitability of spinal neurons. Overall, the results provide insights into neural signal decoding during spinal sensorimotor circuit reconstruction, suggesting that the combination of epidural electrical and muscle stimulation is a promising method for the treatment of spinal cord injury.
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Affiliation(s)
- Kai Zhou
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University; Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215123, China
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, 226001, China
| | - Wei Wei
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University; Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215123, China
| | - Dan Yang
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University; Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215123, China
- Department of Anatomy, School of Basic Medical Science, Guizhou Medical University, Guiyang, 550025, China
| | - Hui Zhang
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University; Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215123, China
| | - Wei Yang
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University; Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215123, China
| | - Yunpeng Zhang
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, 215163, China
| | - Yingnan Nie
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, 200433, China
| | - Mingming Hao
- i-Lab, Key Laboratory of Multifunctional Nanomaterials and Smart Systems, Suzhou Institute of Nano-tech and Nano-bionics, Chinese Academy of Sciences, Suzhou, Jiangsu, 215123, China
- Ningbo Medical Centre Lihuili Hospital, Ningbo, Zhejiang, 315048, China
| | - Pengcheng Wang
- Institutes of Biology and Medical Sciences, Soochow University, Suzhou, Jiangsu, 215123, China
| | - Hang Ruan
- Institutes of Biology and Medical Sciences, Soochow University, Suzhou, Jiangsu, 215123, China
| | - Ting Zhang
- i-Lab, Key Laboratory of Multifunctional Nanomaterials and Smart Systems, Suzhou Institute of Nano-tech and Nano-bionics, Chinese Academy of Sciences, Suzhou, Jiangsu, 215123, China
| | - Shouyan Wang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, 200433, China
| | - Yaobo Liu
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University; Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215123, China.
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, 226001, China.
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12
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Li E, Yan R, Qiao H, Sun J, Zou P, Chang J, Li S, Ma Q, Zhang R, Liao B. Combined transcriptomics and proteomics studies on the effect of electrical stimulation on spinal cord injury in rats. Heliyon 2024; 10:e23960. [PMID: 38226269 PMCID: PMC10788535 DOI: 10.1016/j.heliyon.2023.e23960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 11/20/2023] [Accepted: 12/19/2023] [Indexed: 01/17/2024] Open
Abstract
Electrical stimulation (ES) of the spinal cord is a promising therapy for functional rehabilitation after spinal cord injury (SCI). However, the specific mechanism of action is poorly understood. We designed and applied an implanted ES device in the SCI area in rats and determined the effect of ES on the treatment of motor dysfunction after SCI using behavioral scores. Additionally, we examined the molecular characteristics of the samples using proteomic and transcriptomic sequencing. The differential molecules between groups were identified using statistical analyses. Molecular, network, and pathway-based analyses were used to identify group-specific biological features. ES (0.5 mA, 0.1 ms, 50 Hz) had a positive effect on motor dysfunction and neuronal regeneration in rats after SCI. Six samples (three independent replicates in each group) were used for transcriptome sequencing; we obtained 1026 differential genes, comprising 274 upregulated genes and 752 downregulated genes. A total of 10 samples were obtained: four samples in the ES group and six samples in the SCI group; for the proteome sequencing, 48 differential proteins were identified, including 45 up-regulated and three down-regulated proteins. Combined transcriptomic and proteomic studies have shown that the main enrichment pathway is the hedgehog signaling pathway. Western blot results showed that the expression levels of Sonic hedgehog (SHH) (P < 0.001), Smoothened (SMO) (P = 0.0338), and GLI-1 (P < 0.01) proteins in the ES treatment group were significantly higher than those in the SCI group. The immunofluorescence results showed significantly increased expression of SHH (P = 0.0181), SMO (P = 0.021), and GLI-1 (P = 0.0126) in the ES group compared with that in the SCI group. In conclusion, ES after SCI had a positive effect on motor dysfunction and anti-inflammatory effects in rats. Moreover, transcriptomic and proteomic sequencing also provided unique perspectives on the complex relationships between ES on SCI, where the SHH signaling pathway plays a critical role. Our study provides a significant theoretical foundation for the clinical implementation of ES therapy in patients with SCI.
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Affiliation(s)
- Erliang Li
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Rongbao Yan
- Department of Orthopaedics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Huanhuan Qiao
- Department of Orthopaedics, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi, China
| | - Jin Sun
- Department of Orthopaedics, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi, China
| | - Peng Zou
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jiaqi Chang
- School of Automation Science and Electrical Engineering, Beihang University, 37th Xueyuan Road, Beijing, China
| | - Shuang Li
- Department of Orthopaedics, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi, China
| | - Qiong Ma
- Department of Orthopaedics, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi, China
| | - Rui Zhang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Bo Liao
- Department of Orthopaedics, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi, China
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13
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Capogrosso M, Balaguer JM, Prat-Ortega G, Verma N, Yadav P, Sorensen E, de Freitas R, Ensel S, Borda L, Donadio S, Liang L, Ho J, Damiani A, Grigsby E, Fields D, Gonzalez-Martinez J, Gerszten P, Weber D, Pirondini E. Supraspinal control of motoneurons after paralysis enabled by spinal cord stimulation. RESEARCH SQUARE 2024:rs.3.rs-3650257. [PMID: 38260333 PMCID: PMC10802737 DOI: 10.21203/rs.3.rs-3650257/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Spinal cord stimulation (SCS) restores motor control after spinal cord injury (SCI) and stroke. This evidence led to the hypothesis that SCS facilitates residual supraspinal inputs to spinal motoneurons. Instead, here we show that SCS does not facilitate residual supraspinal inputs but directly triggers motoneurons action potentials. However, supraspinal inputs can shape SCS-mediated activity, mimicking volitional control of motoneuron firing. Specifically, by combining simulations, intraspinal electrophysiology in monkeys and single motor unit recordings in humans with motor paralysis, we found that residual supraspinal inputs transform subthreshold SCS-induced excitatory postsynaptic potentials into suprathreshold events. We then demonstrated that only a restricted set of stimulation parameters enables volitional control of motoneuron firing and that lesion severity further restricts the set of effective parameters. Our results explain the facilitation of voluntary motor control during SCS while predicting the limitations of this neurotechnology in cases of severe loss of supraspinal axons.
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Affiliation(s)
| | - Josep-Maria Balaguer
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
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14
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Bezard E, Bloch J, Courtine G. [A spinal neuroprosthesis against locomotor deficits in Parkinson's disease]. Med Sci (Paris) 2024; 40:104-106. [PMID: 38299913 DOI: 10.1051/medsci/2023185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Affiliation(s)
- Erwan Bezard
- Univ. Bordeaux, CNRS, Institut des maladies neurodégénératives, UMR 5293, Bordeaux, France - Motac Neuroscience, Floirac, France
| | - Jocelyne Bloch
- Institut NeuroX, Faculté des sciences de la vie, École polytechnique fédérale de Lausanne (EPFL), Genève, Suisse - Département de neurosciences cliniques, Centre hospitalier universitaire vaudois (CHUV), université de Lausanne (UNIL), Lausanne, Suisse - NeuroRestore, Centre de neurothérapies interventionnelles Defitech, EPFL, CHUV, UNIL, Lausanne, Suisse - Département de neurochirurgie, CHUV, Lausanne, Suisse
| | - Grégoire Courtine
- Institut NeuroX, Faculté des sciences de la vie, École polytechnique fédérale de Lausanne (EPFL), Genève, Suisse - Département de neurosciences cliniques, Centre hospitalier universitaire vaudois (CHUV), université de Lausanne (UNIL), Lausanne, Suisse - NeuroRestore, Centre de neurothérapies interventionnelles Defitech, EPFL, CHUV, UNIL, Lausanne, Suisse - Département de neurochirurgie, CHUV, Lausanne, Suisse
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15
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Balaguer JM, Prat-Ortega G, Verma N, Yadav P, Sorensen E, de Freitas R, Ensel S, Borda L, Donadio S, Liang L, Ho J, Damiani A, Grigsby E, Fields DP, Gonzalez-Martinez JA, Gerszten PC, Fisher LE, Weber DJ, Pirondini E, Capogrosso M. SUPRASPINAL CONTROL OF MOTONEURONS AFTER PARALYSIS ENABLED BY SPINAL CORD STIMULATION. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.29.23298779. [PMID: 38076797 PMCID: PMC10705627 DOI: 10.1101/2023.11.29.23298779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Spinal cord stimulation (SCS) restores motor control after spinal cord injury (SCI) and stroke. This evidence led to the hypothesis that SCS facilitates residual supraspinal inputs to spinal motoneurons. Instead, here we show that SCS does not facilitate residual supraspinal inputs but directly triggers motoneurons action potentials. However, supraspinal inputs can shape SCS-mediated activity, mimicking volitional control of motoneuron firing. Specifically, by combining simulations, intraspinal electrophysiology in monkeys and single motor unit recordings in humans with motor paralysis, we found that residual supraspinal inputs transform subthreshold SCS-induced excitatory postsynaptic potentials into suprathreshold events. We then demonstrated that only a restricted set of stimulation parameters enables volitional control of motoneuron firing and that lesion severity further restricts the set of effective parameters. Our results explain the facilitation of voluntary motor control during SCS while predicting the limitations of this neurotechnology in cases of severe loss of supraspinal axons.
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Affiliation(s)
- Josep-Maria Balaguer
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, US
| | - Genis Prat-Ortega
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Neurological Surgery, University of Pittsburgh, Pittsburgh, US
| | - Nikhil Verma
- Dept. of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, US
| | - Prakarsh Yadav
- Dept. of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, US
| | - Erynn Sorensen
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, US
| | - Roberto de Freitas
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Neurological Surgery, University of Pittsburgh, Pittsburgh, US
| | - Scott Ensel
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, US
| | - Luigi Borda
- Dept. of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, US
| | - Serena Donadio
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
| | - Lucy Liang
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, US
| | - Jonathan Ho
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- School of Medicine, University of Pittsburgh, Pittsburgh, US
| | - Arianna Damiani
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, US
| | - Erinn Grigsby
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, US
| | - Daryl P. Fields
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Neurological Surgery, University of Pittsburgh, Pittsburgh, US
| | | | - Peter C. Gerszten
- Dept. of Neurological Surgery, University of Pittsburgh, Pittsburgh, US
| | - Lee E. Fisher
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, US
- Dept. of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, US
- Dept. of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, US
| | - Douglas J. Weber
- Dept. of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, US
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, US
| | - Elvira Pirondini
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, US
- Dept. of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, US
| | - Marco Capogrosso
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, US
- Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, US
- Dept. of Neurological Surgery, University of Pittsburgh, Pittsburgh, US
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16
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Alenazy MS, Al-Jaafari R, Daneshgar S, Folkesson-Dey A, Enoka RM. Influence of transcutaneous electrical nerve stimulation on the distance walked by older adults during the 6-min test of walking endurance. J Electromyogr Kinesiol 2023; 73:102827. [PMID: 37793315 DOI: 10.1016/j.jelekin.2023.102827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 10/06/2023] Open
Abstract
The purpose of our study was to compare the influence of two types of transcutaneous electrical nerve stimulation (TENS) on the performance of older adults on the 6-min test of walking endurance and on the ability to maintain balance during upright standing. Twenty-six healthy older adults (72 ± 5.4 yrs) performed tests of motor function while TENS was applied to the tibialis anterior and rectus femoris muscles of each leg. Linear mixed models were used to compare the influence of TENS on walking distance in a 6-min test of walking endurance and on sway-area rate in tests of standing balance. There was a significant decrease in the distances walked in each minute of the 6-min walk test for both the Continuous and Burst TENS modes compared with Baseline (p < 0.01 and p < 0.001, respectively). The influence of TENS on walking distance was associated with several significant effects on the mean and coefficient of variation for stride length and stride frequency between the first and last minute of the test and between the two TENS modes and the Baseline values. In contrast, there was no significant effect of TENS on sway-area rate in any balance test, which indicates that the supplementary sensory feedback compromised walking performance of older adults but not the ability to maintain balance during upright standing.
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Affiliation(s)
- Mohammed S Alenazy
- Department of Integrative Physiology, USA; University of Colorado Boulder, USA
| | - Rehab Al-Jaafari
- Department of Integrative Physiology, USA; University of Colorado Boulder, USA
| | - Sajjad Daneshgar
- Department of Integrative Physiology, USA; University of Colorado Boulder, USA
| | | | - Roger M Enoka
- Department of Integrative Physiology, USA; University of Colorado Boulder, USA.
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17
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Burton A, Wang Z, Song D, Tran S, Hanna J, Ahmad D, Bakall J, Clausen D, Anderson J, Peralta R, Sandepudi K, Benedetto A, Yang E, Basrai D, Miller LE, Tresch MC, Gutruf P. Fully implanted battery-free high power platform for chronic spinal and muscular functional electrical stimulation. Nat Commun 2023; 14:7887. [PMID: 38036552 PMCID: PMC10689769 DOI: 10.1038/s41467-023-43669-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/16/2023] [Indexed: 12/02/2023] Open
Abstract
Electrical stimulation of the neuromuscular system holds promise for both scientific and therapeutic biomedical applications. Supplying and maintaining the power necessary to drive stimulation chronically is a fundamental challenge in these applications, especially when high voltages or currents are required. Wireless systems, in which energy is supplied through near field power transfer, could eliminate complications caused by battery packs or external connections, but currently do not provide the harvested power and voltages required for applications such as muscle stimulation. Here, we introduce a passive resonator optimized power transfer design that overcomes these limitations, enabling voltage compliances of ± 20 V and power over 300 mW at device volumes of 0.2 cm2, thereby improving power transfer 500% over previous systems. We show that this improved performance enables multichannel, biphasic, current-controlled operation at clinically relevant voltage and current ranges with digital control and telemetry in freely behaving animals. Preliminary chronic results indicate that implanted devices remain operational over 6 weeks in both intact and spinal cord injured rats and are capable of producing fine control of spinal and muscle stimulation.
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Affiliation(s)
- Alex Burton
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Zhong Wang
- Department of Neuroscience, Northwestern University, Chicago, IL, 60611, USA
| | - Dan Song
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Sam Tran
- Department of Neuroscience, Northwestern University, Chicago, IL, 60611, USA
| | - Jessica Hanna
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Dhrubo Ahmad
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Jakob Bakall
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - David Clausen
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Jerry Anderson
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Roberto Peralta
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Kirtana Sandepudi
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Alex Benedetto
- Interdepartmental Neuroscience, Northwestern University, Chicago, IL, 60611, USA
| | - Ethan Yang
- Department of Neuroscience, Northwestern University, Chicago, IL, 60611, USA
| | - Diya Basrai
- Department of Neuroscience, Northwestern University, Chicago, IL, 60611, USA
| | - Lee E Miller
- Department of Neuroscience, Northwestern University, Chicago, IL, 60611, USA
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
- Interdepartmental Neuroscience, Northwestern University, Chicago, IL, 60611, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, 60611, USA
| | - Matthew C Tresch
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA.
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, 60611, USA.
- Shirley Ryan AbilityLab, Chicago, IL, 60611, USA.
| | - Philipp Gutruf
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA.
- Bio5 Institute and Department of Neurology, University of Arizona, Tucson, AZ, 85721, USA.
- Department of Electrical and Computer Engineering, University of Arizona, Tucson, AZ, 85721, USA.
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18
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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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19
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Milekovic T, Moraud EM, Macellari N, Moerman C, Raschellà F, Sun S, Perich MG, Varescon C, Demesmaeker R, Bruel A, Bole-Feysot LN, Schiavone G, Pirondini E, YunLong C, Hao L, Galvez A, Hernandez-Charpak SD, Dumont G, Ravier J, Le Goff-Mignardot CG, Mignardot JB, Carparelli G, Harte C, Hankov N, Aureli V, Watrin A, Lambert H, Borton D, Laurens J, Vollenweider I, Borgognon S, Bourre F, Goillandeau M, Ko WKD, Petit L, Li Q, Buschman R, Buse N, Yaroshinsky M, Ledoux JB, Becce F, Jimenez MC, Bally JF, Denison T, Guehl D, Ijspeert A, Capogrosso M, Squair JW, Asboth L, Starr PA, Wang DD, Lacour SP, Micera S, Qin C, Bloch J, Bezard E, Courtine G. A spinal cord neuroprosthesis for locomotor deficits due to Parkinson's disease. Nat Med 2023; 29:2854-2865. [PMID: 37932548 DOI: 10.1038/s41591-023-02584-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/08/2023] [Indexed: 11/08/2023]
Abstract
People with late-stage Parkinson's disease (PD) often suffer from debilitating locomotor deficits that are resistant to currently available therapies. To alleviate these deficits, we developed a neuroprosthesis operating in closed loop that targets the dorsal root entry zones innervating lumbosacral segments to reproduce the natural spatiotemporal activation of the lumbosacral spinal cord during walking. We first developed this neuroprosthesis in a non-human primate model that replicates locomotor deficits due to PD. This neuroprosthesis not only alleviated locomotor deficits but also restored skilled walking in this model. We then implanted the neuroprosthesis in a 62-year-old male with a 30-year history of PD who presented with severe gait impairments and frequent falls that were medically refractory to currently available therapies. We found that the neuroprosthesis interacted synergistically with deep brain stimulation of the subthalamic nucleus and dopaminergic replacement therapies to alleviate asymmetry and promote longer steps, improve balance and reduce freezing of gait. This neuroprosthesis opens new perspectives to reduce the severity of locomotor deficits in people with PD.
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Affiliation(s)
- Tomislav Milekovic
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
- Department of Fundamental Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Eduardo Martin Moraud
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Nicolo Macellari
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Charlotte Moerman
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Flavio Raschellà
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- NeuroX Institute, School of Bioengineering, EPFL, Lausanne, Switzerland
| | - Shiqi Sun
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Matthew G Perich
- Department of Fundamental Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Camille Varescon
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Robin Demesmaeker
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Alice Bruel
- Institute of Bioengineering, School of Engineering, EPFL, Lausanne, Switzerland
| | - Léa N Bole-Feysot
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Giuseppe Schiavone
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Laboratory for Soft Bioelectronic Interfaces (LSBI), NeuroX Institute, EPFL, Lausanne, Switzerland
| | - Elvira Pirondini
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Cheng YunLong
- Motac Neuroscience, UK-M15 6WE, Manchester, UK
- China Academy of Medical Sciences, Beijing, China
- Institute of Laboratory Animal Sciences, Beijing, China
| | - Li Hao
- Motac Neuroscience, UK-M15 6WE, Manchester, UK
- China Academy of Medical Sciences, Beijing, China
- Institute of Laboratory Animal Sciences, Beijing, China
| | - Andrea Galvez
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Sergio Daniel Hernandez-Charpak
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Gregory Dumont
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Jimmy Ravier
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Camille G Le Goff-Mignardot
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Jean-Baptiste Mignardot
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Gaia Carparelli
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Cathal Harte
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Nicolas Hankov
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Viviana Aureli
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | | | | | - David Borton
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
- School of Engineering, Carney Institute for Brain Science, Brown University, Providence, RI, USA
| | - Jean Laurens
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Isabelle Vollenweider
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Simon Borgognon
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - François Bourre
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
- CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
| | - Michel Goillandeau
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
- CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
| | - Wai Kin D Ko
- Motac Neuroscience, UK-M15 6WE, Manchester, UK
- China Academy of Medical Sciences, Beijing, China
- Institute of Laboratory Animal Sciences, Beijing, China
| | - Laurent Petit
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
- CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
| | - Qin Li
- Motac Neuroscience, UK-M15 6WE, Manchester, UK
- China Academy of Medical Sciences, Beijing, China
- Institute of Laboratory Animal Sciences, Beijing, China
| | | | | | - Maria Yaroshinsky
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Jean-Baptiste Ledoux
- Department of Diagnostic and Interventional Radiology, CHUV/UNIL, Lausanne, Switzerland
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, CHUV/UNIL, Lausanne, Switzerland
| | | | - Julien F Bally
- Department of Neurology, CHUV/UNIL, Lausanne, Switzerland
| | | | - Dominique Guehl
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
- CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
| | - Auke Ijspeert
- Institute of Bioengineering, School of Engineering, EPFL, Lausanne, Switzerland
| | - Marco Capogrosso
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jordan W Squair
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Leonie Asboth
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
- Department of Neurosurgery, CHUV, Lausanne, Switzerland
| | - Philip A Starr
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Doris D Wang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Stéphanie P Lacour
- NeuroX Institute, School of Bioengineering, EPFL, Lausanne, Switzerland
- Laboratory for Soft Bioelectronic Interfaces (LSBI), NeuroX Institute, EPFL, Lausanne, Switzerland
| | - Silvestro Micera
- NeuroX Institute, School of Bioengineering, EPFL, Lausanne, Switzerland
- Department of Excellence in Robotics and AI, Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Chuan Qin
- China Academy of Medical Sciences, Beijing, China
| | - Jocelyne Bloch
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland.
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland.
- Department of Neurosurgery, CHUV, Lausanne, Switzerland.
| | - Erwan Bezard
- Motac Neuroscience, UK-M15 6WE, Manchester, UK.
- China Academy of Medical Sciences, Beijing, China.
- Institute of Laboratory Animal Sciences, Beijing, China.
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France.
- CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France.
| | - G Courtine
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland.
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland.
- Department of Neurosurgery, CHUV, Lausanne, Switzerland.
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20
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Kuehn N, Schwarz A, Beretta CA, Schwarte Y, Schmitt F, Motsch M, Weidner N, Puttagunta R. Intermediate gray matter interneurons in the lumbar spinal cord play a critical and necessary role in coordinated locomotion. PLoS One 2023; 18:e0291740. [PMID: 37906544 PMCID: PMC10617729 DOI: 10.1371/journal.pone.0291740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/05/2023] [Indexed: 11/02/2023] Open
Abstract
Locomotion is a complex task involving excitatory and inhibitory circuitry in spinal gray matter. While genetic knockouts examine the function of individual spinal interneuron (SpIN) subtypes, the phenotype of combined SpIN loss remains to be explored. We modified a kainic acid lesion to damage intermediate gray matter (laminae V-VIII) in the lumbar spinal enlargement (spinal L2-L4) in female rats. A thorough, tailored behavioral evaluation revealed deficits in gross hindlimb function, skilled walking, coordination, balance and gait two weeks post-injury. Using a Random Forest algorithm, we combined these behavioral assessments into a highly predictive binary classification system that strongly correlated with structural deficits in the rostro-caudal axis. Machine-learning quantification confirmed interneuronal damage to laminae V-VIII in spinal L2-L4 correlates with hindlimb dysfunction. White matter alterations and lower motoneuron loss were not observed with this KA lesion. Animals did not regain lost sensorimotor function three months after injury, indicating that natural recovery mechanisms of the spinal cord cannot compensate for loss of laminae V-VIII neurons. As gray matter damage accounts for neurological/walking dysfunction in instances of spinal cord injury affecting the cervical or lumbar enlargement, this research lays the groundwork for new neuroregenerative therapies to replace these lost neuronal pools vital to sensorimotor function.
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Affiliation(s)
- Naëmi Kuehn
- Laboratory for Experimental Neuroregeneration, Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas Schwarz
- Laboratory for Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Carlo Antonio Beretta
- Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany
- Institute of Pharmacology, Heidelberg University, Heidelberg, Germany
| | - Yvonne Schwarte
- Laboratory for Experimental Neuroregeneration, Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Francesca Schmitt
- Laboratory for Experimental Neuroregeneration, Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Melanie Motsch
- Laboratory for Experimental Neuroregeneration, Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Norbert Weidner
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Radhika Puttagunta
- Laboratory for Experimental Neuroregeneration, Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
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21
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Kang M, Lee DM, Hyun I, Rubab N, Kim SH, Kim SW. Advances in Bioresorbable Triboelectric Nanogenerators. Chem Rev 2023; 123:11559-11618. [PMID: 37756249 PMCID: PMC10571046 DOI: 10.1021/acs.chemrev.3c00301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Indexed: 09/29/2023]
Abstract
With the growing demand for next-generation health care, the integration of electronic components into implantable medical devices (IMDs) has become a vital factor in achieving sophisticated healthcare functionalities such as electrophysiological monitoring and electroceuticals worldwide. However, these devices confront technological challenges concerning a noninvasive power supply and biosafe device removal. Addressing these challenges is crucial to ensure continuous operation and patient comfort and minimize the physical and economic burden on the patient and the healthcare system. This Review highlights the promising capabilities of bioresorbable triboelectric nanogenerators (B-TENGs) as temporary self-clearing power sources and self-powered IMDs. First, we present an overview of and progress in bioresorbable triboelectric energy harvesting devices, focusing on their working principles, materials development, and biodegradation mechanisms. Next, we examine the current state of on-demand transient implants and their biomedical applications. Finally, we address the current challenges and future perspectives of B-TENGs, aimed at expanding their technological scope and developing innovative solutions. This Review discusses advancements in materials science, chemistry, and microfabrication that can advance the scope of energy solutions available for IMDs. These innovations can potentially change the current health paradigm, contribute to enhanced longevity, and reshape the healthcare landscape soon.
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Affiliation(s)
- Minki Kang
- School
of Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 16419, Republic
of Korea
| | - Dong-Min Lee
- School
of Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 16419, Republic
of Korea
| | - Inah Hyun
- Department
of Materials Science and Engineering, Center for Human-oriented Triboelectric
Energy Harvesting, Yonsei University, Seoul 03722, Republic of Korea
| | - Najaf Rubab
- Department
of Materials Science and Engineering, Gachon
University, Seongnam 13120, Republic
of Korea
| | - So-Hee Kim
- Department
of Materials Science and Engineering, Center for Human-oriented Triboelectric
Energy Harvesting, Yonsei University, Seoul 03722, Republic of Korea
| | - Sang-Woo Kim
- Department
of Materials Science and Engineering, Center for Human-oriented Triboelectric
Energy Harvesting, Yonsei University, Seoul 03722, Republic of Korea
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22
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Zuo Y, Ye J, Cai W, Guo B, Chen X, Lin L, Jin S, Zheng H, Fang A, Qian X, Abdelrahman Z, Wang Z, Zhang Z, Chen Z, Yu B, Gu X, Wang X. Controlled delivery of a neurotransmitter-agonist conjugate for functional recovery after severe spinal cord injury. NATURE NANOTECHNOLOGY 2023; 18:1230-1240. [PMID: 37308588 DOI: 10.1038/s41565-023-01416-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/04/2023] [Indexed: 06/14/2023]
Abstract
Despite considerable unmet medical needs, effective pharmacological treatments that promote functional recovery after spinal cord injury remain limited. Although multiple pathological events are implicated in spinal cord injuries, the development of a microinvasive pharmacological approach that simultaneously targets the different mechanisms involved in spinal cord injury remains a formidable challenge. Here we report the development of a microinvasive nanodrug delivery system that consists of amphiphilic copolymers responsive to reactive oxygen species and an encapsulated neurotransmitter-conjugated KCC2 agonist. Upon intravenous administration, the nanodrugs enter the injured spinal cord due to a disruption in the blood-spinal cord barrier and disassembly due to damage-triggered reactive oxygen species. The nanodrugs exhibit dual functions in the injured spinal cord: scavenging accumulated reactive oxygen species in the lesion, thereby protecting spared tissues, and facilitating the integration of spared circuits into the host spinal cord through targeted modulation of inhibitory neurons. This microinvasive treatment leads to notable functional recovery in rats with contusive spinal cord injury.
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Affiliation(s)
- Yanming Zuo
- Department of Neurobiology and Department of Rehabilitation Medicine, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Jingjia Ye
- Department of Neurobiology and Department of Rehabilitation Medicine, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Wanxiong Cai
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Binjie Guo
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Xiangfeng Chen
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Lingmin Lin
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Shuang Jin
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Hanyu Zheng
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Ao Fang
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Xingran Qian
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Zeinab Abdelrahman
- Department of Neurobiology and Department of Rehabilitation Medicine, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Zhiping Wang
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China
| | - Zhipeng Zhang
- School of Chemistry and Molecular Engineering, Frontiers Science Center for Materiobiology and Dynamic Chemistry, East China University of Science & Technology, Shanghai, P. R. China
| | - Zuobin Chen
- Department of Neurobiology and Department of Rehabilitation Medicine, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China
| | - Bin Yu
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, Nantong, P. R. China
| | - Xiaosong Gu
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, Nantong, P. R. China
| | - Xuhua Wang
- Department of Neurobiology and Department of Rehabilitation Medicine, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China.
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China.
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, China.
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, P. R. China.
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23
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Martinez M. A bi-cortical neuroprosthesis to modulate locomotion after incomplete spinal cord injury. Sci Prog 2023; 106:368504231212788. [PMID: 38189274 PMCID: PMC10775731 DOI: 10.1177/00368504231212788] [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] [Indexed: 01/09/2024]
Abstract
Neuroprosthetic strategies seek to immediately alleviate deficits and reinstate voluntary control of movement. To facilitate recovery, it is crucial to gain a comprehensive understanding of the mechanisms involved in the return of intentional movement. Nevertheless, the precise relationship between the resurgence of cortical commands and the recovery of locomotion remains somewhat elusive. In the study conducted by Duguay, Bonizzato, Delivet-Mongrain, Fortier-Lebel and Martinez, we introduced a neuroprosthesis designed to deliver precise bi-cortical stimulation in a clinically relevant contusive spinal cord injury model. We conducted experiments in both healthy and spinal cord injured cats, where we fine-tuned the timing, duration, amplitude, and site of stimulation to modulate hindlimb locomotor output. In healthy cats, we observed a wide range of motor programs. However, after spinal cord injury, the induced hindlimb movements became highly stereotyped but were effective in modulating gait and reducing bilateral foot dragging. These results suggest that the neural basis for motor recovery traded off selectivity for effectiveness. Through a series of longitudinal assessments, we found that the restoration of locomotion following spinal cord injury was closely linked to the recovery of the descending neural drive. This underscores the importance of directing rehabilitation interventions toward the cortical target. The study results are discussed in terms of their impact and limitations.
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Affiliation(s)
- Marina Martinez
- Marina Martinez, Département de neurosciences, Faculté de médecine, Université de Montréal, C.P. 6128, Succ. Centre-ville, Montréal, Québec, H3C 3J7, Canada.
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24
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Duguay M, Bonizzato M, Delivet-Mongrain H, Fortier-Lebel N, Martinez M. Uncovering and leveraging the return of voluntary motor programs after paralysis using a bi-cortical neuroprosthesis. Prog Neurobiol 2023; 228:102492. [PMID: 37414352 DOI: 10.1016/j.pneurobio.2023.102492] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
Rehabilitative and neuroprosthetic approaches after spinal cord injury (SCI) aim to reestablish voluntary control of movement. Promoting recovery requires a mechanistic understanding of the return of volition over action, but the relationship between re-emerging cortical commands and the return of locomotion is not well established. We introduced a neuroprosthesis delivering targeted bi-cortical stimulation in a clinically relevant contusive SCI model. In healthy and SCI cats, we controlled hindlimb locomotor output by tuning stimulation timing, duration, amplitude, and site. In intact cats, we unveiled a large repertoire of motor programs. After SCI, the evoked hindlimb lifts were highly stereotyped, yet effective in modulating gait and alleviating bilateral foot drag. Results suggest that the neural substrate underpinning motor recovery had traded-off selectivity for efficacy. Longitudinal tests revealed that the return of locomotion after SCI was correlated with recovery of the descending drive, which advocates for rehabilitation interventions directed at the cortical target.
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Affiliation(s)
- Maude Duguay
- Département de Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Québec, Canada; CIUSSS du Nord-de-l'Île-de-Montréal, Québec, Canada
| | - Marco Bonizzato
- Département de Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Québec, Canada; CIUSSS du Nord-de-l'Île-de-Montréal, Québec, Canada; Department of Electrical Engineering, Polytechnique Montréal, Québec, Canada
| | - Hugo Delivet-Mongrain
- Département de Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Québec, Canada
| | - Nicolas Fortier-Lebel
- Département de Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Québec, Canada
| | - Marina Martinez
- Département de Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Québec, Canada; CIUSSS du Nord-de-l'Île-de-Montréal, Québec, Canada.
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25
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Mundra A, Varma Kalidindi K, Chhabra HS, Manghwani J. Spinal cord stimulation for spinal cord injury - Where do we stand? A narrative review. J Clin Orthop Trauma 2023; 43:102210. [PMID: 37663171 PMCID: PMC10470322 DOI: 10.1016/j.jcot.2023.102210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/14/2023] [Accepted: 06/29/2023] [Indexed: 09/05/2023] Open
Abstract
Recovery of function following a complete spinal cord injury (SCI) or an incomplete SCI where recovery has plateaued still eludes us despite extensive research. Epidural spinal cord stimulation (SCS) was initially used for managing neuropathic pain. It has subsequently demonstrated improvement in motor function in otherwise non-recovering chronic spinal cord injury in animal and human trials. The mechanisms of how it is precisely effective in doing so will need further research, which would help refine the technology for broader application. Transcutaneous spinal cord stimulation (TSCS) is also emerging as a modality to improve the functional outcome in SCI individuals, especially when coupled with appropriate rehabilitation. Apart from motor recovery, ESCS and TSCS have also shown improvement in autonomic, metabolic, genitourinary, and pulmonary function. Since the literature on this is still in its infancy, with no large-scale randomised trials and different studies using different protocols in a wide range of patients, a review of the present literature is imperative to better understand the latest developments in this field. This article examines the existing literature on the use of SCS for SCI individuals with the purpose of enabling functional recovery. It also examines the voids in the present research, thus providing future directions.
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Affiliation(s)
- Anuj Mundra
- Department of Spine and Rehabilitation, Sri Balaji Action Medical Institute, New Delhi, 110063, India
| | | | - Harvinder Singh Chhabra
- Department of Spine and Rehabilitation, Sri Balaji Action Medical Institute, New Delhi, 110063, India
| | - Jitesh Manghwani
- Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, 110070, India
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26
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Liang L, Damiani A, Del Brocco M, Rogers ER, Jantz MK, Fisher LE, Gaunt RA, Capogrosso M, Lempka SF, Pirondini E. A systematic review of computational models for the design of spinal cord stimulation therapies: from neural circuits to patient-specific simulations. J Physiol 2023; 601:3103-3121. [PMID: 36409303 PMCID: PMC10259770 DOI: 10.1113/jp282884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/08/2022] [Indexed: 08/02/2023] Open
Abstract
Seventy years ago, Hodgkin and Huxley published the first mathematical model to describe action potential generation, laying the foundation for modern computational neuroscience. Since then, the field has evolved enormously, with studies spanning from basic neuroscience to clinical applications for neuromodulation. Computer models of neuromodulation have evolved in complexity and personalization, advancing clinical practice and novel neurostimulation therapies, such as spinal cord stimulation. Spinal cord stimulation is a therapy widely used to treat chronic pain, with rapidly expanding indications, such as restoring motor function. In general, simulations contributed dramatically to improve lead designs, stimulation configurations, waveform parameters and programming procedures and provided insight into potential mechanisms of action of electrical stimulation. Although the implementation of neural models are relentlessly increasing in number and complexity, it is reasonable to ask whether this observed increase in complexity is necessary for improved accuracy and, ultimately, for clinical efficacy. With this aim, we performed a systematic literature review and a qualitative meta-synthesis of the evolution of computational models, with a focus on complexity, personalization and the use of medical imaging to capture realistic anatomy. Our review showed that increased model complexity and personalization improved both mechanistic and translational studies. More specifically, the use of medical imaging enabled the development of patient-specific models that can help to transform clinical practice in spinal cord stimulation. Finally, we combined our results to provide clear guidelines for standardization and expansion of computational models for spinal cord stimulation.
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Affiliation(s)
- Lucy Liang
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Arianna Damiani
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matteo Del Brocco
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Evan R Rogers
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
| | - Maria K Jantz
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Lee E Fisher
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert A Gaunt
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marco Capogrosso
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Scott F Lempka
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Elvira Pirondini
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
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27
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Bryson N, Lombardi L, Hawthorn R, Fei J, Keesey R, Peiffer J, Seáñez I. Enhanced selectivity of transcutaneous spinal cord stimulation by multielectrode configuration. J Neural Eng 2023; 20:10.1088/1741-2552/ace552. [PMID: 37419109 PMCID: PMC10481387 DOI: 10.1088/1741-2552/ace552] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/07/2023] [Indexed: 07/09/2023]
Abstract
Objective.Transcutaneous spinal cord stimulation (tSCS) has been gaining momentum as a non-invasive rehabilitation approach to restore movement to paralyzed muscles after spinal cord injury (SCI). However, its low selectivity limits the types of movements that can be enabled and, thus, its potential applications in rehabilitation.Approach.In this cross-over study design, we investigated whether muscle recruitment selectivity of individual muscles could be enhanced by multielectrode configurations of tSCS in 16 neurologically intact individuals. We hypothesized that due to the segmental innervation of lower limb muscles, we could identify muscle-specific optimal stimulation locations that would enable improved recruitment selectivity over conventional tSCS. We elicited leg muscle responses by delivering biphasic pulses of electrical stimulation to the lumbosacral enlargement using conventional and multielectrode tSCS.Results.Analysis of recruitment curve responses confirmed that multielectrode configurations could improve the rostrocaudal and lateral selectivity of tSCS. To investigate whether motor responses elicited by spatially selective tSCS were mediated by posterior root-muscle reflexes, each stimulation event was a paired pulse with a conditioning-test interval of 33.3 ms. Muscle responses to the second stimulation pulse were significantly suppressed, a characteristic of post-activation depression suggesting that spatially selective tSCS recruits proprioceptive fibers that reflexively activate muscle-specific motor neurons in the spinal cord. Moreover, the combination of leg muscle recruitment probability and segmental innervation maps revealed a stereotypical spinal activation map in congruence with each electrode's position.Significance. Improvements in muscle recruitment selectivity could be essential for the effective translation into stimulation protocols that selectively enhance single-joint movements in neurorehabilitation.
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Affiliation(s)
- Noah Bryson
- Biomedical Engineering, Washington University in St. Louis
- Division of Neurotechnology, Washington University School of Medicine in St. Louis
| | - Lorenzo Lombardi
- Biomedical Engineering, Washington University in St. Louis
- Division of Neurotechnology, Washington University School of Medicine in St. Louis
| | - Rachel Hawthorn
- Biomedical Engineering, Washington University in St. Louis
- Division of Neurotechnology, Washington University School of Medicine in St. Louis
| | - Jie Fei
- Biomedical Engineering, Washington University in St. Louis
- Division of Neurotechnology, Washington University School of Medicine in St. Louis
| | - Rodolfo Keesey
- Biomedical Engineering, Washington University in St. Louis
- Division of Neurotechnology, Washington University School of Medicine in St. Louis
| | - J.D. Peiffer
- Biomedical Engineering, Washington University in St. Louis
- Division of Neurotechnology, Washington University School of Medicine in St. Louis
- Biomedical Engineering, Northwestern University
| | - Ismael Seáñez
- Biomedical Engineering, Washington University in St. Louis
- Division of Neurotechnology, Washington University School of Medicine in St. Louis
- Neurosurgery, Washington University School of Medicine in St. Louis
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28
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Alenazy MS, Al-Jaafari R, Folkesson-Dey A, Enoka RM. Influence of transcutaneous electrical nerve stimulation on walking kinematics and standing balance of older adults who differ in walking speed. Exp Brain Res 2023:10.1007/s00221-023-06615-8. [PMID: 37310476 DOI: 10.1007/s00221-023-06615-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/06/2023] [Indexed: 06/14/2023]
Abstract
The purpose was to determine the impact of transcutaneous electrical nerve stimulation (TENS) on measures of walking kinematics and standing balance of healthy older adults who were stratified into two groups based on differences in the distance walked during the 6-min test of walking endurance. Regression models were developed to explain the variance in the 6-min distance and to assess the predictive power of balance metrics to categorize the 26 older adults (72 ± 5.4 yrs) as either slow or fast walkers. Walking kinematics were measured during 6- and 2-min walk tests that were performed with and without the concurrent application of TENS to the hip flexor and ankle dorsiflexor muscles. Participants walked briskly during the 6-min test and at a preferred pace during the 2-min test. The supplementary sensory stimulation provided by TENS did not alter the power of the models to explain the variance in the Baseline 6-min distance: Baseline, R2 = 0.85; TENS, R2 = 0.83. In contrast, TENS improved the explanatory power of the data obtained during the 2-min walk to account for the variance in the Baseline 6-min distance: no TENS, R2 = 0.40; TENS, R2 = 0.64. Logistic regression models based on force-plate and kinematic data obtained during the balance tasks were able to discriminate between the two groups with excellent certainty. The impact of TENS was greatest when older adults walked at a preferred speed but not when they walked at a brisk pace or performed tests of standing balance.
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Affiliation(s)
- Mohammed S Alenazy
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, USA.
- College of Medicine, Majmaah University, Al Majma'ah, 15342, Saudi Arabia.
| | - Rehab Al-Jaafari
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, USA
| | - Anneli Folkesson-Dey
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, USA
| | - Roger M Enoka
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, USA
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29
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Pradat PF, Hayon D, Blancho S, Neveu P, Khamaysa M, Guerout N. Advances in Spinal Cord Neuromodulation: The Integration of Neuroengineering, Computational Approaches, and Innovative Conceptual Frameworks. J Pers Med 2023; 13:993. [PMID: 37373982 DOI: 10.3390/jpm13060993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/07/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Spinal cord stimulation (SCS) is an approved treatment for intractable pain and has recently emerged as a promising area of research for restoring function after spinal cord lesion. This review will focus on the historical evolution of this transition and the path that remains to be taken for these methods to be rigorously evaluated for application in clinical practice. New developments in SCS are being driven by advances in the understanding of spinal cord lesions at the molecular, cellular, and neuronal levels, as well as the understanding of compensatory mechanisms. Advances in neuroengineering and the computational neurosciences have enabled the development of new conceptual SCS strategies, such as spatiotemporal neuromodulation, which allows spatially selective stimulation at precise time points during anticipated movement. It has also become increasingly clear that these methods are only effective when combined with intensive rehabilitation techniques, such as new task-oriented methods and robotic aids. The emergence of innovative approaches to spinal cord neuromodulation has sparked significant enthusiasm among patients and in the media. Non-invasive methods are perceived to offer improved safety, patient acceptance, and cost-effectiveness. There is an immediate need for well-designed clinical trials involving consumer or advocacy groups to evaluate and compare the effectiveness of various treatment modalities, assess safety considerations, and establish outcome priorities.
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Affiliation(s)
- Pierre-François Pradat
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, 75013 Paris, France
- APHP, Département de Neurologie, Hôpital Pitié-Salpêtrière, Centre Référent SLA, 75013 Paris, France
- Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry BT47 6SB, UK
- Institut Pour la Recherche Sur la Moelle Epiniere et l'Encéphale (IRME), 25 Rue Duranton, 75015 Paris, France
| | - David Hayon
- Clinique Saint-Roch, Service d'Anesthésie, 56 Rue de Lille, 59223 Roncq, France
| | - Sophie Blancho
- Institut Pour la Recherche Sur la Moelle Epiniere et l'Encéphale (IRME), 25 Rue Duranton, 75015 Paris, France
| | - Pauline Neveu
- Saints Pères Paris Institute for the Neurosciences, Université Paris Cité, CNRS UMR8003, 75006 Paris, France
| | - Mohammed Khamaysa
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, 75013 Paris, France
| | - Nicolas Guerout
- Saints Pères Paris Institute for the Neurosciences, Université Paris Cité, CNRS UMR8003, 75006 Paris, France
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30
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Lorach H, Galvez A, Spagnolo V, Martel F, Karakas S, Intering N, Vat M, Faivre O, Harte C, Komi S, Ravier J, Collin T, Coquoz L, Sakr I, Baaklini E, Hernandez-Charpak SD, Dumont G, Buschman R, Buse N, Denison T, van Nes I, Asboth L, Watrin A, Struber L, Sauter-Starace F, Langar L, Auboiroux V, Carda S, Chabardes S, Aksenova T, Demesmaeker R, Charvet G, Bloch J, Courtine G. Walking naturally after spinal cord injury using a brain-spine interface. Nature 2023; 618:126-133. [PMID: 37225984 PMCID: PMC10232367 DOI: 10.1038/s41586-023-06094-5] [Citation(s) in RCA: 93] [Impact Index Per Article: 93.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 04/17/2023] [Indexed: 05/26/2023]
Abstract
A spinal cord injury interrupts the communication between the brain and the region of the spinal cord that produces walking, leading to paralysis1,2. Here, we restored this communication with a digital bridge between the brain and spinal cord that enabled an individual with chronic tetraplegia to stand and walk naturally in community settings. This brain-spine interface (BSI) consists of fully implanted recording and stimulation systems that establish a direct link between cortical signals3 and the analogue modulation of epidural electrical stimulation targeting the spinal cord regions involved in the production of walking4-6. A highly reliable BSI is calibrated within a few minutes. This reliability has remained stable over one year, including during independent use at home. The participant reports that the BSI enables natural control over the movements of his legs to stand, walk, climb stairs and even traverse complex terrains. Moreover, neurorehabilitation supported by the BSI improved neurological recovery. The participant regained the ability to walk with crutches overground even when the BSI was switched off. This digital bridge establishes a framework to restore natural control of movement after paralysis.
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Affiliation(s)
- Henri Lorach
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Andrea Galvez
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Valeria Spagnolo
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Felix Martel
- Univ. Grenoble Alpes, CEA, LETI, Clinatec, Grenoble, France
| | - Serpil Karakas
- Univ. Grenoble Alpes, CEA, LETI, Clinatec, Grenoble, France
| | - Nadine Intering
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Molywan Vat
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Olivier Faivre
- Univ. Grenoble Alpes, CEA, LETI, Clinatec, Grenoble, France
| | - Cathal Harte
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Salif Komi
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Jimmy Ravier
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Thibault Collin
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Laure Coquoz
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Icare Sakr
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Edeny Baaklini
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Sergio Daniel Hernandez-Charpak
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Gregory Dumont
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | | | | | - Tim Denison
- Medtronic, Minneapolis, MN, USA
- Department of Engineering Science, University of Oxford, Oxford, UK
| | - Ilse van Nes
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Leonie Asboth
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | | | - Lucas Struber
- Univ. Grenoble Alpes, CEA, LETI, Clinatec, Grenoble, France
| | | | - Lilia Langar
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Clinatec, Grenoble, France
| | | | - Stefano Carda
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Stephan Chabardes
- Univ. Grenoble Alpes, CEA, LETI, Clinatec, Grenoble, France
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Clinatec, Grenoble, France
| | | | - Robin Demesmaeker
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland
| | | | - Jocelyne Bloch
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland.
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland.
| | - Grégoire Courtine
- NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland.
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
- NeuroRestore, Defitech Center for Interventional Neurotherapies, EPFL/CHUV/UNIL, Lausanne, Switzerland.
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D’hondt N, Marcial KM, Mittal N, Costanzi M, Hoydonckx Y, Kumar P, Englesakis MF, Burns A, Bhatia A. A Scoping Review of Epidural Spinal Cord Stimulation for Improving Motor and Voiding Function Following Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2023; 29:12-30. [PMID: 37235192 PMCID: PMC10208259 DOI: 10.46292/sci22-00061] [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] [Indexed: 05/28/2023]
Abstract
Objectives To identify and synthesize the existing evidence on the effectiveness and safety of epidural spinal cord stimulation (SCS) for improving motor and voiding function and reducing spasticity following spinal cord injury (SCI). Methods This scoping review was performed according to the framework of Arksey and O'Malley. Comprehensive serial searches in multiple databases (MEDLINE, Embase, Cochrane Central, Cochrane Database of Systematic Reviews, LILACS, PubMed, Web of Science, and Scopus) were performed to identify relevant publications that focused on epidural SCS for improving motor function, including spasticity, and voiding deficits in individuals with SCI. Results Data from 13 case series including 88 individuals with complete or incomplete SCI (American Spinal Injury Association Impairment Scale [AIS] grade A to D) were included. In 12 studies of individuals with SCI, the majority (83 out of 88) demonstrated a variable degree of improvement in volitional motor function with epidural SCS. Two studies, incorporating 27 participants, demonstrated a significant reduction in spasticity with SCS. Two small studies consisting of five and two participants, respectively, demonstrated improved supraspinal control of volitional micturition with SCS. Conclusion Epidural SCS can enhance central pattern generator activity and lower motor neuron excitability in individuals with SCI. The observed effects of epidural SCS following SCI suggest that the preservation of supraspinal transmission is sufficient for the recovery of volitional motor and voiding function, even in patients with complete SCI. Further research is warranted to evaluate and optimize the parameters for epidural SCS and their impact on individuals with differing degrees of severity of SCI.
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Affiliation(s)
- Nina D’hondt
- Department of Pain Medicine, Multidisciplinary Pain Center, VITAZ, Sint-Niklaas, Belgium
| | - Karmi Margaret Marcial
- Department of Anesthesiology, Philippine General Hospital, University of Philippines, Philippines
| | - Nimish Mittal
- Department of Physical Medicine and Rehabilitation, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Matteo Costanzi
- Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Yasmine Hoydonckx
- Department of Anesthesiology and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Pranab Kumar
- Department of Anesthesiology and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Marina F. Englesakis
- MLIS Library & Information Services, University Health Network, Toronto, Ontario, Canada
| | - Anthony Burns
- Department of Physical Medicine and Rehabilitation, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Anuj Bhatia
- Department of Anesthesiology and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
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Luz A, Rupp R, Ahmadi R, Weidner N. Beyond treatment of chronic pain: a scoping review about epidural electrical spinal cord stimulation to restore sensorimotor and autonomic function after spinal cord injury. Neurol Res Pract 2023; 5:14. [PMID: 37055819 PMCID: PMC10103526 DOI: 10.1186/s42466-023-00241-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/30/2023] [Indexed: 04/15/2023] Open
Abstract
Epidural electrical epinal cord stimulation (ESCS) is an established therapeutic option in various chronic pain conditions. In the last decade, proof-of-concept studies have demonstrated that ESCS in combination with task-oriented rehabilitative interventions can partially restore motor function and neurological recovery after spinal cord injury (SCI). In addition to the ESCS applications for improvement of upper and lower extremity function, ESCS has been investigated for treatment of autonomic dysfunction after SCI such as orthostatic hypotension. The aim of this overview is to present the background of ESCS, emerging concepts and its readiness to become a routine therapy in SCI beyond treatment of chronic pain conditions.
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Affiliation(s)
- Antonia Luz
- Spinal Cord Injury Center, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany
| | - Rüdiger Rupp
- Spinal Cord Injury Center, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany
| | - Rezvan Ahmadi
- Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Norbert Weidner
- Spinal Cord Injury Center, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
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Bandres MF, Gomes JL, McPherson JG. Motor-targeted spinal stimulation promotes concurrent rebalancing of pathologic nociceptive transmission in chronic spinal cord injury. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.12.536477. [PMID: 37090665 PMCID: PMC10120632 DOI: 10.1101/2023.04.12.536477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Electrical stimulation of spinal networks below a spinal cord injury (SCI) is a promising approach to restore functions compromised by inadequate excitatory neural drive. The most translationally successful examples are paradigms intended to increase neural transmission in weakened yet spared motor pathways and spinal motor networks rendered dormant after being severed from their inputs by lesion. Less well understood is whether spinal stimulation is also capable of reducing neural transmission in pathways made pathologically overactive by SCI. Debilitating spasms, spasticity, and neuropathic pain are all common manifestations of hyperexcitable spinal responses to sensory feedback. But whereas spasms and spasticity can often be managed pharmacologically, SCI-related neuropathic pain is notoriously medically refractory. Interestingly, however, spinal stimulation is a clinically available option for ameliorating neuropathic pain arising from etiologies other than SCI, and it has traditionally been assumed to modulate sensorimotor networks overlapping with those engaged by spinal stimulation for motor rehabilitation. Thus, we reasoned that spinal stimulation intended to increase transmission in motor pathways may simultaneously reduce transmission in spinal pain pathways. Using a well-validated pre-clinical model of SCI that results in severe bilateral motor impairments and SCI-related neuropathic pain, we show that the responsiveness of neurons integral to the development and persistence of the neuropathic pain state can be enduringly reduced by motor-targeted spinal stimulation while preserving spinal responses to non-pain-related sensory feedback. These results suggest that spinal stimulation paradigms could be intentionally designed to afford multi-modal therapeutic benefits, directly addressing the diverse, intersectional rehabilitation goals of people living with SCI.
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Bonizzato M, Guay Hottin R, Côté SL, Massai E, Choinière L, Macar U, Laferrière S, Sirpal P, Quessy S, Lajoie G, Martinez M, Dancause N. Autonomous optimization of neuroprosthetic stimulation parameters that drive the motor cortex and spinal cord outputs in rats and monkeys. Cell Rep Med 2023; 4:101008. [PMID: 37044093 PMCID: PMC10140617 DOI: 10.1016/j.xcrm.2023.101008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/16/2023] [Accepted: 03/20/2023] [Indexed: 04/14/2023]
Abstract
Neural stimulation can alleviate paralysis and sensory deficits. Novel high-density neural interfaces can enable refined and multipronged neurostimulation interventions. To achieve this, it is essential to develop algorithmic frameworks capable of handling optimization in large parameter spaces. Here, we leveraged an algorithmic class, Gaussian-process (GP)-based Bayesian optimization (BO), to solve this problem. We show that GP-BO efficiently explores the neurostimulation space, outperforming other search strategies after testing only a fraction of the possible combinations. Through a series of real-time multi-dimensional neurostimulation experiments, we demonstrate optimization across diverse biological targets (brain, spinal cord), animal models (rats, non-human primates), in healthy subjects, and in neuroprosthetic intervention after injury, for both immediate and continual learning over multiple sessions. GP-BO can embed and improve "prior" expert/clinical knowledge to dramatically enhance its performance. These results advocate for broader establishment of learning agents as structural elements of neuroprosthetic design, enabling personalization and maximization of therapeutic effectiveness.
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Affiliation(s)
- Marco Bonizzato
- Department of Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montreal, QC H3T 1J4, Canada; Department of Electrical Engineering and Institute of Biomedical Engineering, Polytechnique Montréal, Montreal, QC H3T 1J4, Canada; CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC H4J 1C5, Canada; Mila - Québec AI Institute, Montreal, QC H2S 3H1, Canada.
| | - Rose Guay Hottin
- Department of Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montreal, QC H3T 1J4, Canada; Department of Electrical Engineering and Institute of Biomedical Engineering, Polytechnique Montréal, Montreal, QC H3T 1J4, Canada; Mila - Québec AI Institute, Montreal, QC H2S 3H1, Canada
| | - Sandrine L Côté
- Department of Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Elena Massai
- Department of Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Léo Choinière
- Department of Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montreal, QC H3T 1J4, Canada; Mila - Québec AI Institute, Montreal, QC H2S 3H1, Canada
| | - Uzay Macar
- Department of Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montreal, QC H3T 1J4, Canada; Mila - Québec AI Institute, Montreal, QC H2S 3H1, Canada
| | - Samuel Laferrière
- Mila - Québec AI Institute, Montreal, QC H2S 3H1, Canada; Computer Science Department, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Parikshat Sirpal
- Department of Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montreal, QC H3T 1J4, Canada; Mila - Québec AI Institute, Montreal, QC H2S 3H1, Canada
| | - Stephan Quessy
- Department of Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Guillaume Lajoie
- Mila - Québec AI Institute, Montreal, QC H2S 3H1, Canada; Mathematics and Statistics Department, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Marina Martinez
- Department of Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montreal, QC H3T 1J4, Canada; CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC H4J 1C5, Canada
| | - Numa Dancause
- Department of Neurosciences and Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montreal, QC H3T 1J4, Canada.
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Yu H, Yang S, Li H, Wu R, Lai B, Zheng Q. Activating Endogenous Neurogenesis for Spinal Cord Injury Repair: Recent Advances and Future Prospects. Neurospine 2023; 20:164-180. [PMID: 37016865 PMCID: PMC10080446 DOI: 10.14245/ns.2245184.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/29/2022] [Indexed: 04/03/2023] Open
Abstract
After spinal cord injury (SCI), endogenous neural stem cells are activated and migrate to the injury site where they differentiate into astrocytes, but they rarely differentiate into neurons. It is difficult for brain-derived information to be transmitted through the injury site after SCI because of the lack of neurons that can relay neural information through the injury site, and the functional recovery of adult mammals is difficult to achieve. The development of bioactive materials, tissue engineering, stem cell therapy, and physiotherapy has provided new strategies for the treatment of SCI and shown broad application prospects, such as promoting endogenous neurogenesis after SCI. In this review, we focus on novel approaches including tissue engineering, stem cell technology, and physiotherapy to promote endogenous neurogenesis and their therapeutic effects on SCI. Moreover, we explore the mechanisms and challenges of endogenous neurogenesis for the repair of SCI.
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Affiliation(s)
- Haiyang Yu
- Department of Orthopedics, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Shangbin Yang
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Haotao Li
- Department of Orthopedics, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Rongjie Wu
- Department of Orthopedics, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Biqin Lai
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat-sen University), Ministry of Education, Guangzhou, China
- Co-corresponding Author Biqin Lai Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat-sen University), Ministry of Education, Guangzhou, China
| | - Qiujian Zheng
- Department of Orthopedics, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Southern Medical University, Guangzhou, China
- Corresponding Author Qiujian Zheng Department of Orthopedics, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
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Bryson N, Lombardi L, Hawthorn R, Fei J, Keesey R, Peiffer JD, Seáñez I. Enhanced selectivity of transcutaneous spinal cord stimulation by multielectrode configuration. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.30.534835. [PMID: 37034788 PMCID: PMC10081184 DOI: 10.1101/2023.03.30.534835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Objective Transcutaneous spinal cord stimulation (tSCS) has been gaining momentum as a non-invasive rehabilitation approach to restore movement to paralyzed muscles after spinal cord injury (SCI). However, its low selectivity limits the types of movements that can be enabled and, thus, its potential applications in rehabilitation. Approach In this cross-over study design, we investigated whether muscle recruitment selectivity of individual muscles could be enhanced by multielectrode configurations of tSCS in 16 neurologically intact individuals. We hypothesized that due to the segmental innervation of lower limb muscles, we could identify muscle-specific optimal stimulation locations that would enable improved recruitment selectivity over conventional tSCS. We elicited leg muscle responses by delivering biphasic pulses of electrical stimulation to the lumbosacral enlargement using conventional and multielectrode tSCS. Results Analysis of recruitment curve responses confirmed that multielectrode configurations could improve the rostrocaudal and lateral selectivity of tSCS. To investigate whether motor responses elicited by spatially selective tSCS were mediated by posterior root-muscle reflexes, each stimulation event was a paired pulse with a conditioning-test interval of 33.3 ms. Muscle responses to the second stimulation pulse were significantly suppressed, a characteristic of post-activation depression suggesting that spatially selective tSCS recruits proprioceptive fibers that reflexively activate muscle-specific motor neurons in the spinal cord. Moreover, the combination of leg muscle recruitment probability and segmental innervation maps revealed a stereotypical spinal activation map in congruence with each electrode's position. Significance Improvements in muscle recruitment selectivity could be essential for the effective translation into stimulation protocols that selectively enhance single-joint movements in neurorehabilitation.
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Rouhi S, Rahmani S, Shanesazzadeh F, Ahmadvand T, Namazi M, Fardmanesh M, Kiani S. Stimulation of spinal cord according to recorded theta hippocampal rhythm during rat move on treadmill. BIOMED ENG-BIOMED TE 2023:bmt-2022-0420. [PMID: 36872631 DOI: 10.1515/bmt-2022-0420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/20/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVES Several studies have revealed that after spinal cord injury (SCI), in acute and sub-acute phase the spinal cord neurons below the injury are alive and could stimulate by use of electrical pulses. Spinal cord electrical stimulation could generate movement for paralyzed limbs and is a rehabilitation strategy for paralyzed patients. An innovative idea for controlling spinal cord electrical stimulation onset time is presented in current study. METHODS In our method, the time of applying electrical pulse on the spinal cord is according to rat behavioral movement and two movements behaviors are recognized only based on rat EEG theta rhythm on the treadmill line. Briefly, 5 rats were placed on the treadmill and the animals experienced zero or 12 m/min speeds. RESULTS These speeds were recognized based on EEG signals and off-line periodogram analysis. Finally, the electrical stimulation pulses had been applied to the spinal cord if the results of the EEG analysis had detected running behavior. CONCLUSIONS These findings may guide future research in utilizing theta rhythms for the recognition of animal motor behavior and designing electrical stimulation systems based on it.
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Affiliation(s)
- Shahin Rouhi
- Department of Developmental Biology, University of Science and Culture, ACECR, Tehran, Iran.,Department of Stem Cell and Developmental Biology, Cell Science Research Center, ROYAN Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.,Department of Brain and Cognitive Science, Cell Science Research Center, ROYAN Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Saeid Rahmani
- Institute for Research in Fundamental Science (IPM), Tehran, Iran
| | | | - Tala Ahmadvand
- School of Electrical Engineering, Sharif University of Technology, Tehran, Iran
| | - Mahrokh Namazi
- School of Electrical Engineering, Sharif University of Technology, Tehran, Iran
| | - Mehdi Fardmanesh
- School of Electrical Engineering, Sharif University of Technology, Tehran, Iran
| | - Sahar Kiani
- Department of Stem Cell and Developmental Biology, Cell Science Research Center, ROYAN Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.,Department of Brain and Cognitive Science, Cell Science Research Center, ROYAN Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
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38
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Roussel M, Lafrance-Zoubga D, Josset N, Lemieux M, Bretzner F. Functional contribution of mesencephalic locomotor region nuclei to locomotor recovery after spinal cord injury. Cell Rep Med 2023; 4:100946. [PMID: 36812893 PMCID: PMC9975330 DOI: 10.1016/j.xcrm.2023.100946] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/09/2022] [Accepted: 01/23/2023] [Indexed: 02/23/2023]
Abstract
Spinal cord injury (SCI) results in a disruption of information between the brain and the spinal circuit. Electrical stimulation of the mesencephalic locomotor region (MLR) can promote locomotor recovery in acute and chronic SCI rodent models. Although clinical trials are currently under way, there is still debate about the organization of this supraspinal center and which anatomic correlate of the MLR should be targeted to promote recovery. Combining kinematics, electromyographic recordings, anatomic analysis, and mouse genetics, our study reveals that glutamatergic neurons of the cuneiform nucleus contribute to locomotor recovery by enhancing motor efficacy in hindlimb muscles, and by increasing locomotor rhythm and speed on a treadmill, over ground, and during swimming in chronic SCI mice. In contrast, glutamatergic neurons of the pedunculopontine nucleus slow down locomotion. Therefore, our study identifies the cuneiform nucleus and its glutamatergic neurons as a therapeutical target to improve locomotor recovery in patients living with SCI.
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Affiliation(s)
- Marie Roussel
- Centre de Recherche du CHU de Québec, CHUL-Neurosciences, 2705 Boul. Laurier, Québec, QC G1V 4G2, Canada
| | - David Lafrance-Zoubga
- Centre de Recherche du CHU de Québec, CHUL-Neurosciences, 2705 Boul. Laurier, Québec, QC G1V 4G2, Canada
| | - Nicolas Josset
- Centre de Recherche du CHU de Québec, CHUL-Neurosciences, 2705 Boul. Laurier, Québec, QC G1V 4G2, Canada
| | - Maxime Lemieux
- Centre de Recherche du CHU de Québec, CHUL-Neurosciences, 2705 Boul. Laurier, Québec, QC G1V 4G2, Canada
| | - Frederic Bretzner
- Centre de Recherche du CHU de Québec, CHUL-Neurosciences, 2705 Boul. Laurier, Québec, QC G1V 4G2, Canada; Faculty of Medicine, Department of Psychiatry and Neurosciences, Université Laval, Québec, QC G1V 4G2, Canada.
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Soriano JE, Hudelle R, Squair JW, Mahe L, Amir S, Gautier M, Puchalt VP, Barraud Q, Phillips AA, Courtine G. Longitudinal interrogation of sympathetic neural circuits and hemodynamics in preclinical models. Nat Protoc 2023; 18:340-373. [PMID: 36418397 DOI: 10.1038/s41596-022-00764-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 05/27/2022] [Indexed: 11/24/2022]
Abstract
Neurological disorders, including spinal cord injury, result in hemodynamic instability due to the disruption of supraspinal projections to the sympathetic circuits located in the spinal cord. We recently developed a preclinical model that allows the identification of the topology and dynamics through which sympathetic circuits modulate hemodynamics, supporting the development of a neuroprosthetic baroreflex that precisely controls blood pressure in rats, monkeys and humans with spinal cord injuries. Here, we describe the continuous monitoring of arterial blood pressure and sympathetic nerve activity over several months in preclinical models of chronic neurological disorders using commercially available telemetry technologies, as well as optogenetic and neuronal tract-tracing procedures specifically adapted to the sympathetic circuitry. Using a blueprint to construct a negative-pressure chamber, the approach enables the reproduction, in rats, of well-controlled and reproducible episodes of hypotension-mimicking orthostatic challenges already used in humans. Blood pressure variations can thus be directly induced and linked to the molecular, functional and anatomical properties of specific neurons in the brainstem, spinal cord and ganglia. Each procedure can be completed in under 2 h, while the construction of the negative-pressure chamber requires up to 1 week. With training, individuals with a basic understanding of cardiovascular physiology, engineering or neuroscience can collect longitudinal recordings of hemodynamics and sympathetic nerve activity over several months.
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Affiliation(s)
- Jan Elaine Soriano
- Neuro-X Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (.NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland.,Department of Physiology and Pharmacology, Clinical Neurosciences, Cardiac Sciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Rémi Hudelle
- Neuro-X Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (.NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Jordan W Squair
- Neuro-X Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (.NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland.,Department of Physiology and Pharmacology, Clinical Neurosciences, Cardiac Sciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Lois Mahe
- Neuro-X Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (.NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Suje Amir
- Neuro-X Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (.NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Matthieu Gautier
- Neuro-X Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (.NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Victor Perez Puchalt
- Neuro-X Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (.NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Quentin Barraud
- Neuro-X Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (.NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Aaron A Phillips
- Department of Physiology and Pharmacology, Clinical Neurosciences, Cardiac Sciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | - Gregoire Courtine
- Neuro-X Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland. .,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland. .,Defitech Center for Interventional Neurotherapies (.NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland.
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40
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Lam CM, Latif U, Sack A, Govindan S, Sanderson M, Vu DT, Smith G, Sayed D, Khan T. Advances in Spinal Cord Stimulation. Bioengineering (Basel) 2023; 10:185. [PMID: 36829678 PMCID: PMC9951889 DOI: 10.3390/bioengineering10020185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/17/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Neuromodulation, specifically spinal cord stimulation (SCS), has become a staple of chronic pain management for various conditions including failed back syndrome, chronic regional pain syndrome, refractory radiculopathy, and chronic post operative pain. Since its conceptualization, it has undergone several advances to increase safety and convenience for patients and implanting physicians. Current research and efforts are aimed towards novel programming modalities and modifications of existing hardware. Here we review the recent advances and future directions in spinal cord stimulation including a brief review of the history of SCS, SCS waveforms, new materials for SCS electrodes (including artificial skins, new materials, and injectable electrodes), closed loop systems, and neurorestorative devices.
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Affiliation(s)
- Christopher M. Lam
- Department of Anesthesiology and Pain Medicine, University of Kansas Health System, Kansas City, KS 66160, USA
| | - Usman Latif
- Department of Anesthesiology and Pain Medicine, University of Kansas Health System, Kansas City, KS 66160, USA
| | - Andrew Sack
- Department of Anesthesiology and Pain Medicine, University of Kansas Health System, Kansas City, KS 66160, USA
| | - Susheel Govindan
- Department of Anesthesiology and Pain Medicine, University of Kansas Health System, Kansas City, KS 66160, USA
| | - Miles Sanderson
- Department of Anesthesiology and Pain Medicine, University of Kansas Health System, Kansas City, KS 66160, USA
| | - Dan T. Vu
- Department of Anesthesiology and Pain Medicine, University of Kansas Health System, Kansas City, KS 66160, USA
| | - Gabriella Smith
- School of Medicine, University of Kansas, Kansas City, KS 66160, USA
| | - Dawood Sayed
- Department of Anesthesiology and Pain Medicine, University of Kansas Health System, Kansas City, KS 66160, USA
| | - Talal Khan
- Department of Anesthesiology and Pain Medicine, University of Kansas Health System, Kansas City, KS 66160, USA
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41
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Chen X, Dong X, Feng Y, Jiao Y, Yu J, Song Y, Li X, Zhang L, Hou P, Xie P. Muscle activation patterns and muscle synergies reflect different modes of coordination during upper extremity movement. Front Hum Neurosci 2023; 16:912440. [PMID: 36741782 PMCID: PMC9889926 DOI: 10.3389/fnhum.2022.912440] [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: 04/04/2022] [Accepted: 11/28/2022] [Indexed: 01/20/2023] Open
Abstract
A core issue in motor control is how the central nervous system generates and selects the muscle activation patterns necessary to achieve a variety of behaviors and movements. Extensive studies have verified that it is the foundation to induce a complex movement by the modular combinations of several muscles with a synergetic relationship. However, a few studies focus on the synergetic similarity and dissimilarity among different types of movements, especially for the upper extremity movements. In this study, we introduced the non-negative matrix factorization (NMF) method to explore the muscle activation patterns and synergy structure under 6 types of movements, involving the hand open (HO), hand close (HC), wrist flexion (WF), wrist extension (WE), supination (SU), and pronation (PR). For this, we enrolled 10 healthy subjects to record the electromyography signal for NMF calculation. The results showed a highly modular similarity of the muscle synergy among subjects under the same movement. Furthermore, Spearman's correlation analysis indicated significant similarities among HO-WE, HO-SU, and WE-SU (p < 0.001). Additionally, we also found shared synergy and special synergy in activation patterns among different movements. This study confirmed the theory of modular structure in the central nervous system, which yields a stable synergetic pattern under the same movement. Our findings on muscle synergy will be of great significance to motor control and even to clinical assessment techniques.
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Affiliation(s)
- Xiaoling Chen
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, School of Electrical Engineering, Yanshan University, Qinhuangdao, Hebei, China,Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, School of Electrical Engineering, Yanshan University, Qinhuangdao, Hebei, China
| | - Xiaojiao Dong
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, School of Electrical Engineering, Yanshan University, Qinhuangdao, Hebei, China
| | - Yange Feng
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, School of Electrical Engineering, Yanshan University, Qinhuangdao, Hebei, China
| | - Yuntao Jiao
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, School of Electrical Engineering, Yanshan University, Qinhuangdao, Hebei, China
| | - Jian Yu
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, School of Electrical Engineering, Yanshan University, Qinhuangdao, Hebei, China
| | - Yan Song
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, School of Electrical Engineering, Yanshan University, Qinhuangdao, Hebei, China
| | - Xinxin Li
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, School of Electrical Engineering, Yanshan University, Qinhuangdao, Hebei, China
| | - Lijie Zhang
- School of Mechanical Engineering, Yanshan University, Qinhuangdao, Hebei, China
| | - Peiguo Hou
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, School of Electrical Engineering, Yanshan University, Qinhuangdao, Hebei, China,Peiguo Hou,
| | - Ping Xie
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, School of Electrical Engineering, Yanshan University, Qinhuangdao, Hebei, China,Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, School of Electrical Engineering, Yanshan University, Qinhuangdao, Hebei, China,*Correspondence: Ping Xie,
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Gupta A, Vardalakis N, Wagner FB. Neuroprosthetics: from sensorimotor to cognitive disorders. Commun Biol 2023; 6:14. [PMID: 36609559 PMCID: PMC9823108 DOI: 10.1038/s42003-022-04390-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
Neuroprosthetics is a multidisciplinary field at the interface between neurosciences and biomedical engineering, which aims at replacing or modulating parts of the nervous system that get disrupted in neurological disorders or after injury. Although neuroprostheses have steadily evolved over the past 60 years in the field of sensory and motor disorders, their application to higher-order cognitive functions is still at a relatively preliminary stage. Nevertheless, a recent series of proof-of-concept studies suggest that electrical neuromodulation strategies might also be useful in alleviating some cognitive and memory deficits, in particular in the context of dementia. Here, we review the evolution of neuroprosthetics from sensorimotor to cognitive disorders, highlighting important common principles such as the need for neuroprosthetic systems that enable multisite bidirectional interactions with the nervous system.
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Affiliation(s)
- Ankur Gupta
- grid.462010.1Univ. Bordeaux, CNRS, IMN, UMR 5293, F-33000 Bordeaux, France
| | | | - Fabien B. Wagner
- grid.462010.1Univ. Bordeaux, CNRS, IMN, UMR 5293, F-33000 Bordeaux, France
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43
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Lemos N, Fernandes GL, Ribeiro AM, Maia-Lemos PS, Contiero W, Croos-Bezerra V, Tomlison G, Faber J, Oliveira ASB, Girão MJBC. Rehabilitation of People With Chronic Spinal Cord Injury Using a Laparoscopically Implanted Neurostimulator: Impact on Mobility and Urinary, Anorectal, and Sexual Functions. Neuromodulation 2023; 26:233-245. [PMID: 35248460 DOI: 10.1016/j.neurom.2022.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/01/2021] [Accepted: 01/04/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study aimed to assess the impact of the laparoscopic implantation of neuromodulation electrodes (Possover-LION procedure) on mobility and on sexual, urinary, and anorectal functions of people with chronic spinal cord injury (SCI). MATERIAL AND METHODS Longitudinal analysis of 30 patients with chronic SCI (21 ASIA impairment scale (AIS) A, eight AIS B, and one AIS C) submitted to the Possover-LION procedure for bilateral neuromodulation of femoral, sciatic, and pudendal nerves. Assessments were performed before the surgical procedure and at 3, 6, and 12 months postoperatively. The primary outcome was evolution in walking, measured by the Walking Index for Spinal Cord Injury score, preoperatively and at 12 months. Secondary outcomes were changes in overall mobility (Mobility Assessment Tool for Evaluation of Rehabilitation score), urinary function and quality of life (Qualiveen questionnaire), and bowel (time for bowel emptying proceedings and Wexner's Fecal Incontinence Severity Index [FISI]) and sexual functions (International Index of Erectile Function for men and Female Sexual Function Index for women). Surgical time, intraoperative bleeding, and perioperative complications were also recorded. RESULTS Qualitatively, 18 of 25 (72%) patients with thoracic injury and 3 of 5 (60%) patients with cervical injury managed to establish a walker-assisted gait at one-year follow-up (p < 0.0001). A total of 11 (47.8%) have improved in their urinary incontinence (p < 0.0001), and seven (30.4%) improved their enuresis (p = 0.0156). The FISI improved from a median of 9 points preoperatively to 5.5 at 12 months (p = 0.0056). Of note, 20 of 28 (71.4%) patients reported an improvement on genital sensitivity at 12 months postoperatively (p < 0.0001), but this was not reflected in sexual quality-of-life questionnaires. CONCLUSIONS Patients experienced improved mobility and genital sensitivity and a reduction in the number of urinary and fecal incontinence episodes. By demonstrating reproducible outcomes and safety, this study helps establish the Possover-LION procedure as an addition to the therapeutic armamentarium for the rehabilitation of patients with chronic SCI. CLINICAL TRIAL REGISTRATION This study was registered at the WHO Clinical Trials Database through the Brazilian Registry of Clinical Trials-REBEC (Universal Tracking Number: U1111-1261-4428).
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Affiliation(s)
- Nucelio Lemos
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil.
| | - Gustavo L Fernandes
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil; Department of Obstetrics and Gynecology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - Augusta M Ribeiro
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil
| | - Priscila S Maia-Lemos
- Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil
| | - Wellington Contiero
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil
| | - Victor Croos-Bezerra
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil
| | - George Tomlison
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Jean Faber
- Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | - Acary S B Oliveira
- Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | - Manoel J B C Girão
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil
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Sun SY, Giszter SF, Harkema SJ, Angeli CA. Modular organization of locomotor networks in people with severe spinal cord injury. Front Neurosci 2022; 16:1041015. [PMID: 36570830 PMCID: PMC9768556 DOI: 10.3389/fnins.2022.1041015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Previous studies support modular organization of locomotor circuitry contributing to the activation of muscles in a spatially and temporally organized manner during locomotion. Human spinal circuitry may reorganize after spinal cord injury; however, it is unclear if reorganization of spinal circuitry post-injury affects the modular organization. Here we characterize the modular synergy organization of locomotor muscle activity expressed during assisted stepping in subjects with complete and incomplete spinal cord injury (SCI) of varying chronicity, before any explicit training regimen. We also investigated whether the synergy characteristics changed in two subjects who achieved independent walking after training with spinal cord epidural stimulation. Methods To capture synergy structures during stepping, individuals with SCI were stepped on a body-weight supported treadmill with manual facilitation, while electromyography (EMGs) were recorded from bilateral leg muscles. EMGs were analyzed using non-negative matrix factorization (NMF) and independent component analysis (ICA) to identify synergy patterns. Synergy patterns from the SCI subjects were compared across different clinical characteristics and to non-disabled subjects (NDs). Results Results for both NMF and ICA indicated that the subjects with SCI were similar among themselves, but expressed a greater variability in the number of synergies for criterion variance capture compared to NDs, and weaker correlation to NDs. ICA yielded a greater number of muscle synergies than NMF. Further, the clinical characteristics of SCI subjects and chronicity did not predict any significant differences in the spatial synergy structures despite any neuroplastic changes. Further, post-training synergies did not become closer to ND synergies in two individuals. Discussion These findings suggest fundamental differences between motor modules expressed in SCIs and NDs, as well as a striking level of spatial and temporal synergy stability in motor modules in the SCI population, absent the application of specific interventions.
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Affiliation(s)
- Soo Yeon Sun
- Department of Physical Therapy, Alvernia University, Reading, PA, United States
| | - Simon F. Giszter
- Department of Neurobiology and Anatomy, College of Medicine, Drexel University, Philadelphia, PA, United States,School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, United States
| | - Susan J. Harkema
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United States,Department of Neurological Surgery, University of Louisville, Louisville, KY, United States,Frazier Rehab Institute, University of Louisville Health, Louisville, KY, United States
| | - Claudia A. Angeli
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United States,Frazier Rehab Institute, University of Louisville Health, Louisville, KY, United States,Department of Bioengineering, University of Louisville, Louisville, KY, United States,*Correspondence: Claudia A. Angeli,
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Anderson MA, Squair JW, Gautier M, Hutson TH, Kathe C, Barraud Q, Bloch J, Courtine G. Natural and targeted circuit reorganization after spinal cord injury. Nat Neurosci 2022; 25:1584-1596. [PMID: 36396975 DOI: 10.1038/s41593-022-01196-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/05/2022] [Indexed: 11/18/2022]
Abstract
A spinal cord injury disrupts communication between the brain and the circuits in the spinal cord that regulate neurological functions. The consequences are permanent paralysis, loss of sensation and debilitating dysautonomia. However, the majority of circuits located above and below the injury remain anatomically intact, and these circuits can reorganize naturally to improve function. In addition, various neuromodulation therapies have tapped into these processes to further augment recovery. Emerging research is illuminating the requirements to reconstitute damaged circuits. Here, we summarize these natural and targeted reorganizations of circuits after a spinal cord injury. We also advocate for new concepts of reorganizing circuits informed by multi-omic single-cell atlases of recovery from injury. These atlases will uncover the molecular logic that governs the selection of 'recovery-organizing' neuronal subpopulations, and are poised to herald a new era in spinal cord medicine.
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Affiliation(s)
- Mark A Anderson
- NeuroX Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland.,Wyss Center for Bio and Neuroengineering, Geneva, Switzerland
| | - Jordan W Squair
- NeuroX Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Matthieu Gautier
- NeuroX Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Thomas H Hutson
- NeuroX Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland.,Wyss Center for Bio and Neuroengineering, Geneva, Switzerland
| | - Claudia Kathe
- NeuroX Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Quentin Barraud
- NeuroX Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Jocelyne Bloch
- NeuroX Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - Grégoire Courtine
- NeuroX Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland. .,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland. .,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland.
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Qin C, Yue Z, Wallace GG, Chen J. Bipolar Electrochemical Stimulation Using Conducting Polymers for Wireless Electroceuticals and Future Directions. ACS APPLIED BIO MATERIALS 2022; 5:5041-5056. [PMID: 36260917 DOI: 10.1021/acsabm.2c00679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Electrochemistry has become a powerful strategy to modulate cellular behavior and biological activity by manipulating electrical signals. Subsequent electrical stimulus-responsive conducting polymers (CPs) have advanced traditional wired electrochemical stimulation (ES) systems and developed wireless cell stimulation systems due to their electroconductivity, biocompatibility, stability, and flexibility. Bipolar electrochemistry (BPE), i.e., wireless electrochemistry, offers an effective pathway to modify wired ES systems into a desirable contactless mode, turning out a potential technique to offer fundamental insights into neural cell stimulation and neural network formation. This review commences with a brief discussion of the BPE technique and also the advantages of a bipolar electrochemical stimulation (BPES) system compared to traditional wired ES systems and other wireless ES systems. Then, the BPES system is elucidated through four aspects: the benefits of BPES, the key factors to establish BPES platforms for cell stimulation, the limits/barriers to overcome for current rigid materials in particular metals-based systems, and a brief overview of the concept proved by CPs-based systems. Furthermore, how to refine the existing BPES system from materials/devices modification that combine CP compositions with 3D fabrication/bioprinting technologies is elaborately discussed as well. Finally, the review ends together with future research directions, picturing the potential of BPES system in biomedical applications.
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Affiliation(s)
- Chunyan Qin
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, Australian Institute for Innovative Materials, Innovation Campus, University of Wollongong, Squires Way, North Wollongong, New South Wales2519, Australia
| | - Zhilian Yue
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, Australian Institute for Innovative Materials, Innovation Campus, University of Wollongong, Squires Way, North Wollongong, New South Wales2519, Australia
| | - Gordon G Wallace
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, Australian Institute for Innovative Materials, Innovation Campus, University of Wollongong, Squires Way, North Wollongong, New South Wales2519, Australia
| | - Jun Chen
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, Australian Institute for Innovative Materials, Innovation Campus, University of Wollongong, Squires Way, North Wollongong, New South Wales2519, Australia
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Kathe C, Skinnider MA, Hutson TH, Regazzi N, Gautier M, Demesmaeker R, Komi S, Ceto S, James ND, Cho N, Baud L, Galan K, Matson KJE, Rowald A, Kim K, Wang R, Minassian K, Prior JO, Asboth L, Barraud Q, Lacour SP, Levine AJ, Wagner F, Bloch J, Squair JW, Courtine G. The neurons that restore walking after paralysis. Nature 2022; 611:540-547. [DOI: 10.1038/s41586-022-05385-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 09/23/2022] [Indexed: 11/10/2022]
Abstract
AbstractA spinal cord injury interrupts pathways from the brain and brainstem that project to the lumbar spinal cord, leading to paralysis. Here we show that spatiotemporal epidural electrical stimulation (EES) of the lumbar spinal cord1–3 applied during neurorehabilitation4,5 (EESREHAB) restored walking in nine individuals with chronic spinal cord injury. This recovery involved a reduction in neuronal activity in the lumbar spinal cord of humans during walking. We hypothesized that this unexpected reduction reflects activity-dependent selection of specific neuronal subpopulations that become essential for a patient to walk after spinal cord injury. To identify these putative neurons, we modelled the technological and therapeutic features underlying EESREHAB in mice. We applied single-nucleus RNA sequencing6–9 and spatial transcriptomics10,11 to the spinal cords of these mice to chart a spatially resolved molecular atlas of recovery from paralysis. We then employed cell type12,13 and spatial prioritization to identify the neurons involved in the recovery of walking. A single population of excitatory interneurons nested within intermediate laminae emerged. Although these neurons are not required for walking before spinal cord injury, we demonstrate that they are essential for the recovery of walking with EES following spinal cord injury. Augmenting the activity of these neurons phenocopied the recovery of walking enabled by EESREHAB, whereas ablating them prevented the recovery of walking that occurs spontaneously after moderate spinal cord injury. We thus identified a recovery-organizing neuronal subpopulation that is necessary and sufficient to regain walking after paralysis. Moreover, our methodology establishes a framework for using molecular cartography to identify the neurons that produce complex behaviours.
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Li Y, Jiang Y, Lan L, Ge X, Cheng R, Zhan Y, Chen G, Shi L, Wang R, Zheng N, Yang C, Cheng JX. Optically-generated focused ultrasound for noninvasive brain stimulation with ultrahigh precision. LIGHT, SCIENCE & APPLICATIONS 2022; 11:321. [PMID: 36323662 PMCID: PMC9630534 DOI: 10.1038/s41377-022-01004-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/29/2022] [Accepted: 10/07/2022] [Indexed: 06/01/2023]
Abstract
High precision neuromodulation is a powerful tool to decipher neurocircuits and treat neurological diseases. Current non-invasive neuromodulation methods offer limited precision at the millimeter level. Here, we report optically-generated focused ultrasound (OFUS) for non-invasive brain stimulation with ultrahigh precision. OFUS is generated by a soft optoacoustic pad (SOAP) fabricated through embedding candle soot nanoparticles in a curved polydimethylsiloxane film. SOAP generates a transcranial ultrasound focus at 15 MHz with an ultrahigh lateral resolution of 83 µm, which is two orders of magnitude smaller than that of conventional transcranial-focused ultrasound (tFUS). Here, we show effective OFUS neurostimulation in vitro with a single ultrasound cycle. We demonstrate submillimeter transcranial stimulation of the mouse motor cortex in vivo. An acoustic energy of 0.6 mJ/cm2, four orders of magnitude less than that of tFUS, is sufficient for successful OFUS neurostimulation. OFUS offers new capabilities for neuroscience studies and disease treatments by delivering a focus with ultrahigh precision non-invasively.
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Affiliation(s)
- Yueming Li
- Department of Mechanical Engineering, Boston University, Boston, MA, 02215, USA
| | - Ying Jiang
- Graduate Program for Neuroscience, Boston University, Boston, MA, 02215, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02142, USA
| | - Lu Lan
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA
| | - Xiaowei Ge
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA
| | - Ran Cheng
- Department of Chemistry, Boston University, Boston, MA, 02215, USA
| | - Yuewei Zhan
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
| | - Guo Chen
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA
| | - Linli Shi
- Department of Chemistry, Boston University, Boston, MA, 02215, USA
| | - Runyu Wang
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA
| | - Nan Zheng
- Division of Materials Science and Engineering, Boston University, Boston, MA, 02215, USA
| | - Chen Yang
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA.
- Department of Chemistry, Boston University, Boston, MA, 02215, USA.
| | - Ji-Xin Cheng
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA.
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA.
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Go GT, Lee Y, Seo DG, Lee TW. Organic Neuroelectronics: From Neural Interfaces to Neuroprosthetics. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2201864. [PMID: 35925610 DOI: 10.1002/adma.202201864] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/17/2022] [Indexed: 06/15/2023]
Abstract
Requirements and recent advances in research on organic neuroelectronics are outlined herein. Neuroelectronics such as neural interfaces and neuroprosthetics provide a promising approach to diagnose and treat neurological diseases. However, the current neural interfaces are rigid and not biocompatible, so they induce an immune response and deterioration of neural signal transmission. Organic materials are promising candidates for neural interfaces, due to their mechanical softness, excellent electrochemical properties, and biocompatibility. Also, organic nervetronics, which mimics functional properties of the biological nerve system, is being developed to overcome the limitations of the complex and energy-consuming conventional neuroprosthetics that limit long-term implantation and daily-life usage. Examples of organic materials for neural interfaces and neural signal recordings are reviewed, recent advances of organic nervetronics that use organic artificial synapses are highlighted, and then further requirements for neuroprosthetics are discussed. Finally, the future challenges that must be overcome to achieve ideal organic neuroelectronics for next-generation neuroprosthetics are discussed.
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Affiliation(s)
- Gyeong-Tak Go
- Department of Materials Science and Engineering, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - Yeongjun Lee
- Department of Chemical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Dae-Gyo Seo
- Department of Materials Science and Engineering, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - Tae-Woo Lee
- Department of Materials Science and Engineering, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
- Institute of Engineering Research, Research Institute of Advanced Materials, Soft Foundry, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
- School of Chemical and Biological Engineering, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
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Insausti-Delgado A, López-Larraz E, Nishimura Y, Ziemann U, Ramos-Murguialday A. Non-invasive brain-spine interface: Continuous control of trans-spinal magnetic stimulation using EEG. Front Bioeng Biotechnol 2022; 10:975037. [PMID: 36394044 PMCID: PMC9659618 DOI: 10.3389/fbioe.2022.975037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/23/2022] [Indexed: 08/22/2023] Open
Abstract
Brain-controlled neuromodulation has emerged as a promising tool to promote functional recovery in patients with motor disorders. Brain-machine interfaces exploit this neuromodulatory strategy and could be used for restoring voluntary control of lower limbs. In this work, we propose a non-invasive brain-spine interface (BSI) that processes electroencephalographic (EEG) activity to volitionally control trans-spinal magnetic stimulation (ts-MS), as an approach for lower-limb neurorehabilitation. This novel platform allows to contingently connect motor cortical activation during leg motor imagery with the activation of leg muscles via ts-MS. We tested this closed-loop system in 10 healthy participants using different stimulation conditions. This BSI efficiently removed stimulation artifacts from EEG regardless of ts-MS intensity used, allowing continuous monitoring of cortical activity and real-time closed-loop control of ts-MS. Our BSI induced afferent and efferent evoked responses, being this activation ts-MS intensity-dependent. We demonstrated the feasibility, safety and usability of this non-invasive BSI. The presented system represents a novel non-invasive means of brain-controlled neuromodulation and opens the door towards its integration as a therapeutic tool for lower-limb rehabilitation.
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Affiliation(s)
- Ainhoa Insausti-Delgado
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
- International Max Planck Research School (IMPRS) for Cognitive and Systems Neuroscience, Tübingen, Germany
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
- TECNALIA, Basque Research and Technology Alliance (BRTA), Donostia-San Sebastián, Spain
| | - Eduardo López-Larraz
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
- Bitbrain, Zaragoza, Spain
| | - Yukio Nishimura
- Neural Prosthetics Project, Department of Brain and Neuroscience, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Ulf Ziemann
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Ander Ramos-Murguialday
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
- TECNALIA, Basque Research and Technology Alliance (BRTA), Donostia-San Sebastián, Spain
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