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Levett JJ, Elkaim LM, Niazi F, Weber MH, Iorio-Morin C, Bonizzato M, Weil AG. Invasive Brain Computer Interface for Motor Restoration in Spinal Cord Injury: A Systematic Review. Neuromodulation 2024; 27:597-603. [PMID: 37943244 DOI: 10.1016/j.neurom.2023.10.006] [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: 06/12/2023] [Revised: 09/10/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023]
Abstract
STUDY DESIGN Systematic review of the literature. OBJECTIVES In recent years, brain-computer interface (BCI) has emerged as a potential treatment for patients with spinal cord injury (SCI). This is the first systematic review of the literature on invasive closed-loop BCI technologies for the treatment of SCI in humans. MATERIALS AND METHODS A comprehensive search of PubMed MEDLINE, Web of Science, and Ovid EMBASE was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Of 8316 articles collected, 19 studies met all the inclusion criteria. Data from 21 patients were extracted from these studies. All patients sustained a cervical SCI and were treated using either a BCI with intracortical microelectrode arrays (n = 18, 85.7%) or electrocorticography (n = 3, 14.3%). To decode these neural signals, machine learning and statistical models were used: support vector machine in eight patients (38.1%), linear estimator in seven patients (33.3%), Hidden Markov Model in three patients (14.3%), and other in three patients (14.3%). As the outputs, ten patients (47.6%) underwent noninvasive functional electrical stimulation (FES) with a cuff; one (4.8%) had an invasive FES with percutaneous stimulation, and ten (47.6%) used an external device (neuroprosthesis or virtual avatar). Motor function was restored in all patients for each assigned task. Clinical outcome measures were heterogeneous across all studies. CONCLUSIONS Invasive techniques of BCI show promise for the treatment of SCI, but there is currently no technology that can restore complete functional autonomy in patients with SCI. The current techniques and outcomes of BCI vary greatly. Because invasive BCIs are still in the early stages of development, further clinical studies should be conducted to optimize the prognosis for patients with SCI.
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Affiliation(s)
- Jordan J Levett
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Lior M Elkaim
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Farbod Niazi
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Michael H Weber
- Department of Orthopaedic Surgery, McGill University, Montreal, Quebec, Canada
| | | | - Marco Bonizzato
- Department of Electrical Engineering and Institute of Biomedical Engineering, Polytechnique Montréal, Montreal, Quebec, Canada; Department of Neuroscience and Centre interdisciplinaire sur le cerveau et l'apprentissage, University of Montreal, Montreal, Quebec, Canada
| | - Alexander G Weil
- Division of Neurosurgery, St-Justine University Hospital, Montreal, Quebec, Canada.
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2
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Regniez M, Dufort-Gervais J, Provost C, Mongrain V, Martinez M. Characterization of Sleep, Emotional, and Cognitive Functions in a New Rat Model of Concomitant Spinal Cord and Traumatic Brain Injuries. J Neurotrauma 2024; 41:1044-1059. [PMID: 37885242 DOI: 10.1089/neu.2023.0387] [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: 10/28/2023] Open
Abstract
Traumatic injuries to the spinal cord or the brain have serious medical consequences and lead to long-term disability. The epidemiology, medical complications, and prognosis of isolated spinal cord injury (SCI) and traumatic brain injury (TBI) have been well described. However, there are limited data on patients suffering from concurrent SCI and TBI, even if a large proportion of SCI patients have concomitant TBI. The complications associated with this "dual-diagnosis" such as cognitive or behavioral dysfunction are well known in the rehabilitation setting, but evidence-based and standardized approaches for diagnosis and treatment are lacking. Our goal was to develop and characterize a pre-clinical animal model of concurrent SCI and TBI to help identifying "dual-diagnosis" tools. Female rats received a unilateral contusive SCI at the thoracic level alone (SCI group) or combined with a TBI centered on the contralateral sensorimotor cortex (SCI-TBI group). We first validated that the SCI extent was comparable between SCI-TBI and SCI groups, and that hindlimb function was impaired. We characterized various neurological outcomes, including locomotion, sleep architecture, brain activity during sleep, depressive- and anxiety-like behaviors, and working memory. We report that SCI-TBI and SCI groups show similar impairments in global locomotor function. While wake/sleep amount and distribution and anxiety- and depression-like symptoms were not affected in SCI-TBI and SCI groups in comparison to the control group (laminectomy and craniotomy only), working memory was impaired only in SCI-TBI rats. This pre-clinical model of concomitant SCI and TBI, including more severe variations of it, shows a translational value for the identification of biomarkers to refine the "dual-diagnosis" of neurotrauma in humans.
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Affiliation(s)
- Morgane Regniez
- Department of Neuroscience, Université de Montreal, Montréal, Québec, Canada
- Recherche CIUSSS-NIM, Montréal, Québec, Canada
| | | | | | - Valérie Mongrain
- Department of Neuroscience, Université de Montreal, Montréal, Québec, Canada
- Recherche CIUSSS-NIM, Montréal, Québec, Canada
- Research Center of the CHUM, Montréal, Québec, Canada
| | - Marina Martinez
- Department of Neuroscience, Université de Montreal, Montréal, Québec, Canada
- Recherche CIUSSS-NIM, Montréal, Québec, Canada
- Groupe de recherche sur la Signalisation Neurale et la Circuiterie, Université de Montreal, Montréal, Québec, Canada
- Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage, Université de Montreal, Montréal, Québec, Canada
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3
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Saway BF, Palmer C, Hughes C, Triano M, Suresh RE, Gilmore J, George M, Kautz SA, Rowland NC. The evolution of neuromodulation for chronic stroke: From neuroplasticity mechanisms to brain-computer interfaces. Neurotherapeutics 2024; 21:e00337. [PMID: 38377638 PMCID: PMC11103214 DOI: 10.1016/j.neurot.2024.e00337] [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: 10/16/2023] [Revised: 02/05/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024] Open
Abstract
Stroke is one of the most common and debilitating neurological conditions worldwide. Those who survive experience motor, sensory, speech, vision, and/or cognitive deficits that severely limit remaining quality of life. While rehabilitation programs can help improve patients' symptoms, recovery is often limited, and patients frequently continue to experience impairments in functional status. In this review, invasive neuromodulation techniques to augment the effects of conventional rehabilitation methods are described, including vagus nerve stimulation (VNS), deep brain stimulation (DBS) and brain-computer interfaces (BCIs). In addition, the evidence base for each of these techniques, pivotal trials, and future directions are explored. Finally, emerging technologies such as functional near-infrared spectroscopy (fNIRS) and the shift to artificial intelligence-enabled implants and wearables are examined. While the field of implantable devices for chronic stroke recovery is still in a nascent stage, the data reviewed are suggestive of immense potential for reducing the impact and impairment from this globally prevalent disorder.
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Affiliation(s)
- Brian F Saway
- Department of Neurosurgery, Medical University of South Carolina, SC 29425, USA.
| | - Charles Palmer
- Department of Psychiatry, Medical University of South Carolina, SC 29425, USA
| | - Christopher Hughes
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Matthew Triano
- Department of Neurosurgery, Medical University of South Carolina, SC 29425, USA
| | - Rishishankar E Suresh
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Jordon Gilmore
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA
| | - Mark George
- Department of Psychiatry, Medical University of South Carolina, SC 29425, USA; Ralph H Johnson VA Health Care System, Charleston, SC 29425, USA
| | - Steven A Kautz
- Department of Health Science and Research, Medical University of South Carolina, SC 29425, USA; Ralph H Johnson VA Health Care System, Charleston, SC 29425, USA
| | - Nathan C Rowland
- Department of Neurosurgery, Medical University of South Carolina, SC 29425, USA; MUSC Institute for Neuroscience Discovery (MIND), Medical University of South Carolina, SC 29425, USA
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Choinière L, Guay-Hottin R, Picard R, Lajoie G, Bonizzato M, Dancause N. Gaussian-process-based Bayesian optimization for neurostimulation interventions in rats. STAR Protoc 2024; 5:102885. [PMID: 38358881 PMCID: PMC10876592 DOI: 10.1016/j.xpro.2024.102885] [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: 09/14/2023] [Revised: 12/11/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024] Open
Abstract
Effective neural stimulation requires adequate parametrization. Gaussian-process (GP)-based Bayesian optimization (BO) offers a framework to discover optimal stimulation parameters in real time. Here, we first provide a general protocol to deploy this framework in neurostimulation interventions and follow by exemplifying its use in detail. Specifically, we describe the steps to implant rats with multi-channel electrode arrays in the hindlimb motor cortex. We then detail how to utilize the GP-BO algorithm to maximize evoked target movements, measured as electromyographic responses. For complete details on the use and execution of this protocol, please refer to Bonizzato and colleagues (2023).1.
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Affiliation(s)
- 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.
| | - 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
| | - Rémi Picard
- 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
| | - Guillaume Lajoie
- Mila - Québec AI Institute, Montreal, QC H2S 3H1, Canada; Mathematics and Statistics Department, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - 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; Mila - Québec AI Institute, Montreal, QC H2S 3H1, 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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5
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Wu Z, Feng K, Huang J, Ye X, Yang R, Huang Q, Jiang Q. Brain region changes following a spinal cord injury. Neurochem Int 2024; 174:105696. [PMID: 38354751 DOI: 10.1016/j.neuint.2024.105696] [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: 08/11/2023] [Revised: 01/16/2024] [Accepted: 02/10/2024] [Indexed: 02/16/2024]
Abstract
Brain-related complications are common in clinical practice after spinal cord injury (SCI); however, the molecular mechanisms of these complications are still unclear. Here, we reviewed the changes in the brain regions caused by SCI from three perspectives: imaging, molecular analysis, and electrophysiology. Imaging studies revealed abnormal functional connectivity, gray matter volume atrophy, and metabolic abnormalities in brain regions after SCI, leading to changes in the structure and function of brain regions. At the molecular level, chemokines, inflammatory factors, and damage-associated molecular patterns produced in the injured area were retrogradely transmitted through the corticospinal tract, cerebrospinal fluid, or blood circulation to the specific brain area to cause pathologic changes. Electrophysiologic recordings also suggested abnormal changes in brain electrical activity after SCI. Transcranial magnetic stimulation, transcranial direct current stimulation, and deep brain stimulation alleviated pain and improved motor function in patients with SCI; therefore, transcranial therapy may be a new strategy for the treatment of patients with SCI.
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Affiliation(s)
- Zhiwu Wu
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China
| | - Kaiming Feng
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China
| | - Jinqing Huang
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China
| | - Xinyun Ye
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China
| | - Ruijin Yang
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China
| | - Qianliang Huang
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China.
| | - Qiuhua Jiang
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China.
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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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7
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Yang F, Wang F, Ma X, Zhou M, Jiang S, Xu W. Longitudinal optogenetic mapping reveals enhanced motor control by the contralesional cortex after traumatic brain injury in mice. Exp Neurol 2023; 369:114546. [PMID: 37751813 DOI: 10.1016/j.expneurol.2023.114546] [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: 04/11/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 09/28/2023]
Abstract
Traumatic brain injury (TBI) is a significant cause of human disability, and understanding its spontaneous recovery pattern after injury is critical for potential treatments. However, studies on the function of the contralesional cortex after TBI have mostly focused on acute-phase changes, and long-term dynamic changes in the control of the affected limb by the contralesional cortex are less understood. To unravel long-term adaptations in the contralesional cortex, we developed a mouse model of TBI and used longitudinal optogenetic motor mapping to observe the function of contralesional corticospinal neurons (CSNs) projecting to the unilateral seventh cervical (C7) segment of the spinal cord. We injected a retrograde adeno-associated virus (AAV) expressing channelrhodopsin-2 to optogenetically stimulate and map the functional connections of the motor-sensory cortex. We validated the effectiveness of transcranial optogenetic stimulation for functional mapping and observed a general increase in the control of the affected limb by the contralesional cortex over time. Using retrograde labeling techniques, we showed that TBI does not affect the distribution of C7-CSNs but alters their function, and the labeled CSNs are concentrated in the caudal and rostral forelimb areas. Our findings provide new insights into harnessing contralesional cortical plasticity to improve treatment for affected limbs. This study sheds light on the long-term adaptations in the contralesional cortex after TBI, paving the way for potential clinical applications of optogenetic stimulation to improve motor control and rehabilitation outcomes.
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Affiliation(s)
- Fangjing Yang
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Fei Wang
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; The National Clinical Research Center for Aging and Medicine, Fudan University, Shanghai, China; Department of Hand and Upper Extremity Surgery, Jing'an District Central Hospital, Fudan University, Shanghai, China
| | - Xingyi Ma
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Mingjie Zhou
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Su Jiang
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Wendong Xu
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; The National Clinical Research Center for Aging and Medicine, Fudan University, Shanghai, China; Department of Hand and Upper Extremity Surgery, Jing'an District Central Hospital, Fudan University, Shanghai, China; Institutes of Brain Science, Fudan University, Shanghai, China; State Key Laboratory of Medical Neurobiology, Collaborative Innovation Center of Brain Science, Fudan University, Shanghai, China; Co-innovation Center of Neuroregeneration, Nantong University,226000 Nantong, China; Research Unit of Synergistic Reconstruction of Upper and Lower Limbs After Brain Injury, Chinese Academy of Medical Sciences, Beijing, China.
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8
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Yang S, Cheng J, Shang J, Hang C, Qi J, Zhong L, Rao Q, He L, Liu C, Ding L, Zhang M, Chakrabarty S, Jiang X. Stretchable surface electromyography electrode array patch for tendon location and muscle injury prevention. Nat Commun 2023; 14:6494. [PMID: 37838683 PMCID: PMC10576757 DOI: 10.1038/s41467-023-42149-x] [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: 11/10/2022] [Accepted: 09/29/2023] [Indexed: 10/16/2023] Open
Abstract
Surface electromyography (sEMG) can provide multiplexed information about muscle performance. If current sEMG electrodes are stretchable, arrayed, and able to be used multiple times, they would offer adequate high-quality data for continuous monitoring. The lack of these properties delays the widespread use of sEMG in clinics and in everyday life. Here, we address these constraints by design of an adhesive dry electrode using tannic acid, polyvinyl alcohol, and PEDOT:PSS (TPP). The TPP electrode offers superior stretchability (~200%) and adhesiveness (0.58 N/cm) compared to current electrodes, ensuring stable and long-term contact with the skin for recording (>20 dB; >5 days). In addition, we developed a metal-polymer electrode array patch (MEAP) comprising liquid metal (LM) circuits and TPP electrodes. The MEAP demonstrated better conformability than commercial arrays, resulting in higher signal-to-noise ratio and more stable recordings during muscle movements. Manufactured using scalable screen-printing, these MEAPs feature a completely stretchable material and array architecture, enabling real-time monitoring of muscle stress, fatigue, and tendon displacement. Their potential to reduce muscle and tendon injuries and enhance performance in daily exercise and professional sports holds great promise.
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Grants
- We thank the National Key R&D Program of China (2021YFF1200800, 2021YFF1200100, 2022YFB3804700, and 2018YFA0902600), the National Natural Science Foundation of China (22234004), Shenzhen Science and Technology Program (JCYJ20200109141231365 and KQTD 20190929172743294), Shenzhen Key Laboratory of Smart Healthcare Engineering (ZDSYS20200811144003009), Guangdong Innovative and Entrepreneurial Research Team Program (2019ZT08Y191), Guangdong Provincial Key Laboratory of Advanced Biomaterials (2022B1212010003), Tencent Foundation through the XPLORER PRIZE, Guangdong Major Talent Introduction Project (2019CX01Y196). We also acknowledge the assistance of SUSTech Core Research Facilities.
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Affiliation(s)
- Shuaijian Yang
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - Jinhao Cheng
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China
| | - Jin Shang
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China
| | - Chen Hang
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China
| | - Jie Qi
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China
| | - Leni Zhong
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China
| | - Qingyan Rao
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China
| | - Lei He
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China
| | - Chenqi Liu
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China
| | - Li Ding
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China
| | - Mingming Zhang
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China
| | - Samit Chakrabarty
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, LS2 9JT, UK.
| | - Xingyu Jiang
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, P. R. China.
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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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10
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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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11
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Disse GD, Nandakumar B, Pauzin FP, Blumenthal GH, Kong Z, Ditterich J, Moxon KA. Neural ensemble dynamics in trunk and hindlimb sensorimotor cortex encode for the control of postural stability. Cell Rep 2023; 42:112347. [PMID: 37027302 DOI: 10.1016/j.celrep.2023.112347] [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: 10/22/2022] [Revised: 02/09/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023] Open
Abstract
The cortex has a disputed role in monitoring postural equilibrium and intervening in cases of major postural disturbances. Here, we investigate the patterns of neural activity in the cortex that underlie neural dynamics during unexpected perturbations. In both the primary sensory (S1) and motor (M1) cortices of the rat, unique neuronal classes differentially covary their responses to distinguish different characteristics of applied postural perturbations; however, there is substantial information gain in M1, demonstrating a role for higher-order computations in motor control. A dynamical systems model of M1 activity and forces generated by the limbs reveals that these neuronal classes contribute to a low-dimensional manifold comprised of separate subspaces enabled by congruent and incongruent neural firing patterns that define different computations depending on the postural responses. These results inform how the cortex engages in postural control, directing work aiming to understand postural instability after neurological disease.
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Affiliation(s)
- Gregory D Disse
- Neuroscience Graduate Group, University of California, Davis, Davis, CA 95616, USA; Biomedical Engineering, University of California, Davis, Davis, CA 95616, USA
| | | | - Francois P Pauzin
- Biomedical Engineering, University of California, Davis, Davis, CA 95616, USA
| | - Gary H Blumenthal
- School of Biomedical Engineering Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA
| | - Zhaodan Kong
- Mechanical and Aerospace Engineering, University of California, Davis, Davis, CA 95616, USA
| | - Jochen Ditterich
- Neuroscience Graduate Group, University of California, Davis, Davis, CA 95616, USA; Neurobiology, Physiology and Behavior, University of California, Davis, Davis, CA 95616, USA
| | - Karen A Moxon
- Neuroscience Graduate Group, University of California, Davis, Davis, CA 95616, USA; Biomedical Engineering, University of California, Davis, Davis, CA 95616, USA.
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12
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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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13
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Composite Fibrin and Carbon Microfibre Implant to Modulate Postraumatic Inflammation after Spinal Cord Injury. Cells 2023; 12:cells12060839. [PMID: 36980180 PMCID: PMC10047285 DOI: 10.3390/cells12060839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/02/2023] [Accepted: 03/05/2023] [Indexed: 03/11/2023] Open
Abstract
Poor functional recovery after spinal cord injury (SCI) drives the development of novel strategies to manage this devastating condition. We recently showed promising immunomodulatory and pro-regenerative actions of bio-functionalized carbon microfibres (MFs) implanted in a rodent model of SCI. In order to maximize tissue repair while easing MF implantation, we produced a composite implant based on the embedding of several MFs within a fibrin hydrogel. We used intravital imaging of fluorescent reporter mice at the early stages and spinal sections of the same animals 3 months later to characterize the neuroinflammatory response to the implant and its impact on axonal regeneration. Whereas fibrin alone was inert in the first week, its enzymatic degradation drove the chronic activation of microglial cells and axonal degeneration within 3 months. However, the presence of MFs inside the fibrin hydrogel slowed down fibrin degradation and boosted the early recruitment of immune cells. Noteworthy, there was an enhanced contribution of monocyte-derived dendritic cells (moDCs), preceding a faster transition toward an anti-inflammatory environment with increased axonal regeneration over 3 months. The inclusion of MF here ensured the long-term biocompatibility of fibrin hydrogels, which would otherwise preclude successful spinal cord regeneration.
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14
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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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15
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Stretchable Surface Electrode Arrays Using an Alginate/PEDOT:PSS-Based Conductive Hydrogel for Conformal Brain Interfacing. Polymers (Basel) 2022; 15:polym15010084. [PMID: 36616434 PMCID: PMC9824691 DOI: 10.3390/polym15010084] [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: 11/14/2022] [Revised: 12/01/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
An electrocorticogram (ECoG) is the electrical activity obtainable from the cerebral cortex and an informative source with considerable potential for future advanced applications in various brain-interfacing technologies. Considerable effort has been devoted to developing biocompatible, conformal, soft, and conductive interfacial materials for bridging devices and brain tissue; however, the implementation of brain-adaptive materials with optimized electrical and mechanical characteristics remains challenging. Herein, we present surface electrode arrays using the soft tough ionic conductive hydrogel (STICH). The newly proposed STICH features brain-adaptive softness with Young's modulus of ~9.46 kPa, which is sufficient to form a conformal interface with the cortex. Additionally, the STICH has high toughness of ~36.85 kJ/mm3, highlighting its robustness for maintaining the solid structure during interfacing with wet brain tissue. The stretchable metal electrodes with a wavy pattern printed on the elastomer were coated with the STICH as an interfacial layer, resulting in an improvement of the impedance from 60 kΩ to 10 kΩ at 1 kHz after coating. Acute in vivo experiments for ECoG monitoring were performed in anesthetized rodents, thereby successfully realizing conformal interfacing to the animal's cortex and the sensitive recording of electrical activity using the STICH-coated electrodes, which exhibited a higher visual-evoked potential (VEP) amplitude than that of the control device.
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16
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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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17
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New Therapy for Spinal Cord Injury: Autologous Genetically-Enriched Leucoconcentrate Integrated with Epidural Electrical Stimulation. Cells 2022; 11:cells11010144. [PMID: 35011706 PMCID: PMC8750549 DOI: 10.3390/cells11010144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/07/2021] [Accepted: 12/29/2021] [Indexed: 12/17/2022] Open
Abstract
The contemporary strategy for spinal cord injury (SCI) therapy aims to combine multiple approaches to control pathogenic mechanisms of neurodegeneration and stimulate neuroregeneration. In this study, a novel regenerative approach using an autologous leucoconcentrate enriched with transgenes encoding vascular endothelial growth factor (VEGF), glial cell line-derived neurotrophic factor (GDNF), and neural cell adhesion molecule (NCAM) combined with supra- and sub-lesional epidural electrical stimulation (EES) was tested on mini-pigs similar in morpho-physiological scale to humans. The complex analysis of the spinal cord recovery after a moderate contusion injury in treated mini-pigs compared to control animals revealed: better performance in behavioural and joint kinematics, restoration of electromyography characteristics, and improvement in selected immunohistology features related to cell survivability, synaptic protein expression, and glial reorganization above and below the injury. These results for the first time demonstrate the positive effect of intravenous infusion of autologous genetically-enriched leucoconcentrate producing recombinant molecules stimulating neuroregeneration combined with neuromodulation by translesional multisite EES on the restoration of the post-traumatic spinal cord in mini-pigs and suggest the high translational potential of this novel regenerative therapy for SCI patients.
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18
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Martinez M. Targeting the motor cortex to restore walking after incomplete spinal cord injury. Neural Regen Res 2021; 17:1489-1490. [PMID: 34916428 PMCID: PMC8771094 DOI: 10.4103/1673-5374.330603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Marina Martinez
- Département de Neurosciences, Groupe de recherche sur la Signalisation Neurale et la Circuiterie and Centre Interdisciplinaire de Recherche sur le Cerveau au service de l'Apprentissage, Université de Montréal; CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, QC, Canada
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19
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Randelman M, Zholudeva LV, Vinit S, Lane MA. Respiratory Training and Plasticity After Cervical Spinal Cord Injury. Front Cell Neurosci 2021; 15:700821. [PMID: 34621156 PMCID: PMC8490715 DOI: 10.3389/fncel.2021.700821] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/11/2021] [Indexed: 12/30/2022] Open
Abstract
While spinal cord injuries (SCIs) result in a vast array of functional deficits, many of which are life threatening, the majority of SCIs are anatomically incomplete. Spared neural pathways contribute to functional and anatomical neuroplasticity that can occur spontaneously, or can be harnessed using rehabilitative, electrophysiological, or pharmacological strategies. With a focus on respiratory networks that are affected by cervical level SCI, the present review summarizes how non-invasive respiratory treatments can be used to harness this neuroplastic potential and enhance long-term recovery. Specific attention is given to "respiratory training" strategies currently used clinically (e.g., strength training) and those being developed through pre-clinical and early clinical testing [e.g., intermittent chemical stimulation via altering inhaled oxygen (hypoxia) or carbon dioxide stimulation]. Consideration is also given to the effect of training on non-respiratory (e.g., locomotor) networks. This review highlights advances in this area of pre-clinical and translational research, with insight into future directions for enhancing plasticity and improving functional outcomes after SCI.
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Affiliation(s)
- Margo Randelman
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, United States.,Marion Murray Spinal Cord Research Center, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Lyandysha V Zholudeva
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, United States.,Marion Murray Spinal Cord Research Center, Drexel University College of Medicine, Philadelphia, PA, United States.,Gladstone Institutes, San Francisco, CA, United States
| | - Stéphane Vinit
- INSERM, END-ICAP, Université Paris-Saclay, UVSQ, Versailles, France
| | - Michael A Lane
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, United States.,Marion Murray Spinal Cord Research Center, Drexel University College of Medicine, Philadelphia, PA, United States
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20
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Shokur S, Mazzoni A, Schiavone G, Weber DJ, Micera S. A modular strategy for next-generation upper-limb sensory-motor neuroprostheses. MED 2021; 2:912-937. [DOI: 10.1016/j.medj.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/28/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023]
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21
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Brown AR, Martinez M. Chronic inactivation of the contralesional hindlimb motor cortex after thoracic spinal cord hemisection impedes locomotor recovery in the rat. Exp Neurol 2021; 343:113775. [PMID: 34081986 DOI: 10.1016/j.expneurol.2021.113775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/13/2021] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
After incomplete spinal cord injury (SCI), cortical plasticity is involved in hindlimb locomotor recovery. Nevertheless, whether cortical activity is required for motor map plasticity and recovery remains unresolved. Here, we combined a unilateral thoracic spinal cord injury (SCI) with a cortical inactivation protocol that uncovered a functional role of contralesional cortical activity in hindlimb recovery and ipsilesional map plasticity. In adult rats, left hindlimb paralysis was induced by sectioning half of the spinal cord at the thoracic level (hemisection) and we used a continuous infusion of muscimol (GABAA agonist, 10 mM, 0.11 µl/h) delivered via implanted osmotic pump (n = 9) to chronically inactivate the contralesional hindlimb motor cortex. Hemisected rats with saline infusion served as a SCI control group (n = 8), and intact rats with muscimol infusion served as an inactivation control group (n = 6). Locomotion was assessed in an open field, on a horizontal ladder, and on a treadmill prior to and for three weeks after hemisection. Cortical inactivation after hemisection significantly impeded hindlimb locomotor recovery in all tasks and specifically disrupted the ability of rats to generate proper flexion of the affected hindlimb during stepping compared to SCI controls, with no significant effect of inactivation in intact rats. Chronic and acute (n = 4) cortical inactivation after hemisection also significantly reduced the representation of the affected hindlimb in the ipsilesional motor cortex derived with intracortical microsimulation (ICMS). Our results provide evidence that residual activity in the contralesional hindlimb motor cortex after thoracic hemisection contributes to spontaneous locomotor recovery and map plasticity.
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Affiliation(s)
- Andrew R Brown
- Département de Neurosciences Groupe de recherche sur le système nerveux central (GRSNC) and Centre Interdisciplinaire de Recherche sur le Cerveau au service de l'Apprentissage (CIRCA), Université de Montréal, Québec, Canada; CIUSSS du Nord-de-l'Île-de-Montréal, Québec, Canada
| | - Marina Martinez
- Département de Neurosciences Groupe de recherche sur le système nerveux central (GRSNC) and Centre Interdisciplinaire de Recherche sur le Cerveau au service de l'Apprentissage (CIRCA), Université de Montréal, Québec, Canada; CIUSSS du Nord-de-l'Île-de-Montréal, Québec, Canada.
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