Block-based robust control of stepping using intraspinal microstimulation

Control strategy for intraspinal microstimulation based on central pattern generator

Intraspinal microstimulation (ISMS) is considered as a special functional electrical stimulation (FES) method. This method can restore the movement of paralyzed limbs in patients with spinal cord injury (SCI) using electrical stimulation of spinal cord. There is a special site for central pattern generator (CPG) in the spinal cord. The ISMS acts on the CPG site, and single electrode stimulation produces alternating motion in the hindlimbs of SCI rats. Based on the long short-term memory network (LSTM), a mapping model was established between the stimulation intensity of specific CPG sites and the angle of the knee joint to reflect the motor characteristics of the rat hindlimb. We proposed an LSTM-iterative learning control (ILC) strategy to form a closed-loop control to accurately control hindlimb movement. The proposed LSTM model fits the actual joint angle curve well, and the LSTM-ILC strategy can accurately regulate the hindlimb movement, allowing rats to perform rehabilitation training based on pre-set knee trajectories.

Effect of anesthesia on motor responses evoked by spinal neural prostheses during intraoperative procedures

OBJECTIVE

The overall goal of this study was to investigate the effects of various anesthetic protocols on the intraoperative responses to intraspinal microstimulation (ISMS). ISMS is a neuroprosthetic approach that targets the motor networks in the ventral horns of the spinal cord to restore function after spinal cord injury. In preclinical studies, ISMS in the lumbosacral enlargement produced standing and walking by activating networks controlling the hindlimb muscles. ISMS implants are placed surgically under anesthesia, and refinements in placement are made based on the evoked responses. Anesthesia can have a significant effect on the responses evoked by spinal neuroprostheses; therefore, in preparation for clinical testing of ISMS, we compared the evoked responses under a common clinical neurosurgical anesthetic protocol with those evoked under protocols commonly used in preclinical studies.

APPROACH

Experiments were conducted in seven pigs. An ISMS microelectrode array was implanted in the lumbar enlargement and responses to ISMS were measured under three anesthetic protocols: (1) isoflurane, an agent used pre-clinically and clinically, (2) total intravenous anesthesia (TIVA) with propofol as the main agent commonly used in clinical neurosurgical procedures, (3) TIVA with sodium pentobarbital, an anesthetic agent used mostly preclinically. Responses to ISMS were evaluated based on stimulation thresholds, movement kinematics, and joint torques. Motor evoked potentials (MEP) and plasma concentrations of propofol were also measured.

MAIN RESULTS

ISMS under propofol anesthesia produced large and functional responses that were not statistically different from those produced under pentobarbital anesthesia. Isoflurane, however, significantly suppressed the ISMS-evoked responses.

SIGNIFICANCE

This study demonstrated that the choice of anesthesia is critical for intraoperative assessments of motor responses evoked by spinal neuroprostheses. Propofol and pentobarbital anesthesia did not overly suppress the effects of ISMS; therefore, propofol is expected to be a suitable anesthetic agent for clinical intraoperative testing of an intraspinal neuroprosthetic system.