1
|
Scarlat KA, Tchoumi CA, Feldman AG, Levin MF. Referent Control of Side-to-Side Body-Weight Transfer During Standing and Stepping in Adults. Neuroscience 2024; 551:94-102. [PMID: 38762084 DOI: 10.1016/j.neuroscience.2024.05.016] [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: 11/27/2023] [Revised: 05/08/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024]
Abstract
Research suggests that locomotion may be primarily caused by shifting stable body balance from one location in the environment to another with subsequent rhythmical muscle activation by the central pattern generator (CPG), constituting a multi-level control system. All levels interact with environmental forces affected by proprioceptive and vestibular reflexes as well as vision. A similar multi-level control schema is likely used to shift body balance laterally when the body weight is rhythmically transferred from side-to-side. In order to do so, the system shifts a specific body posture in space. This body posture is referred to as the threshold or referent body posture, R, at which all muscles involved can be at rest but are activated depending on the deflection of the actual body posture, Q, from R. This concept has previously been investigated for forward and backward locomotion. The purpose of the present study was to verify if it was also applicable to locomotor tasks in other directions such as sidestepping. We predicted that during sidestepping, the actual and referent posture can transiently match each other bringing the activity of multiple muscles to a minimum. The existence of such minima was demonstrated in healthy adults performing three locomotor tasks involving shifts of the body weight from side-to-side thus further supporting the validity of the multi-level control scheme of locomotion.
Collapse
Affiliation(s)
- Katharine A Scarlat
- Integrated Program in Neuroscience, McGill University, Montreal, Qc., Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Qc., Canada
| | - Carl A Tchoumi
- Integrated Program in Neuroscience, McGill University, Montreal, Qc., Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Qc., Canada
| | - Anatol G Feldman
- Department of Neuroscience, University of Montreal, Montreal, Qc., Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Qc., Canada.
| | - Mindy F Levin
- School of Physical and Occupational Therapy, McGill University, Montreal, Qc., Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Qc., Canada
| |
Collapse
|
2
|
Kawai K, Tazoe T, Yanai T, Kazuyuki K, Nishimura Y. Transsynaptic activation of human lumbar spinal motoneurons by transvertebral magnetic stimulation. Neurosci Res 2024; 200:20-27. [PMID: 37793496 DOI: 10.1016/j.neures.2023.10.001] [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: 08/14/2023] [Revised: 09/15/2023] [Accepted: 10/01/2023] [Indexed: 10/06/2023]
Abstract
Noninvasive spinal stimulation has been increasingly used in research on motor control and neurorehabilitation. Despite advances in percutaneous electrical stimulation techniques, magnetic stimulation is not as commonly used as electrical stimulation. Therefore, it is still under discussion what neuronal elements are activated by magnetic stimulation of the human spinal cord. In this study, we demonstrated that transvertebral magnetic stimulation (TVMS) induced transsynaptic activation of spinal motoneuron pools in the lumbar cord. In healthy humans, paired-pulse TVMS was given over an intervertebral space between the L1-L2 vertebrae with an interpulse interval of 100 ms, and the stimulus-evoked electromyographic (EMG) responses were recorded in the lower limb muscles. The results show that the evoked EMG responses after the 2nd pulse were clearly suppressed compared with the widespread responses evoked after the 1st pulse in the muscles of the lower extremity, indicating that the transsynaptic activation of spinal motoneurons by the 2nd pulse was suppressed by the effects produced by the 1st pulse. The inconsistent modulation of response suppression to stimulus intensity across individuals suggests that the TVMS-evoked EMG responses are composed of the compound potentials mediated by the direct activation of motor axons and the transsynaptic activation of motoneuron pools through sensory afferents and that the recruitment order of those fibers by TVMS may be nonhomogeneous across individuals.
Collapse
Affiliation(s)
- Kazutake Kawai
- College of Sports Sciences, Nihon University, Setagaya, Tokyo 154-8513, Japan; Neural Prosthetics Project, Department of Brain and Neuroscience, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo 156-8506, Japan; Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama 359-1192, Japan
| | - Toshiki Tazoe
- Neural Prosthetics Project, Department of Brain and Neuroscience, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo 156-8506, Japan.
| | - Toshimasa Yanai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama 359-1192, Japan
| | - Kanosue Kazuyuki
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama 359-1192, Japan
| | - Yukio Nishimura
- Neural Prosthetics Project, Department of Brain and Neuroscience, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo 156-8506, Japan
| |
Collapse
|
3
|
Ivanenko Y, Shapkova EY, Petrova DA, Kleeva DF, Lebedev MA. Exoskeleton gait training with spinal cord neuromodulation. Front Hum Neurosci 2023; 17:1194702. [PMID: 37250689 PMCID: PMC10213721 DOI: 10.3389/fnhum.2023.1194702] [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] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Neuromodulating the locomotor network through spinal cord electrical stimulation (SCES) is effective for restoring function in individuals with gait deficits. However, SCES alone has limited effectiveness without concurrent locomotor function training that enhances activity-dependent plasticity of spinal neuronal networks by sensory feedback. This mini review discusses recent developments in using combined interventions, such as SCES added to exoskeleton gait training (EGT). To develop personalized therapies, it is crucial to assess the state of spinal circuitry through a physiologically relevant approach that identifies individual characteristics of spinal cord function to develop person-specific SCES and EGT. The existing literature suggests that combining SCES and EGT to activate the locomotor network can have a synergistic rehabilitative effect on restoring walking abilities, somatic sensation, and cardiovascular and bladder function in paralyzed individuals.
Collapse
Affiliation(s)
| | - Elena Y. Shapkova
- Saint-Petersburg State Research Institute of Phthisiopulmonology, Saint Petersburg, Russia
- Institute of Translational Biomedicine, St. Petersburg State University, Saint Petersburg, Russia
| | - Daria A. Petrova
- Vladimir Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Daria F. Kleeva
- Vladimir Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Mikhail A. Lebedev
- Faculty of Mechanics and Mathematics, Lomonosov Moscow State University, Moscow, Russia
- Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Sciences, Saint Petersburg, Russia
| |
Collapse
|
4
|
Shoja O, Towhidkhah F, Hassanlouei H, Levin MF, Bahramian A, Nadeau S, Zhang L, Feldman AG. Reaction of human walking to transient block of vision: analysis in the context of indirect, referent control of motor actions. Exp Brain Res 2023; 241:1353-1365. [PMID: 37010540 DOI: 10.1007/s00221-023-06593-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 03/05/2023] [Indexed: 04/04/2023]
Abstract
Human locomotion may result from monotonic shifts in the referent position, R, of the body in the environment. R is also the spatial threshold at which muscles can be quiescent but are activated depending on the deflection of the current body configuration Q from R. Shifts in R are presumably accomplished with the participation of proprioceptive and visual feedback and responsible for transferring stable body balance (equilibrium) from one place in the environment to another, resulting in rhythmic activity of multiple muscles by a central pattern generator (CPG). We tested predictions of this two-level control scheme. In particular, in response to a transient block of vision during locomotion, the system can temporarily slow shifts in R. As a result, the phase of rhythmical movements of all four limbs will be changed for some time, even though the rhythm and other characteristics of locomotion will be fully restored after perturbation, a phenomenon called long-lasting phase resetting. Another prediction of the control scheme is that the activity of multiple muscles of each leg can be minimized reciprocally at specific phases of the gait cycle both in the presence and absence of vision. Speed of locomotion is related to the rate of shifts in the referent body position in the environment. Results confirmed that human locomotion is likely guided by feedforward shifts in the referent body location, with subsequent changes in the activity of multiple muscles by the CPG. Neural structures responsible for shifts in the referent body configuration causing locomotion are suggested.
Collapse
Affiliation(s)
- Otella Shoja
- Department of Neuroscience, University of Montreal, Montreal, QC, Canada
| | - Farzad Towhidkhah
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Hamidollah Hassanlouei
- Department of Motor Behaviour, Faculty of Sport Science and Health, Shahid Beheshti University, Tehran, Iran
| | - Mindy F Levin
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Alireza Bahramian
- Department of Neuroscience, University of Montreal, Montreal, QC, Canada
| | - Sylvie Nadeau
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
- Faculté de Médecine-École de Réadaptation, Montreal, QC, Canada
| | - Lei Zhang
- Institute for Neural Computation, Ruhr University Bochum, Bochum, Germany
| | - Anatol G Feldman
- Department of Neuroscience, University of Montreal, Montreal, QC, Canada.
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.
- Institut de réadaptation Gingras-Lindsay-de-Montréal (IRGLM), 6300 Darlington, Montreal, QC, H3S 2J4, Canada.
| |
Collapse
|
5
|
Aljović A, Jacobi A, Marcantoni M, Kagerer F, Loy K, Kendirli A, Bräutigam J, Fabbio L, Van Steenbergen V, Pleśniar K, Kerschensteiner M, Bareyre FM. Synaptogenic gene therapy with FGF22 improves circuit plasticity and functional recovery following spinal cord injury. EMBO Mol Med 2023; 15:e16111. [PMID: 36601738 PMCID: PMC9906383 DOI: 10.15252/emmm.202216111] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/06/2023] Open
Abstract
Functional recovery following incomplete spinal cord injury (SCI) depends on the rewiring of motor circuits during which supraspinal connections form new contacts onto spinal relay neurons. We have recently identified a critical role of the presynaptic organizer FGF22 for the formation of new synapses in the remodeling spinal cord. Here, we now explore whether and how targeted overexpression of FGF22 can be used to mitigate the severe functional consequences of SCI. By targeting FGF22 expression to either long propriospinal neurons, excitatory interneurons, or a broader population of interneurons, we establish that FGF22 can enhance neuronal rewiring both in a circuit-specific and comprehensive way. We can further demonstrate that the latter approach can restore functional recovery when applied either on the day of the lesion or within 24 h. Our study thus establishes viral gene transfer of FGF22 as a new synaptogenic treatment for SCI and defines a critical therapeutic window for its application.
Collapse
Affiliation(s)
- Almir Aljović
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany,Graduate School of Systemic NeurosciencesLMU MunichPlaneggGermany
| | - Anne Jacobi
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany,Present address:
F.M. Kirby Neurobiology Center, Boston Children's Hospital, and Department of NeurologyHarvard Medical SchoolBostonMAUSA
| | - Maite Marcantoni
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany
| | - Fritz Kagerer
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany,Elite Graduate Program M.Sc. Biomedical NeuroscienceTUMMunichGermany
| | - Kristina Loy
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany
| | - Arek Kendirli
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany,Graduate School of Systemic NeurosciencesLMU MunichPlaneggGermany
| | - Jonas Bräutigam
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany
| | - Luca Fabbio
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany
| | - Valérie Van Steenbergen
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany
| | - Katarzyna Pleśniar
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany
| | - Martin Kerschensteiner
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany,Munich Cluster of Systems Neurology (SyNergy)MunichGermany
| | - Florence M Bareyre
- Institute of Clinical Neuroimmunology, University HospitalLMU MunichMunichGermany,Biomedical Center Munich (BMC), Faculty of MedicineLMU MunichPlaneggGermany,Munich Cluster of Systems Neurology (SyNergy)MunichGermany
| |
Collapse
|
6
|
Singh G, Lucas K, Keller A, Martin R, Behrman A, Vissarionov S, Gerasimenko YP. Transcutaneous Spinal Stimulation From Adults to Children: A Review. Top Spinal Cord Inj Rehabil 2022; 29:16-32. [PMID: 36819932 PMCID: PMC9936896 DOI: 10.46292/sci21-00084] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Neuromodulation via spinal stimulation is a promising therapy that can augment the neuromuscular capacity for voluntary movements, standing, stepping, and posture in individuals with spinal cord injury (SCI). The spinal locomotor-related neuronal network known as a central pattern generator (CPG) can generate a stepping-like motor output in the absence of movement-related afferent signals from the limbs. Using epidural stimulation (EP) in conjunction with activity-based locomotor training (ABLT), the neural circuits can be neuromodulated to facilitate the recovery of locomotor functions in persons with SCI. Recently, transcutaneous spinal stimulation (scTS) has been developed as a noninvasive alternative to EP. Early studies of scTS at thoracolumbar, coccygeal, and cervical regions have demonstrated its effectiveness in producing voluntary leg movements, posture control, and independent standing and improving upper extremity function in adults with chronic SCI. In pediatric studies, the technology of spinal neuromodulation is not yet widespread. There are a limited number of publications reporting on the use of scTS in children and adolescents with either cerebral palsy, spina bifida, or SCI.
Collapse
Affiliation(s)
- Goutam Singh
- Kosair Charities School of Physical Therapy, Spalding University, Louisville, Kentucky
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
| | - Kathryn Lucas
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
| | - Anastasia Keller
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
| | - Rebecca Martin
- International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger Institute, Baltimore, Maryland
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andrea Behrman
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
| | - Sergey Vissarionov
- Turner Scientific Research Institute for Children's Orthopedics, St. Petersburg, Russia
| | - Yury P Gerasimenko
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
- Department of Physiology, University of Louisville, Louisville, Kentucky
- Pavlov Institute of Physiology Russian Academy of Sciences, St. Petersburg, Russia
| |
Collapse
|
7
|
Role of Cervical Spinal Magnetic Stimulation in Improving Posture and Functional Ambulation of Patients with Relapsing Remitting Multiple Sclerosis. Rehabil Res Pract 2022; 2022:6009104. [DOI: 10.1155/2022/6009104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 11/23/2022] Open
Abstract
Balance impairment is one of the hallmarks of early MS. Proprioceptive deficit was found to be one of the main causes of this imbalance. The cervical enlargement has a strong proprioceptive system, with its projections to the reticular formation and the central pattern generators, helping in rhythmic pattern generation and alternate leg movements. Repetitive trans-spinal magnetic stimulation (rTSMS) is a noninvasive technique, which can trigger massive proprioceptive afferents. Therefore, it has the potential of improving proprioceptive deficits and motor control. Objective. To determine the effectiveness of repetitive cervical magnetic stimulation in improving functional ambulation of patients with relapsing remitting multiple sclerosis (RRMS). Design. Prospective sequential clinical trial. Setting. University and academic hospital. Participants. A total of 32 participants (
) with RRMS. Interventions. Outpatient rehabilitation. The 32 patients received 10 sessions over two weeks of 20 Hz cervical spinal magnetic stimulation (SMS). Both groups were assessed at baseline, after 2 weeks, then one month later. Patients were enrolled as a control group at first and received Sham SMS, and then a wash out period of one month was done for all the patients, followed by a baseline assessment. Second, the same 32 patients rejoined as the active group, which received real magnetic stimulation. Both groups performed an intensive physical therapy program with the spinal magnetic stimulation. Main Outcome Measures. Extended Disability status score (EDSS), Timed up and Go test (TUG), Mini-Best test, dynamic posturography sensory organization composite score, and motor composite score. Results. Thirty-two RRMS patients with EDSS range from 1.5 to 6. They showed statistically significant difference between active and control groups in Mini-Best test score. We divided our patients according to EDSS into 3 subgroups: (a) mild: ≤2.5, (b) moderate: 3-5.5, and (c) severe: ≥6. Mild cases showed significant differences in EDSS score, TUG test, Mini-Best test, and dynamic posturography sensory composite scale. The effect size between the different patient subgroups was also measured and showed highly significant improvements in all measured parameters among our mild patients, indicating that this subgroup could be the best responders to cervical repetitive high-frequency magnetic stimulation. Moderate cases showed highly significant improvement in TUG score and Mini-Best test and significant change in EDSS score and the dynamic posturography sensory composite score. Severe cases showed only significant improvements in TUG, Mini-Best test, and sensory composite score. Conclusion. Cervical repetitive magnetic stimulation can help improve balance and functional ambulation and decreases the risk of falls in RRMS patients, especially in the mild, low disability cases.
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Kawai K, Tazoe T, Yanai T, Kanosue K, Nishimura Y. Activation of human spinal locomotor circuitry using transvertebral magnetic stimulation. Front Hum Neurosci 2022; 16:1016064. [PMID: 36211130 PMCID: PMC9537552 DOI: 10.3389/fnhum.2022.1016064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
Transvertebral magnetic stimulation (TVMS) of the human lumbar spinal cord can evoke bilateral rhythmic leg movements, as in walking, supposedly through the activation of spinal locomotor neural circuitry. However, an appropriate stimulus intensity that can effectively drive the human spinal locomotor circuitry to evoke walking-like movements has not been determined. To address this issue, TVMS was delivered over an intervertebral space of the lumbar cord (L1–L3) at different stimulus intensities (10–70% of maximum stimulator output) in healthy human adults. In a stimulus intensity-dependent manner, TVMS evoked two major patterns of rhythmic leg movements in which the left-right movement cycles were coordinated with different phase relationships: hopping-like movements, in which both legs moved in the same direction in phase, and walking-like movements, in which both legs moved alternatively in anti-phase; uncategorized movements were also observed which could not be categorized as either movement type. Even at the same stimulation site, the stimulus-evoked rhythmic movements changed from hopping-like movements to walking-like movements as stimulus intensity was increased. Different leg muscle activation patterns were engaged in the induction of the hopping- and walking-like movements. The magnitude of the evoked hopping- and walking-like movements was positively correlated with stimulus intensity. The human spinal neural circuitry required a higher intensity of magnetic stimulation to produce walking-like leg movements than to produce hopping-like movements. These results suggest that TVMS activates distinct neural modules in the human spinal cord to generate hopping- and walking-like movements.
Collapse
Affiliation(s)
- Kazutake Kawai
- College of Sports Sciences, Nihon University, Tokyo, Japan
- Neural Prosthetics Project, Department of Brain and Neuroscience, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Toshiki Tazoe
- Neural Prosthetics Project, Department of Brain and Neuroscience, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Toshimasa Yanai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Kazuyuki Kanosue
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Institute of Health and Sports Science and Medicine, Juntendo University, Chiba, Japan
| | - Yukio Nishimura
- Neural Prosthetics Project, Department of Brain and Neuroscience, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| |
Collapse
|
10
|
Bersch I, Alberty M, Fridén J. Robot-assisted training with functional electrical stimulation enhances lower extremity function after spinal cord injury. Artif Organs 2022; 46:2009-2014. [PMID: 35976046 DOI: 10.1111/aor.14386] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/04/2022] [Accepted: 08/10/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Functional Electrical Stimulation (FES) synchronized with robot-assisted lower extremity training is used in spinal cord injury (SCI) rehabilitation to promote residual function. METHODS Data of SCI inpatients who trained lower limb mobilization on a stationary robotic system were retrospectively analyzed. The primary outcome was the improvement of muscle strength from the first through to the last training session during FES-induced as well as voluntarily induced flexion and extension. The secondary outcome was the sum score of voluntary muscle function in the lower limbs before and after the training period. RESULTS Data from 72 patients with SCI (AIS A-D) were analyzed. For extension, FES-assisted strength increased (p<0.001) from 25.2 to 44.0 N, voluntary force (p<0.001) from 24.4 to 39.9 N. For flexion, FES-assisted flexion (p<0.006) increased from 14.1 to 19.0 N, voluntary flexion (p<0.005) from 12.6 to 17.1 N. There was a significant correlation between the increase in FES-assisted force and voluntary flexion (r=0.730, p=0.001) as well as between the increase in FES-assisted force and voluntary extension (r=0.881, p<0.001). The sum score in muscle test increased from 15 to 24 points. CONCLUSION Robot-assisted training with FES seems to support the regeneration of residual functions after SCI. This is evidenced by an improvement in motor function and strength in the lower limbs.
Collapse
Affiliation(s)
- Ines Bersch
- International FES Centre®, Swiss Paraplegic Centre Nottwil, Switzerland
| | - Marie Alberty
- International FES Centre®, Swiss Paraplegic Centre Nottwil, Switzerland
| | - Jan Fridén
- International FES Centre®, Swiss Paraplegic Centre Nottwil, Switzerland.,Department of Tetrahand Surgery, Swiss Paraplegic Centre Nottwil, Switzerland
| |
Collapse
|
11
|
Solopova IA, Selionov VA, Blinov EO, Dolinskaya IY, Zhvansky DS, Lacquaniti F, Ivanenko Y. Higher Responsiveness of Pattern Generation Circuitry to Sensory Stimulation in Healthy Humans Is Associated with a Larger Hoffmann Reflex. BIOLOGY 2022; 11:biology11050707. [PMID: 35625435 PMCID: PMC9138260 DOI: 10.3390/biology11050707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/26/2022] [Accepted: 05/02/2022] [Indexed: 11/25/2022]
Abstract
Simple Summary Individual differences in the sensorimotor circuitry play an important role for understanding the nature of behavioral variability and developing personalized therapies. While the spinal network likely requires relatively rigid organization, it becomes increasingly evident that adaptability and inter-individual variability in the functioning of the neuronal circuitry is present not only in the brain but also in the spinal cord. In this study we investigated the relationship between the excitability of pattern generation circuitry and segmental reflexes in healthy humans. We found that the high individual responsiveness of pattern generation circuitries to tonic sensory input in both the upper and lower limbs was related to larger H-reflexes. The results provide further evidence for the importance of physiologically relevant assessments of spinal cord neuromodulation and the individual physiological state of reflex pathways. Abstract The state and excitability of pattern generators are attracting the increasing interest of neurophysiologists and clinicians for understanding the mechanisms of the rhythmogenesis and neuromodulation of the human spinal cord. It has been previously shown that tonic sensory stimulation can elicit non-voluntary stepping-like movements in non-injured subjects when their limbs were placed in a gravity-neutral unloading apparatus. However, large individual differences in responsiveness to such stimuli were observed, so that the effects of sensory neuromodulation manifest only in some of the subjects. Given that spinal reflexes are an integral part of the neuronal circuitry, here we investigated the extent to which spinal pattern generation excitability in response to the vibrostimulation of muscle proprioceptors can be related to the H-reflex magnitude, in both the lower and upper limbs. For the H-reflex measurements, three conditions were used: stationary limbs, voluntary limb movement and passive limb movement. The results showed that the H-reflex was considerably higher in the group of participants who demonstrated non-voluntary rhythmic responses than it was in the participants who did not demonstrate them. Our findings are consistent with the idea that spinal reflex measurements play important roles in assessing the rhythmogenesis of the spinal cord.
Collapse
Affiliation(s)
- Irina A. Solopova
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Russian Academy of Sciences, 127951 Moscow, Russia; (I.A.S.); (V.A.S.); (I.Y.D.); (D.S.Z.)
| | - Victor A. Selionov
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Russian Academy of Sciences, 127951 Moscow, Russia; (I.A.S.); (V.A.S.); (I.Y.D.); (D.S.Z.)
| | - Egor O. Blinov
- School of Biological and Medical Physics, Moscow Institute of Physics and Technology, 141701 Dolgoprudny, Russia;
| | - Irina Y. Dolinskaya
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Russian Academy of Sciences, 127951 Moscow, Russia; (I.A.S.); (V.A.S.); (I.Y.D.); (D.S.Z.)
- School of Biological and Medical Physics, Moscow Institute of Physics and Technology, 141701 Dolgoprudny, Russia;
| | - Dmitry S. Zhvansky
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Russian Academy of Sciences, 127951 Moscow, Russia; (I.A.S.); (V.A.S.); (I.Y.D.); (D.S.Z.)
| | - Francesco Lacquaniti
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy;
- Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Yury Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy;
- Correspondence:
| |
Collapse
|
12
|
Adapting Human-Based Transcutaneous Spinal Cord Stimulation to Develop a Clinically Relevant Animal Model. J Clin Med 2022; 11:jcm11072023. [PMID: 35407636 PMCID: PMC8999945 DOI: 10.3390/jcm11072023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 02/01/2023] Open
Abstract
Transcutaneous spinal cord stimulation (tSCS) as a neuromodulatory strategy has received great attention as a method to promote functional recovery after spinal cord injury (SCI). However, due to the noninvasive nature of tSCS, investigations have primarily focused on human applications. This leaves a critical need for the development of a suitable animal model to further our understanding of this therapeutic intervention in terms of functional and neuroanatomical plasticity and to optimize stimulation protocols. The objective of this study is to establish a new animal model of thoracolumbar tSCS that (1) can accurately recapitulate studies in healthy humans and (2) can receive a repeated and stable tSCS treatment after SCI with minimal restraint, while the electrode remains consistently positioned. We show that our model displays bilateral evoked potentials in multisegmental leg muscles characteristically comparable to humans. Our data also suggest that tSCS mainly activates dorsal root structures like in humans, thereby accounting for the different electrode-to-body-size ratio between the two species. Finally, a repeated tSCS treatment protocol in the awake rat after a complete spinal cord transection is feasible, tolerable, and safe, even with minimal body restraint. Additionally, repeated tSCS was capable of modulating motor output after SCI, providing an avenue to further investigate stimulation-based neuroplasticity and optimize treatment.
Collapse
|
13
|
Wecht JR, Savage WM, Famodimu GO, Mendez GA, Levine JM, Maher MT, Weir JP, Wecht JM, Carmel JB, Wu YK, Harel NY. Posteroanterior Cervical Transcutaneous Spinal Cord Stimulation: Interactions with Cortical and Peripheral Nerve Stimulation. J Clin Med 2021; 10:jcm10225304. [PMID: 34830584 PMCID: PMC8623612 DOI: 10.3390/jcm10225304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 12/27/2022] Open
Abstract
Transcutaneous spinal cord stimulation (TSCS) has demonstrated potential to beneficially modulate spinal cord motor and autonomic circuitry. We are interested in pairing cervical TSCS with other forms of nervous system stimulation to enhance synaptic plasticity in circuits serving hand function. We use a novel configuration for cervical TSCS in which the anode is placed anteriorly over ~C4–C5 and the cathode posteriorly over ~T2–T4. We measured the effects of single pulses of TSCS paired with single pulses of motor cortex or median nerve stimulation timed to arrive at the cervical spinal cord at varying intervals. In 13 participants with and 15 participants without chronic cervical spinal cord injury, we observed that subthreshold TSCS facilitates hand muscle responses to motor cortex stimulation, with a tendency toward greater facilitation when TSCS is timed to arrive at cervical synapses simultaneously or up to 10 milliseconds after cortical stimulus arrival. Single pulses of subthreshold TSCS had no effect on the amplitudes of median H-reflex responses or F-wave responses. These findings support a model in which TSCS paired with appropriately timed cortical stimulation has the potential to facilitate convergent transmission between descending motor circuits, segmental afferents, and spinal motor neurons serving the hand. Studies with larger numbers of participants and repetitively paired cortical and spinal stimulation are needed.
Collapse
Affiliation(s)
- Jaclyn R. Wecht
- James J. Peters VA Medical Center, Bronx, NY 10468, USA; (J.R.W.); (W.M.S.); (G.O.F.); (G.A.M.); (J.M.L.); (M.T.M.); (J.M.W.); (Y.-K.W.)
| | - William M. Savage
- James J. Peters VA Medical Center, Bronx, NY 10468, USA; (J.R.W.); (W.M.S.); (G.O.F.); (G.A.M.); (J.M.L.); (M.T.M.); (J.M.W.); (Y.-K.W.)
| | - Grace O. Famodimu
- James J. Peters VA Medical Center, Bronx, NY 10468, USA; (J.R.W.); (W.M.S.); (G.O.F.); (G.A.M.); (J.M.L.); (M.T.M.); (J.M.W.); (Y.-K.W.)
| | - Gregory A. Mendez
- James J. Peters VA Medical Center, Bronx, NY 10468, USA; (J.R.W.); (W.M.S.); (G.O.F.); (G.A.M.); (J.M.L.); (M.T.M.); (J.M.W.); (Y.-K.W.)
| | - Jonah M. Levine
- James J. Peters VA Medical Center, Bronx, NY 10468, USA; (J.R.W.); (W.M.S.); (G.O.F.); (G.A.M.); (J.M.L.); (M.T.M.); (J.M.W.); (Y.-K.W.)
| | - Matthew T. Maher
- James J. Peters VA Medical Center, Bronx, NY 10468, USA; (J.R.W.); (W.M.S.); (G.O.F.); (G.A.M.); (J.M.L.); (M.T.M.); (J.M.W.); (Y.-K.W.)
| | - Joseph P. Weir
- Department of Health, Sport & Exercise Sciences, University of Kansas, Lawrence, KS 66045, USA;
| | - Jill M. Wecht
- James J. Peters VA Medical Center, Bronx, NY 10468, USA; (J.R.W.); (W.M.S.); (G.O.F.); (G.A.M.); (J.M.L.); (M.T.M.); (J.M.W.); (Y.-K.W.)
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jason B. Carmel
- Department of Orthopedic Surgery, Columbia University, New York, NY 10032, USA;
| | - Yu-Kuang Wu
- James J. Peters VA Medical Center, Bronx, NY 10468, USA; (J.R.W.); (W.M.S.); (G.O.F.); (G.A.M.); (J.M.L.); (M.T.M.); (J.M.W.); (Y.-K.W.)
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Noam Y. Harel
- James J. Peters VA Medical Center, Bronx, NY 10468, USA; (J.R.W.); (W.M.S.); (G.O.F.); (G.A.M.); (J.M.L.); (M.T.M.); (J.M.W.); (Y.-K.W.)
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Correspondence:
| |
Collapse
|
14
|
Sasada S, Kadowaki S, Tazoe T, Murayama T, Kato K, Nakao Y, Matsumoto H, Nishimura Y, Ugawa Y. Assessment of safety of self-controlled repetitive trans-vertebral magnetic stimulation. Clin Neurophysiol 2021; 132:3166-3176. [PMID: 34758417 DOI: 10.1016/j.clinph.2021.09.016] [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: 11/20/2020] [Revised: 08/26/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to assess safety issues of self-controlled repetitive trans-vertebral magnetic stimulation (rTVMS) in humans. METHODS We investigated effects of self-controlled rTVMS (≤20 Hz, ≤90% intensity) on vital signs and subjective sensations in 1690 trials of 30 healthy volunteers and 12 patients with spinal cord disorders. RESULTS Healthy volunteers and the patients received 4595 ± 2345, and 4450 ± 2304 pulses in one day, respectively. No serious adverse events were observed in any participants, and only minor events were seen as follows. While blood pressure was unaffected in the patients, the diastolic blood pressure increased slightly after rTVMS in healthy volunteers. The peripheral capillary oxygen saturation increased after rTVMS in healthy volunteers. "Pain" or "Discomfort" was reported in approximately 10% of trials in both participants groups. Degree of the evoked sensation positively correlated with stimulus intensity and was affected by the site of stimulation. CONCLUSION Self-controlled rTVMS (≤20 Hz and ≤90% intensity) did not induce any serious adverse effects in healthy volunteers and patients with spinal cord disorders. SIGNIFICANCE Our results indicate that rTVMS can be used safely in physiological investigations in healthy volunteers and also as treatment for neurological disorders.
Collapse
Affiliation(s)
- Syusaku Sasada
- Department of Developmental Physiology, National Institute for Physiological Sciences, National Institutes of Natural Sciences, Aichi, Japan; Department of Food and Nutrition Science, Sagami Women's University, Kanagawa, Japan
| | - Suguru Kadowaki
- Department of Neurology, Ohta General Hospital, Fukushima, Japan
| | - Toshiki Tazoe
- Neural Prosthetics Project, Department of Neuroscience, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Takashi Murayama
- Rehabilitation Therapy, Chiba Rehabilitation Center, Chiba, Japan
| | - Kenji Kato
- Department of Developmental Physiology, National Institute for Physiological Sciences, National Institutes of Natural Sciences, Aichi, Japan
| | - Yaoki Nakao
- Department of Developmental Physiology, National Institute for Physiological Sciences, National Institutes of Natural Sciences, Aichi, Japan
| | | | - Yukio Nishimura
- Department of Developmental Physiology, National Institute for Physiological Sciences, National Institutes of Natural Sciences, Aichi, Japan; Neural Prosthetics Project, Department of Neuroscience, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; Department of Physiological Sciences, School of Life Science, The Graduate University for Advanced Studies, SOKENDAI, Japan.
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Fukushima, Japan.
| |
Collapse
|
15
|
Kumar S, Pal A, Jain S, Velpandian T, Mathur R. Electromagnetic Field Stimulation Attenuates Phasic Nociception after Complete Spinal Cord Injury in Rats. Brain Sci 2021; 11:brainsci11111431. [PMID: 34827430 PMCID: PMC8615391 DOI: 10.3390/brainsci11111431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022] Open
Abstract
Traumatic spinal cord injury (SCI) is one of the most incapacitating pathologies, leading to huge rehabilitation challenges besides a social-economic burden on SCI patients and their families. There is no complete curative treatment available so far. Non-invasive and patient-friendly use of extremely low-frequency electromagnetic field stimulation (EMF) has emerged as a therapeutic and rehabilitation option. In this study, we tested whole-body EMF stimulation on thoracic complete SCI-induced nociception including sensorimotor deficits in rats. The EMF application significantly attenuated hyperalgesia and allodynia to thermal, electrical, and chemical stimuli from 6 weeks onwards as well as restoration of spinal reflexes, viz., H-reflex and nociceptive flexion reflex at the study endpoint (week 8). Besides, massively increased glutamate at the SCI injury site was observed in SCI rats with no treatment, which was also attenuated significantly by EMF stimulation. Spinal cord histology of the injury area showed a decrease in lesion volume and glial population in the EMF-stimulated rats. These findings indicate the beneficial role of EMF stimulation after thoracic complete SCI in adult male rats and, thereby, a beneficial patient-friendly rehabilitation tool.
Collapse
Affiliation(s)
- Suneel Kumar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi 110029, India; (A.P.); (S.J.); (R.M.)
- Correspondence:
| | - Ajay Pal
- Department of Physiology, All India Institute of Medical Sciences, New Delhi 110029, India; (A.P.); (S.J.); (R.M.)
| | - Suman Jain
- Department of Physiology, All India Institute of Medical Sciences, New Delhi 110029, India; (A.P.); (S.J.); (R.M.)
| | - Thirumurthy Velpandian
- Department of Ocular Pharmacy and Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India;
| | - Rashmi Mathur
- Department of Physiology, All India Institute of Medical Sciences, New Delhi 110029, India; (A.P.); (S.J.); (R.M.)
| |
Collapse
|
16
|
Noninvasive spinal stimulation safely enables upright posture in children with spinal cord injury. Nat Commun 2021; 12:5850. [PMID: 34615867 PMCID: PMC8494794 DOI: 10.1038/s41467-021-26026-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/06/2021] [Indexed: 12/23/2022] Open
Abstract
In children with spinal cord injury (SCI), scoliosis due to trunk muscle paralysis frequently requires surgical treatment. Transcutaneous spinal stimulation enables trunk stability in adults with SCI and may pose a non-invasive preventative therapeutic alternative. This non-randomized, non-blinded pilot clinical trial (NCT03975634) determined the safety and efficacy of transcutaneous spinal stimulation to enable upright sitting posture in 8 children with trunk control impairment due to acquired SCI using within-subject repeated measures study design. Primary safety and efficacy outcomes (pain, hemodynamics stability, skin irritation, trunk kinematics) and secondary outcomes (center of pressure displacement, compliance rate) were assessed within the pre-specified endpoints. One participant did not complete the study due to pain with stimulation on the first day. One episode of autonomic dysreflexia during stimulation was recorded. Following hemodynamic normalization, the participant completed the study. Overall, spinal stimulation was well-tolerated and enabled upright sitting posture in 7 out of the 8 participants. Scoliosis due to trunk muscle paralysis frequently requires surgical treatment in children with spinal cord injury. The authors demonstrate the safety and efficacy of transcutaneous spinal stimulation to enable upright sitting posture in 7/8 children with trunk control impairment in a within-subjects, repeated measures pilot clinical trial.
Collapse
|
17
|
Martins Â, Gouveia D, Cardoso A, Carvalho C, Silva C, Coelho T, Gamboa Ó, Ferreira A. Functional Neurorehabilitation in Dogs with an Incomplete Recovery 3 Months following Intervertebral Disc Surgery: A Case Series. Animals (Basel) 2021; 11:ani11082442. [PMID: 34438900 PMCID: PMC8388785 DOI: 10.3390/ani11082442] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 12/27/2022] Open
Abstract
Simple Summary A non-invasive neurorehabilitation multimodal protocol (NRMP) may be applicable to chronic T3-L3 dogs 3 months after undergoing surgery for acute Intervertebral Disc Disease (IVDD) Hansen type I; this protocol has been shown to be safe, feasible, and potentially effective at improving ambulation in both open field score (OFS) 0 and OFS 1 dogs. The specific sample population criteria limit the number of dogs included, mainly due to owners withdrawing over time. Thus, the present case series study aimed to demonstrate that an NRMP could contribute to a functional treatment possibly based on synaptic and anatomic reorganization of the spinal cord. Abstract This case series study aimed to evaluate the safety, feasibility, and positive outcome of the neurorehabilitation multimodal protocol (NRMP) in 16 chronic post-surgical IVDD Hansen type I dogs, with OFS 0/DPP− (n = 9) and OFS 1/DPP+ (n = 7). All were enrolled in the NRMP for a maximum of 90 days and were clinically discharged after achieving ambulation. The NRMP was based on locomotor training, functional electrical stimulation, transcutaneous electrical spinal cord stimulation, and 4-aminopyridine (4-AP) pharmacological management. In the Deep Pain Perception (DPP)+ dogs, 100% recovered ambulation within a mean period of 47 days, reaching OFS ≥11, which suggests that a longer period of time is needed for recovery. At follow-up, all dogs presented a positive evolution with voluntary micturition. Of the DPP− dogs admitted, all achieved a flexion/extension locomotor pattern within 30 days, and after starting the 4-AP, two dogs were discharged at outcome day 45, with 78% obtaining Spinal Reflex Locomotion (SRL) and automatic micturition within a mean period of 62 days. At follow-up, all dogs maintained their neurological status. After the NRMP, ambulatory status was achieved in 88% (14/16) of dogs, without concurrent events. Thus, an NRMP may be an important therapeutic option to reduce the need for euthanasia in the clinical setting.
Collapse
Affiliation(s)
- Ângela Martins
- Faculty of Veterinary Medicine, Lusófona University, Campo Grande, 1300-477 Lisboa, Portugal
- Animal Rehabilitation Center, Arrábida Veterinary Hospital, Azeitão, 2925-583 Setúbal, Portugal; (D.G.); (A.C.); (C.C.); (C.S.); (T.C.)
- CIISA—Centro Interdisciplinar-Investigação em Saúde Animal, Faculdade de Medicina Veterinária, Av. Universidade Técnica de Lisboa, 1300-477 Lisboa, Portugal;
- Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Campo Grande, 1300-477 Lisboa, Portugal
- Correspondence:
| | - Débora Gouveia
- Animal Rehabilitation Center, Arrábida Veterinary Hospital, Azeitão, 2925-583 Setúbal, Portugal; (D.G.); (A.C.); (C.C.); (C.S.); (T.C.)
- Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Campo Grande, 1300-477 Lisboa, Portugal
| | - Ana Cardoso
- Animal Rehabilitation Center, Arrábida Veterinary Hospital, Azeitão, 2925-583 Setúbal, Portugal; (D.G.); (A.C.); (C.C.); (C.S.); (T.C.)
| | - Carla Carvalho
- Animal Rehabilitation Center, Arrábida Veterinary Hospital, Azeitão, 2925-583 Setúbal, Portugal; (D.G.); (A.C.); (C.C.); (C.S.); (T.C.)
| | - Cátia Silva
- Animal Rehabilitation Center, Arrábida Veterinary Hospital, Azeitão, 2925-583 Setúbal, Portugal; (D.G.); (A.C.); (C.C.); (C.S.); (T.C.)
| | - Tiago Coelho
- Animal Rehabilitation Center, Arrábida Veterinary Hospital, Azeitão, 2925-583 Setúbal, Portugal; (D.G.); (A.C.); (C.C.); (C.S.); (T.C.)
| | - Óscar Gamboa
- Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal;
| | - António Ferreira
- CIISA—Centro Interdisciplinar-Investigação em Saúde Animal, Faculdade de Medicina Veterinária, Av. Universidade Técnica de Lisboa, 1300-477 Lisboa, Portugal;
- Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal;
| |
Collapse
|
18
|
Petrosyan H, Liang L, Tesfa A, Sisto SA, Fahmy M, Arvanian VL. Modulation of H-reflex responses and frequency-dependent depression by repetitive spinal electromagnetic stimulation: From rats to humans and back to chronic spinal cord injured rats. Eur J Neurosci 2020; 52:4875-4889. [PMID: 32594554 PMCID: PMC7818466 DOI: 10.1111/ejn.14885] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/15/2020] [Accepted: 06/12/2020] [Indexed: 11/30/2022]
Abstract
The lack of propagation of signals through survived fibers is among the major reasons for functional loss after incomplete spinal cord injury (SCI). Our recent results of animal studies demonstrate that spinal electromagnetic stimulation (SEMS) can enhance transmission in damaged spinal cord, and this type of modulation depends on the function of NMDA receptors at the neuronal networks below the injury level. Here, our pilot human study revealed that administration of repetitive SEMS induced long‐lasting modulation of H‐responses in both healthy and participants with chronic SCI. In order to understand the mechanisms underlying these effects, we have used an animal model and examined effects of SEMS on H‐responses. Effects of SEMS on H‐responses, frequency‐dependent depression (FDD) of H‐reflex, and possible underlying mechanisms have been examined in both naïve and rats with SCI. Our results demonstrate that consistent with the effects of SEMS on H‐reflex seen in humans, repetitive SEMS induced similar modulation in excitability of peripheral nerve responses in both non‐injured and rats with SCI. Importantly, our results confirmed the reduced FDD of H‐reflex in SCI animals and revealed that SEMS was able to recover FDD in rats with chronic SCI. Using intraspinal injections of the NMDA receptor blocker MK‐801, we have identified NMDA receptors as an important contributor to these SEMS‐induced effects in rats with SCI. These results identify SEMS as a novel non‐invasive technique for modulation of neuro‐muscular circuits and, importantly, modulation of spinal networks after chronic SCI.
Collapse
Affiliation(s)
- Hayk Petrosyan
- Research Services, Northport Veterans Affairs Medical Center, Northport, New York, USA.,Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, New York, USA
| | - Li Liang
- Research Services, Northport Veterans Affairs Medical Center, Northport, New York, USA.,Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, New York, USA
| | - Asrat Tesfa
- Research Services, Northport Veterans Affairs Medical Center, Northport, New York, USA
| | - Sue A Sisto
- Department of Physical Therapy, Division of Rehabilitation Sciences, Stony Brook University, Stony Brook, New York, USA.,Department of Rehabilitation Science, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Magda Fahmy
- Physical Medicine and Rehabilitation Services, Northport Veterans Affairs Medical Center, Northport, New York, USA
| | - Victor L Arvanian
- Research Services, Northport Veterans Affairs Medical Center, Northport, New York, USA.,Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, New York, USA
| |
Collapse
|
19
|
Duffell LD, Donaldson NDN. A Comparison of FES and SCS for Neuroplastic Recovery After SCI: Historical Perspectives and Future Directions. Front Neurol 2020; 11:607. [PMID: 32714270 PMCID: PMC7344227 DOI: 10.3389/fneur.2020.00607] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/25/2020] [Indexed: 12/17/2022] Open
Abstract
There is increasing evidence that neuroplastic changes can occur even years after spinal cord injury, leading to reduced disability and better health which should reduce the cost of healthcare. In motor-incomplete spinal cord injury, recovery of leg function may occur if repetitive training causes afferent input to the lumbar spinal cord. The afferent input may be due to activity-based therapy without electrical stimulation but we present evidence that it is faster with electrical stimulation. This may be spinal cord stimulation or peripheral nerve stimulation. Recovery is faster if the stimulation is phasic and that the patient is trying to use their legs during the training. All the published studies are small, so all conclusions are provisional, but it appears that patients with more disability (AIS A and B) may need to continue using stimulation and for them, an implanted stimulator is likely to be convenient. Patients with less disability (AIS C and D) may make useful recovery and improve their quality of life from a course of therapy. This might be locomotion therapy but we argue that cycling with electrical stimulation, which uses biofeedback to encourage descending drive, causes rapid recovery and might be used with little supervision at home, making it much less expensive. Such an electrical therapy followed by conventional physiotherapy might be affordable for the many people living with chronic SCI. To put this in perspective, we present some information about what treatments are funded in the UK and the US.
Collapse
Affiliation(s)
- Lynsey D Duffell
- Implanted Devices Group, University College London, London, United Kingdom.,Aspire CREATe, University College London, London, United Kingdom
| | | |
Collapse
|
20
|
Why do we move to the beat? A multi-scale approach, from physical principles to brain dynamics. Neurosci Biobehav Rev 2020; 112:553-584. [DOI: 10.1016/j.neubiorev.2019.12.024] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 10/20/2019] [Accepted: 12/13/2019] [Indexed: 01/08/2023]
|
21
|
On Primitives in Motor Control. Motor Control 2020; 24:318-346. [DOI: 10.1123/mc.2019-0099] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/03/2019] [Accepted: 12/07/2019] [Indexed: 11/18/2022]
Abstract
The concept of primitives has been used in motor control both as a theoretical construct and as a means of describing the results of experimental studies involving multiple moving elements. This concept is close to Bernstein’s notion of engrams and level of synergies. Performance primitives have been explored in spaces of peripheral variables but interpreted in terms of neural control primitives. Performance primitives reflect a variety of mechanisms ranging from body mechanics to spinal mechanisms and to supraspinal circuitry. This review suggests that primitives originate at the task level as preferred time functions of spatial referent coordinates or at mappings from higher level referent coordinates to lower level, frequently abundant, referent coordinate sets. Different patterns of performance primitives can emerge depending, in particular, on the external force field.
Collapse
|
22
|
Calabrò RS, Billeri L, Andronaco VA, Accorinti M, Milardi D, Cannavò A, Aliberti E, Militi A, Bramanti P, Naro A. Walking on the Moon: A randomized clinical trial on the role of lower body positive pressure treadmill training in post-stroke gait impairment. J Adv Res 2020; 21:15-24. [PMID: 31641534 PMCID: PMC6796731 DOI: 10.1016/j.jare.2019.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/09/2019] [Accepted: 09/18/2019] [Indexed: 12/14/2022] Open
Abstract
The effects of LBPP on locomotion in neurologic patients are poorly predictable. The mechanisms through which LPBB acts on gait are partially unknown. Gait training using AlterG improves functional gait in post-stroke patients. AlterG increases muscle activation and/or phasic muscle activation in post-stroke. This knowledge may be useful to plan patient-tailored LBPP locomotor training.
Body weight–supported treadmill training (BWSTT) can be usefully employed to facilitate gait recovery in patients with neurological injuries. Specifically, lower body positive pressure support system (LBPPSS) decreases weight-bearing and ground reaction forces with potentially positive effects on qualitative gait indices. However, which gait features are being shaped by LBPPSS in post-stroke patients is yet poorly predictable. A pilot study on the effects of LBPPSS on qualitative and quantitative gait indices was carried out in patients with hemiparesis due to stroke in the chronic phase. Fifty patients, who suffered from a first, single, ischemic, supra-tentorial stroke that occurred at least 6 months before study inclusion, were enrolled in the study. They were provided with 24 daily sessions of gait training using either the AlterG device or conventional treadmill gait training (TGT). These patients were compared with 25 age-matched healthy controls (HC), who were provided with the same amount of AlterG. Qualitative and quantitative gait features, including Functional Ambulation Categories, gait cycle features, and muscle activation patterns were analyzed before and after the training. It was found that AlterG provided the patients with higher quantitative but not qualitative gait features, as compared to TGT. In particular, AlterG specifically shaped muscle activation phases and gait cycle features in patients, whereas it increased only overall muscle activation in HC. These data suggest that treadmill gait training equipped with LBPPSS specifically targets the gait features that are abnormal in chronic post-stroke patients. It is hypothesizable that the specificity of AlterG effects may depend on a selective reshape of gait rhythmogenesis elaborated by the locomotor spinal circuits receiving a deteriorated corticospinal drive. Even though further studies are warranted to clarify the role of treadmills equipped with LBPPSS in gait training of chronic post-stroke patients, the knowledge of the exact gait pattern during weight-relief is potentially useful to plan patient-tailored locomotor training.
Collapse
Affiliation(s)
- Rocco Salvatore Calabrò
- Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
- Corresponding author at: Rocco Salvatore Calabrò, IRCCS Centro Neurolesi Bonino Pulejo; via Palermo, SS 113, ctr. Casazza, 98124 Messina, Italy.
| | - Luana Billeri
- Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | | | - Maria Accorinti
- Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Demetrio Milardi
- Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
- Department of Biomorphology and Biotechnologies, University of Messina, Messina, Italy
| | - Antonino Cannavò
- Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Enrico Aliberti
- Department of Motor Sciences, University of Messina, Messina, Italy
| | - Angela Militi
- Department of Motor Sciences, University of Messina, Messina, Italy
| | - Placido Bramanti
- Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Antonino Naro
- Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| |
Collapse
|
23
|
Functional State of the Neuromotor Apparatus of the Gastrocnemius Muscle in Rat Under Microgravity: Effect of Spinal Cord Stimulation. BIONANOSCIENCE 2019. [DOI: 10.1007/s12668-019-00611-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
24
|
Spinal Cord Epidural Stimulation for Lower Limb Motor Function Recovery in Individuals with Motor Complete Spinal Cord Injury. Phys Med Rehabil Clin N Am 2019; 30:337-354. [DOI: 10.1016/j.pmr.2018.12.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
25
|
Synergistic influences of sensory and central stimuli on non-voluntary rhythmic arm movements. Hum Mov Sci 2019; 64:230-239. [PMID: 30798047 DOI: 10.1016/j.humov.2019.02.008] [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: 05/23/2018] [Revised: 01/26/2019] [Accepted: 02/14/2019] [Indexed: 11/22/2022]
Abstract
In recent years, neuromodulation of the cervical spinal circuitry has become an area of interest for investigating rhythmogenesis of the human spinal cord and interaction between cervical and lumbosacral circuitries, given the involvement of rhythmic arm muscle activity in many locomotor tasks. We have previously shown that arm muscle vibrostimulation can elicit non-voluntary upper limb oscillations in unloading body conditions. Here we investigated the excitability of the cervical spinal circuitry by applying different peripheral and central stimuli in healthy humans. The rationale for applying combined stimuli is that the efficiency of only one stimulus is generally limited. We found that low-intensity electrical stimulation of the superficial arm median nerve can evoke rhythmic arm movements. Furthermore, the movements were enhanced by additional peripheral stimuli (e.g., arm muscle vibration, head turns or passive rhythmic leg movements). Finally, low-frequency transcranial magnetic stimulation of the motor cortex significantly facilitated rhythmogenesis. The findings are discussed in the general framework of a brain-spinal interface for developing adaptive central pattern generator-modulating therapies.
Collapse
|
26
|
Effects of periodic sensory perturbations during electrical stimulation on gait cycle period. PLoS One 2019; 13:e0209781. [PMID: 30596726 PMCID: PMC6312303 DOI: 10.1371/journal.pone.0209781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 12/11/2018] [Indexed: 11/19/2022] Open
Abstract
The spinal cord contains the neural circuitry needed to generate rhythmic walking motions, and afferent sensory feedbacks are involved in the control of locomotion. In this study, we examined the influence of periodic electrical stimulation on the change in gait cycle period during treadmill walking. 40 subjects walked on a treadmill while receiving periodic bursts of electrical stimulation at various perturbation periods (-20, -40, -60, +20, +40 milliseconds from their initial gait cycle periods). Eleven subjects received electrical stimulation to the hamstring, and 29 received electrical stimulation to the calf. Each subject completed four trials; two trials were conducted using high amplitude stimulation causing a slight degree of joint motion, and the other two trials were conducted using reduced amplitude stimulation which did not cause observable motion. Through the trials, we sought to answer the following questions: 1) does the amplitude of electrical stimulation have an effect on the level of entrainment? 2) does the stimulation site effect the level of entrainment? Entrainment refers to the synchronization of gait cycle period to the period of electrical stimulation. The results showed that entrainment was observed when the perturbation periods were induced relatively close to the subject’s initial gait cycle period. For both stimulation sites, entrainment was shown in 59% of subjects at +/- 20 milliseconds from the initial gait cycle period. With reduced amplitude, entrainment was still observed (51% all stimulation site groups at +/- 20 milliseconds). In addition, after-effects following electrical perturbation were present as seen by changes in the mean gait cycle period. Our results suggest that human locomotor control is organized with a semi-autonomous peripheral oscillator influenced by afferent information, and that electrical stimulation has the potential to be a simpler, and cost-effective tool for locomotion rehabilitation.
Collapse
|
27
|
Gerasimenko Y, Sayenko D, Gad P, Kozesnik J, Moshonkina T, Grishin A, Pukhov A, Moiseev S, Gorodnichev R, Selionov V, Kozlovskaya I, Edgerton VR. Electrical Spinal Stimulation, and Imagining of Lower Limb Movements to Modulate Brain-Spinal Connectomes That Control Locomotor-Like Behavior. Front Physiol 2018; 9:1196. [PMID: 30283341 PMCID: PMC6157483 DOI: 10.3389/fphys.2018.01196] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/08/2018] [Indexed: 12/26/2022] Open
Abstract
Neuronal control of stepping movement in healthy human is based on integration between brain, spinal neuronal networks, and sensory signals. It is generally recognized that there are continuously occurring adjustments in the physiological states of supraspinal centers during all routines movements. For example, visual as well as all other sources of information regarding the subject's environment. These multimodal inputs to the brain normally play an important role in providing a feedforward source of control. We propose that the brain routinely uses these continuously updated assessments of the environment to provide additional feedforward messages to the spinal networks, which provides a synergistic feedforwardness for the brain and spinal cord. We tested this hypothesis in 8 non-injured individuals placed in gravity neutral position with the lower limbs extended beyond the edge of the table, but supported vertically, to facilitate rhythmic stepping. The experiment was performed while visualizing on the monitor a stick figure mimicking bilateral stepping or being motionless. Non-invasive electrical stimulation was used to neuromodulate a wide range of excitabilities of the lumbosacral spinal segments that would trigger rhythmic stepping movements. We observed that at the same intensity level of transcutaneous electrical spinal cord stimulation (tSCS), the presence or absence of visualizing a stepping-like movement of a stick figure immediately initiated or terminated the tSCS-induced rhythmic stepping motion, respectively. We also demonstrated that during both voluntary and imagined stepping, the motor potentials in leg muscles were facilitated when evoked cortically, using transcranial magnetic stimulation (TMS), and inhibited when evoked spinally, using tSCS. These data suggest that the ongoing assessment of the environment within the supraspinal centers that play a role in planning a movement can routinely modulate the physiological state of spinal networks that further facilitates a synergistic neuromodulation of the brain and spinal cord in preparing for movements.
Collapse
Affiliation(s)
- Yury Gerasimenko
- Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia.,Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, United States.,Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Dimitry Sayenko
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, United States
| | - Parag Gad
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Justin Kozesnik
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Tatiana Moshonkina
- Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia
| | - Aleksandr Grishin
- Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia
| | - Aleksandr Pukhov
- Velikie Luki State Academy of Physical Education and Sport, Velikiye Luki, Russia
| | - Sergey Moiseev
- Velikie Luki State Academy of Physical Education and Sport, Velikiye Luki, Russia
| | - Ruslan Gorodnichev
- Velikie Luki State Academy of Physical Education and Sport, Velikiye Luki, Russia
| | - Victor Selionov
- Institute for Information Transmission Problems, Russian Academy of Science, Moscow, Russia
| | - Inessa Kozlovskaya
- Russian Federation State Scientific Center, Institute for Bio-Medical Problems, Russian Academy of Sciences, Moscow, Russia
| | - V Reggie Edgerton
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, United States.,Institute Guttmann, Hospital de Neurorehabilitació, Institut Universitari adscrit a la Universitat Autònoma de Barcelona, Badalona, Spain.,The Center for Neuroscience and Regenerative Medicine, University of Technology Sydney, Ultimo, NSW, Australia
| |
Collapse
|
28
|
Muscle synergies are consistent across level and uphill treadmill running. Sci Rep 2018; 8:5979. [PMID: 29654291 PMCID: PMC5899144 DOI: 10.1038/s41598-018-24332-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/21/2018] [Indexed: 12/30/2022] Open
Abstract
This study aimed to identify muscle synergies of the lower limb during treadmill running on level and inclined ground. Eight subjects ran on a treadmill at three speeds (2.5, 3.3, and 4.1 m/s) and two grades (level and 10% grade). Surface electromyographic (EMG) signals were recorded from 10 muscles of the lower limb, including deeper muscles such as vastus intermedius, adductor magnus, and adductor longus. Muscle synergies were extracted applying a non-negative matrix factorization algorithm, and relative co-activations across muscles and the temporal recruitment pattern were identified by muscle synergy vector and synergy activation coefficient, respectively. The scalar product between pairs of synergy vectors and synergy activation coefficients during level and uphill running conditions were analyzed as a similarity index, with values above 0.8 recognized as similar. Approximately 4 muscle synergies controlled the majority of variability in 10 EMGs during running, and were common between level and uphill conditions. At each running speed, inter-condition similarity was observed in synergy vector (r > 0.83) and synergy activation coefficients (r > 0.84) at each type of synergy. These results suggest that types of synergy are consistent between level and uphill running.
Collapse
|
29
|
Gad PN, Gerasimenko YP, Zdunowski S, Sayenko D, Haakana P, Turner A, Lu D, Roy RR, Edgerton VR. Iron 'ElectriRx' man: Overground stepping in an exoskeleton combined with noninvasive spinal cord stimulation after paralysis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2015:1124-7. [PMID: 26736463 DOI: 10.1109/embc.2015.7318563] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We asked whether coordinated voluntary movement of the lower limbs could be regained in an individual having been completely paralyzed (>4 yr) and completely absent of vision (>15 yr) using a novel strategy - transcutaneous spinal cord stimulation at selected sites over the spinal vertebrae with just one week of training. We also asked whether this stimulation strategy could facilitate stepping assisted by an exoskeleton (EKSO, EKSO Bionics) that is designed so that the subject can voluntarily complement the work being performed by the exoskeleton. We found that spinal cord stimulation enhanced the level of effort that the subject could generate while stepping in the exoskeleton. In addition, stimulation improved the coordination patterns of the lower limb muscles resulting in a more continuous, smooth stepping motion in the exoskeleton. These stepping sessions in the presence of stimulation were accompanied by greater cardiac responses and sweating than could be attained without the stimulation. Based on the data from this case study it appears that there is considerable potential for positive synergistic effects after complete paralysis by combining the overground stepping in an exoskeleton, a novel transcutaneous spinal cord stimulation paradigm, and daily training.
Collapse
|
30
|
Klarner T, Zehr EP. Sherlock Holmes and the curious case of the human locomotor central pattern generator. J Neurophysiol 2018. [PMID: 29537920 DOI: 10.1152/jn.00554.2017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Evidence first described in reduced animal models over 100 years ago led to deductions about the control of locomotion through spinal locomotor central pattern-generating (CPG) networks. These discoveries in nature were contemporaneous with another form of deductive reasoning found in popular culture, that of Arthur Conan Doyle's detective, Sherlock Holmes. Because the invasive methods used in reduced nonhuman animal preparations are not amenable to study in humans, we are left instead with deducing from other measures and observations. Using the deductive reasoning approach of Sherlock Holmes as a metaphor for framing research into human CPGs, we speculate and weigh the evidence that should be observable in humans based on knowledge from other species. This review summarizes indirect inference to assess "observable evidence" of pattern-generating activity that leads to the logical deduction of CPG contributions to arm and leg activity during locomotion in humans. The question of where a CPG may be housed in the human nervous system remains incompletely resolved at this time. Ongoing understanding, elaboration, and application of functioning locomotor CPGs in humans is important for gait rehabilitation strategies in those with neurological injuries.
Collapse
Affiliation(s)
- Taryn Klarner
- Rehabilitation Neuroscience Laboratory, University of Victoria , Victoria, British Columbia , Canada.,Human Discovery Science, International Collaboration on Repair Discoveries , Vancouver, British Columbia , Canada.,Centre for Biomedical Research, University of Victoria , Victoria, British Columbia , Canada
| | - E Paul Zehr
- Rehabilitation Neuroscience Laboratory, University of Victoria , Victoria, British Columbia , Canada.,Human Discovery Science, International Collaboration on Repair Discoveries , Vancouver, British Columbia , Canada.,Centre for Biomedical Research, University of Victoria , Victoria, British Columbia , Canada.,Division of Medical Sciences, University of Victoria, British Columbia, Canada
| |
Collapse
|
31
|
Early manifestation of arm–leg coordination during stepping on a surface in human neonates. Exp Brain Res 2018; 236:1105-1115. [DOI: 10.1007/s00221-018-5201-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 02/07/2018] [Indexed: 12/23/2022]
|
32
|
Yokoyama H, Ogawa T, Shinya M, Kawashima N, Nakazawa K. Speed dependency in α-motoneuron activity and locomotor modules in human locomotion: indirect evidence for phylogenetically conserved spinal circuits. Proc Biol Sci 2018; 284:rspb.2017.0290. [PMID: 28356457 DOI: 10.1098/rspb.2017.0290] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 03/01/2017] [Indexed: 01/13/2023] Open
Abstract
Coordinated locomotor muscle activity is generated by the spinal central pattern generators (CPGs). Vertebrate studies have demonstrated the following two characteristics of the speed control mechanisms of the spinal CPGs: (i) rostral segment activation is indispensable for achieving high-speed locomotion; and (ii) specific combinations between spinal interneuronal modules and motoneuron (MN) pools are sequentially activated with increasing speed. Here, to investigate whether similar control mechanisms exist in humans, we examined spinal neural activity during varied-speed locomotion by mapping the distribution of MN activity in the spinal cord and extracting locomotor modules, which generate basic MN activation patterns. The MN activation patterns and the locomotor modules were analysed from multi-muscle electromyographic recordings. The reconstructed MN activity patterns were divided into the following three patterns depending on the speed of locomotion: slow walking, fast walking and running. During these three activation patterns, the proportion of the activity in rostral segments to that in caudal segments increased as locomotion speed increased. Additionally, the different MN activation patterns were generated by distinct combinations of locomotor modules. These results are consistent with the speed control mechanisms observed in vertebrates, suggesting phylogenetically conserved spinal mechanisms of neural control of locomotion.
Collapse
Affiliation(s)
- Hikaru Yokoyama
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan.,Department of Rehabilitation for the Movement Functions, Research Institute of National Rehabilitation Center for the Disabled, Saitama, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Tetsuya Ogawa
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Masahiro Shinya
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Noritaka Kawashima
- Department of Rehabilitation for the Movement Functions, Research Institute of National Rehabilitation Center for the Disabled, Saitama, Japan
| | - Kimitaka Nakazawa
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
33
|
Yokoyama H, Hagio K, Ogawa T, Nakazawa K. Motor module activation sequence and topography in the spinal cord during air-stepping in human: Insights into the traveling wave in spinal locomotor circuits. Physiol Rep 2017; 5:5/22/e13504. [PMID: 29180480 PMCID: PMC5704080 DOI: 10.14814/phy2.13504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 10/24/2017] [Accepted: 10/25/2017] [Indexed: 01/06/2023] Open
Abstract
Coordinated locomotor muscle activity is generated by the spinal central pattern generators (CPGs), which are modulated by peripheral and supraspinal inputs. The CPGs would consist of multiple motor modules generating basic muscle activity, which are distributed rostrocaudally along the spinal cord. To activate the motor modules in proper sequence, rostrocaudally traveling waves of activation in the spinal cord are important mechanisms in the CPGs. The traveling waves of activation have been observed in nonhuman vertebrates. However, they have not yet been confirmed during human locomotion. Although, rostrocaudal wave‐like activations in the spinal cord were observed during walking in humans in a previous study, the propagation shifted rostrally toward the upper lumbar segments at foot contact. Here, using an air stepping task to remove the foot‐contact interactions, we examined whether the traveling wave mechanism exists in the human spinal circuits based on the activation sequence of motor modules and their topography. We measured electromyographic activity of lower leg muscles during the air‐stepping task. Then, we extracted motor modules (i.e., basic patterns of sets of muscle activations: muscle synergies) from the measured muscle activities using nonnegative matrix factorization method. Next, we reconstructed motoneuron (MN) activity from each module activity based on myotomal charts. We identified four types of motor modules from muscle activities during the air‐stepping task. Each motor module represented different sets of synergistic muscle activations. MN clusters innervating each motor module were sequentially activated from the rostral to caudal region in the spinal cord, from the initial flexion to the last extension phase during air‐stepping. The rostrocaudally sequential activation of MN clusters suggests the possibility that rostrocaudally traveling waves exist in human locomotor spinal circuits. The present results advance the understanding of human locomotor control mechanisms, and provide important insights into the evolution of locomotor networks in vertebrates.
Collapse
Affiliation(s)
- Hikaru Yokoyama
- Laboratory of Sports Sciences, Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan.,Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Kohtaroh Hagio
- Laboratory of Sports Sciences, Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Tetsuya Ogawa
- Laboratory of Sports Sciences, Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Kimitaka Nakazawa
- Laboratory of Sports Sciences, Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
34
|
Lacquaniti F, Ivanenko YP, Sylos-Labini F, La Scaleia V, La Scaleia B, Willems PA, Zago M. Human Locomotion in Hypogravity: From Basic Research to Clinical Applications. Front Physiol 2017; 8:893. [PMID: 29163225 PMCID: PMC5682019 DOI: 10.3389/fphys.2017.00893] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 10/24/2017] [Indexed: 01/07/2023] Open
Abstract
We have considerable knowledge about the mechanisms underlying compensation of Earth gravity during locomotion, a knowledge obtained from physiological, biomechanical, modeling, developmental, comparative, and paleoanthropological studies. By contrast, we know much less about locomotion and movement in general under sustained hypogravity. This lack of information poses a serious problem for human space exploration. In a near future humans will walk again on the Moon and for the first time on Mars. It would be important to predict how they will move around, since we know that locomotion and mobility in general may be jeopardized in hypogravity, especially when landing after a prolonged weightlessness of the space flight. The combination of muscle weakness, of wearing a cumbersome spacesuit, and of maladaptive patterns of locomotion in hypogravity significantly increase the risk of falls and injuries. Much of what we currently know about locomotion in hypogravity derives from the video archives of the Apollo missions on the Moon, the experiments performed with parabolic flight or with body weight support on Earth, and the theoretical models. These are the topics of our review, along with the issue of the application of simulated hypogravity in rehabilitation to help patients with deambulation problems. We consider several issues that are common to the field of space science and clinical rehabilitation: the general principles governing locomotion in hypogravity, the methods used to reduce gravity effects on locomotion, the extent to which the resulting behavior is comparable across different methods, the important non-linearities of several locomotor parameters as a function of the gravity reduction, the need to use multiple methods to obtain reliable results, and the need to tailor the methods individually based on the physiology and medical history of each person.
Collapse
Affiliation(s)
- Francesco Lacquaniti
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Center of Space BioMedicine, University of Rome Tor Vergata, Rome, Italy
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Yury P. Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Francesca Sylos-Labini
- Center of Space BioMedicine, University of Rome Tor Vergata, Rome, Italy
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Valentina La Scaleia
- Center of Space BioMedicine, University of Rome Tor Vergata, Rome, Italy
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Barbara La Scaleia
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Patrick A. Willems
- Laboratory of Biomechanics and Physiology of Locomotion, Institute of NeuroScience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Myrka Zago
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| |
Collapse
|
35
|
Taccola G, Sayenko D, Gad P, Gerasimenko Y, Edgerton VR. And yet it moves: Recovery of volitional control after spinal cord injury. Prog Neurobiol 2017; 160:64-81. [PMID: 29102670 PMCID: PMC5773077 DOI: 10.1016/j.pneurobio.2017.10.004] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 10/09/2017] [Accepted: 10/21/2017] [Indexed: 12/12/2022]
Abstract
Preclinical and clinical neurophysiological and neurorehabilitation research has generated rather surprising levels of recovery of volitional sensory-motor function in persons with chronic motor paralysis following a spinal cord injury. The key factor in this recovery is largely activity-dependent plasticity of spinal and supraspinal networks. This key factor can be triggered by neuromodulation of these networks with electrical and pharmacological interventions. This review addresses some of the systems-level physiological mechanisms that might explain the effects of electrical modulation and how repetitive training facilitates the recovery of volitional motor control. In particular, we substantiate the hypotheses that: (1) in the majority of spinal lesions, a critical number and type of neurons in the region of the injury survive, but cannot conduct action potentials, and thus are electrically non-responsive; (2) these neuronal networks within the lesioned area can be neuromodulated to a transformed state of electrical competency; (3) these two factors enable the potential for extensive activity-dependent reorganization of neuronal networks in the spinal cord and brain, and (4) propriospinal networks play a critical role in driving this activity-dependent reorganization after injury. Real-time proprioceptive input to spinal networks provides the template for reorganization of spinal networks that play a leading role in the level of coordination of motor pools required to perform a given functional task. Repetitive exposure of multi-segmental sensory-motor networks to the dynamics of task-specific sensory input as occurs with repetitive training can functionally reshape spinal and supraspinal connectivity thus re-enabling one to perform complex motor tasks, even years post injury.
Collapse
Affiliation(s)
- G Taccola
- Department of Integrative Biology and Physiology, University of California, Los Angeles, CA 90095 USA; Neuroscience Department, International School for Advanced Studies (SISSA), Bonomea 265, Trieste, Italy
| | - D Sayenko
- Department of Integrative Biology and Physiology, University of California, Los Angeles, CA 90095 USA
| | - P Gad
- Department of Integrative Biology and Physiology, University of California, Los Angeles, CA 90095 USA
| | - Y Gerasimenko
- Department of Integrative Biology and Physiology, University of California, Los Angeles, CA 90095 USA; Pavlov Institute of Physiology, St. Petersburg 199034, Russia
| | - V R Edgerton
- Department of Integrative Biology and Physiology, University of California, Los Angeles, CA 90095 USA; Department of Neurobiology, University of California, Los Angeles, CA 90095 USA; Department of Neurosurgery, University of California, Los Angeles, CA 90095 USA; Brain Research Institute, University of California, Los Angeles, CA 90095 USA; The Centre for Neuroscience and Regenerative Medicine, Faculty of Science, University of Technology Sydney, Ultimo, 2007 NSW, Australia; Institut Guttmann, Hospital de Neurorehabilitació, Institut Universitari adscrit a la Universitat Autònoma de Barcelona, Barcelona, 08916 Badalona, Spain.
| |
Collapse
|
36
|
Distinct sets of locomotor modules control the speed and modes of human locomotion. Sci Rep 2016; 6:36275. [PMID: 27805015 PMCID: PMC5090253 DOI: 10.1038/srep36275] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 09/29/2016] [Indexed: 12/25/2022] Open
Abstract
Although recent vertebrate studies have revealed that different spinal networks are recruited in locomotor mode- and speed-dependent manners, it is unknown whether humans share similar neural mechanisms. Here, we tested whether speed- and mode-dependence in the recruitment of human locomotor networks exists or not by statistically extracting locomotor networks. From electromyographic activity during walking and running over a wide speed range, locomotor modules generating basic patterns of muscle activities were extracted using non-negative matrix factorization. The results showed that the number of modules changed depending on the modes and speeds. Different combinations of modules were extracted during walking and running, and at different speeds even during the same locomotor mode. These results strongly suggest that, in humans, different spinal locomotor networks are recruited while walking and running, and even in the same locomotor mode different networks are probably recruited at different speeds.
Collapse
|
37
|
Paired Stimulation to Promote Lasting Augmentation of Corticospinal Circuits. Neural Plast 2016; 2016:7043767. [PMID: 27800189 PMCID: PMC5075312 DOI: 10.1155/2016/7043767] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 08/11/2016] [Indexed: 01/22/2023] Open
Abstract
After injury, electrical stimulation of the nervous system can augment plasticity of spared or latent circuits through focal modulation. Pairing stimulation of two parts of a spared circuit can target modulation more specifically to the intended circuit. We discuss 3 kinds of paired stimulation in the context of the corticospinal system, because of its importance in clinical neurorehabilitation. The first uses principles of Hebbian plasticity: by altering the stimulation timing of presynaptic neurons and their postsynaptic targets, synapse function can be modulated up or down. The second form uses synchronized presynaptic inputs onto a common synaptic target. We dub this a “convergent” mechanism, because stimuli have to converge on a common target with coordinated timing. The third form induces focal modulation by tonic excitation of one region (e.g., the spinal cord) during phasic stimulation of another (e.g., motor cortex). Additionally, endogenous neural activity may be paired with exogenous electrical stimulation. This review addresses what is known about paired stimulation of the corticospinal system of both humans and animal models, emphasizes how it qualitatively differs from single-site stimulation, and discusses the gaps in knowledge that must be addressed to maximize its use and efficacy in neurorehabilitation.
Collapse
|
38
|
Ross CL, Syed I, Smith TL, Harrison BS. The regenerative effects of electromagnetic field on spinal cord injury. Electromagn Biol Med 2016; 36:74-87. [DOI: 10.3109/15368378.2016.1160408] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
39
|
Kumar S, Dey S, Jain S. Extremely low-frequency electromagnetic fields: A possible non-invasive therapeutic tool for spinal cord injury rehabilitation. Electromagn Biol Med 2016; 36:88-101. [PMID: 27399648 DOI: 10.1080/15368378.2016.1194290] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Traumatic insults to the spinal cord induce both immediate mechanical damage and subsequent tissue degeneration. The latter involves a range of events namely cellular disturbance, homeostatic imbalance, ionic and neurotransmitters derangement that ultimately result in loss of sensorimotor functions. The targets for improving function after spinal cord injury (SCI) are mainly directed toward limiting these secondary injury events. Extremely low-frequency electromagnetic field (ELF-EMF) is a possible non-invasive therapeutic intervention for SCI rehabilitation which has the potential to constrain the secondary injury-induced events. In the present review, we discuss the effects of ELF-EMF on experimental and clinical SCI as well as on biological system.
Collapse
Affiliation(s)
- Suneel Kumar
- a Department of Physiology , All India Institute of Medical Sciences , New Delhi , India.,b W. M. Keck Center for Collaborative Neuroscience, Rutgers, The State University of New Jersey , Piscataway , NJ , USA
| | - Soumil Dey
- a Department of Physiology , All India Institute of Medical Sciences , New Delhi , India
| | - Suman Jain
- a Department of Physiology , All India Institute of Medical Sciences , New Delhi , India
| |
Collapse
|
40
|
Gerasimenko Y, Gad P, Sayenko D, McKinney Z, Gorodnichev R, Puhov A, Moshonkina T, Savochin A, Selionov V, Shigueva T, Tomilovskaya E, Kozlovskaya I, Edgerton VR. Integration of sensory, spinal, and volitional descending inputs in regulation of human locomotion. J Neurophysiol 2016; 116:98-105. [PMID: 27075538 PMCID: PMC4961746 DOI: 10.1152/jn.00146.2016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 04/01/2016] [Indexed: 01/03/2023] Open
Abstract
We reported previously that both transcutaneous electrical spinal cord stimulation and direct pressure stimulation of the plantar surfaces of the feet can elicit rhythmic involuntary step-like movements in noninjured subjects with their legs in a gravity-neutral apparatus. The present experiments investigated the convergence of spinal and plantar pressure stimulation and voluntary effort in the activation of locomotor movements in uninjured subjects under full body weight support in a vertical position. For all conditions, leg movements were analyzed using electromyographic (EMG) recordings and optical motion capture of joint kinematics. Spinal cord stimulation elicited rhythmic hip and knee flexion movements accompanied by EMG bursting activity in the hamstrings of 6/6 subjects. Similarly, plantar stimulation induced bursting EMG activity in the ankle flexor and extensor muscles in 5/6 subjects. Moreover, the combination of spinal and plantar stimulation exhibited a synergistic effect in all six subjects, eliciting greater motor responses than either modality alone. While the motor responses to spinal vs. plantar stimulation seems to activate distinct but overlapping spinal neural networks, when engaged simultaneously, the stepping responses were functionally complementary. As observed during induced (involuntary) stepping, the most significant modulation of voluntary stepping occurred in response to the combination of spinal and plantar stimulation. In light of the known automaticity and plasticity of spinal networks in absence of supraspinal input, these findings support the hypothesis that spinal and plantar stimulation may be effective tools for enhancing the recovery of motor control in individuals with neurological injuries and disorders.
Collapse
Affiliation(s)
- Yury Gerasimenko
- Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia; Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, California;
| | - Parag Gad
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, California
| | - Dimitry Sayenko
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, California
| | - Zach McKinney
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California
| | - Ruslan Gorodnichev
- Velikiye Luki State Academy of Physical Education and Sport, Velikiye Luki, Russia
| | - Aleksandr Puhov
- Velikiye Luki State Academy of Physical Education and Sport, Velikiye Luki, Russia
| | - Tatiana Moshonkina
- Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia
| | - Aleksandr Savochin
- Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia
| | - Victor Selionov
- Institute for Information Transmission Problems, Russian Academy of Science, Moscow, Russia; and
| | - Tatiana Shigueva
- Russian Federation State Scientific Center-Institute for Bio-Medical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Elena Tomilovskaya
- Russian Federation State Scientific Center-Institute for Bio-Medical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Inessa Kozlovskaya
- Russian Federation State Scientific Center-Institute for Bio-Medical Problems, Russian Academy of Sciences, Moscow, Russia
| | - V Reggie Edgerton
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, California
| |
Collapse
|
41
|
Wenger N, Moraud EM, Raspopovic S, Bonizzato M, DiGiovanna J, Musienko P, Morari M, Micera S, Courtine G. Closed-loop neuromodulation of spinal sensorimotor circuits controls refined locomotion after complete spinal cord injury. Sci Transl Med 2016; 6:255ra133. [PMID: 25253676 DOI: 10.1126/scitranslmed.3008325] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Neuromodulation of spinal sensorimotor circuits improves motor control in animal models and humans with spinal cord injury. With common neuromodulation devices, electrical stimulation parameters are tuned manually and remain constant during movement. We developed a mechanistic framework to optimize neuromodulation in real time to achieve high-fidelity control of leg kinematics during locomotion in rats. We first uncovered relationships between neuromodulation parameters and recruitment of distinct sensorimotor circuits, resulting in predictive adjustments of leg kinematics. Second, we established a technological platform with embedded control policies that integrated robust movement feedback and feed-forward control loops in real time. These developments allowed us to conceive a neuroprosthetic system that controlled a broad range of foot trajectories during continuous locomotion in paralyzed rats. Animals with complete spinal cord injury performed more than 1000 successive steps without failure, and were able to climb staircases of various heights and lengths with precision and fluidity. Beyond therapeutic potential, these findings provide a conceptual and technical framework to personalize neuromodulation treatments for other neurological disorders.
Collapse
Affiliation(s)
- Nikolaus Wenger
- International Paraplegic Foundation Chair in Spinal Cord Repair, Center for Neuroprosthetics and Brain Mind Institute, Swiss Federal Institute of Technology (EPFL), Lausanne CH-1015, Switzerland
| | - Eduardo Martin Moraud
- Translational Neural Engineering Lab, Center for Neuroprosthetics and Institute of Bioengineering, School of Bioengineering, Swiss Federal Institute of Technology (EPFL), Lausanne CH-1015, Switzerland. Automatic Control Laboratory, Swiss Federal Institute of Technology (ETHZ), Zurich CH-8092, Switzerland
| | - Stanisa Raspopovic
- Translational Neural Engineering Lab, Center for Neuroprosthetics and Institute of Bioengineering, School of Bioengineering, Swiss Federal Institute of Technology (EPFL), Lausanne CH-1015, Switzerland. The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa IT-56025, Italy
| | - Marco Bonizzato
- Translational Neural Engineering Lab, Center for Neuroprosthetics and Institute of Bioengineering, School of Bioengineering, Swiss Federal Institute of Technology (EPFL), Lausanne CH-1015, Switzerland
| | - Jack DiGiovanna
- Translational Neural Engineering Lab, Center for Neuroprosthetics and Institute of Bioengineering, School of Bioengineering, Swiss Federal Institute of Technology (EPFL), Lausanne CH-1015, Switzerland
| | - Pavel Musienko
- International Paraplegic Foundation Chair in Spinal Cord Repair, Center for Neuroprosthetics and Brain Mind Institute, Swiss Federal Institute of Technology (EPFL), Lausanne CH-1015, Switzerland. Pavlov Institute of Physiology, St. Petersburg RU-100034, Russia
| | - Manfred Morari
- Automatic Control Laboratory, Swiss Federal Institute of Technology (ETHZ), Zurich CH-8092, Switzerland
| | - Silvestro Micera
- Translational Neural Engineering Lab, Center for Neuroprosthetics and Institute of Bioengineering, School of Bioengineering, Swiss Federal Institute of Technology (EPFL), Lausanne CH-1015, Switzerland. The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa IT-56025, Italy
| | - Grégoire Courtine
- International Paraplegic Foundation Chair in Spinal Cord Repair, Center for Neuroprosthetics and Brain Mind Institute, Swiss Federal Institute of Technology (EPFL), Lausanne CH-1015, Switzerland.
| |
Collapse
|
42
|
Dose F, Taccola G. Two Distinct Stimulus Frequencies Delivered Simultaneously at Low Intensity Generate Robust Locomotor Patterns. Neuromodulation 2016; 19:563-75. [PMID: 26968869 DOI: 10.1111/ner.12402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 12/21/2015] [Accepted: 12/29/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Explore the primary characteristics of afferent noisy stimuli, which optimally activate locomotor patterns at low intensity. MATERIALS AND METHODS Intracellular and extracellular electrophysiological traces were derived from single motoneurons and from ventral roots, respectively. From these recordings, we obtained noisy stimulating protocols, delivered to a dorsal root (DR) of an isolated neonatal rat spinal cord, while recording fictive locomotion (FL) from ventral roots. RESULTS We decreased complexity of efficient noisy stimulating protocols down to single cell spikes. Then, we identified four main components within the power spectrum of these signals and used them to construct a basic multifrequency protocol of rectangular impulses, able to induce FL. Further disassembling generated the minimum stimulation paradigm that activated FL, which consisted of a pair of 35 and 172 Hz frequency pulse trains, strongly effective at low intensity when delivered either jointly to one lumbosacral DR or as single simultaneous trains to two distinct DRs. This simplified pulse schedule always activated a locomotor rhythm, even when delivered for a very short time (500 ms). One prerequisite for the two-frequency protocol to activate FL at low intensity when applied to sacrocaudal afferents was the ability to induce ascending volleys of greater amplitude. CONCLUSION Multifrequency protocols can support future studies in defining the most effective characteristics for electrical stimulation to reactivate stepping following motor injury.
Collapse
Affiliation(s)
- Francesco Dose
- Neuroscience Area, International School for Advanced Studies (SISSA), Trieste, TS, Italy.,SPINAL (Spinal Person Injury Neurorehabilitation Applied Laboratory), Istituto di Medicina Fisica e Riabilitazione (IMFR), Udine, UD, Italy
| | - Giuliano Taccola
- Neuroscience Area, International School for Advanced Studies (SISSA), Trieste, TS, Italy.,SPINAL (Spinal Person Injury Neurorehabilitation Applied Laboratory), Istituto di Medicina Fisica e Riabilitazione (IMFR), Udine, UD, Italy
| |
Collapse
|
43
|
Solopova IA, Selionov VA, Zhvansky DS, Gurfinkel VS, Ivanenko Y. Human cervical spinal cord circuitry activated by tonic input can generate rhythmic arm movements. J Neurophysiol 2015; 115:1018-30. [PMID: 26683072 DOI: 10.1152/jn.00897.2015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/16/2015] [Indexed: 01/03/2023] Open
Abstract
The coordination between arms and legs during human locomotion shares many features with that in quadrupeds, yet there is limited evidence for the central pattern generator for the upper limbs in humans. Here we investigated whether different types of tonic stimulation, previously used for eliciting stepping-like leg movements, may evoke nonvoluntary rhythmic arm movements. Twenty healthy subjects participated in this study. The subject was lying on the side, the trunk was fixed, and all four limbs were suspended in a gravity neutral position, allowing unrestricted low-friction limb movements in the horizontal plane. The results showed that peripheral sensory stimulation (continuous muscle vibration) and central tonic activation (postcontraction state of neuronal networks following a long-lasting isometric voluntary effort, Kohnstamm phenomenon) could evoke nonvoluntary rhythmic arm movements in most subjects. In ∼40% of subjects, tonic stimulation elicited nonvoluntary rhythmic arm movements together with rhythmic movements of suspended legs. The fact that not all participants exhibited nonvoluntary limb oscillations may reflect interindividual differences in responsiveness of spinal pattern generation circuitry to its activation. The occurrence and the characteristics of induced movements highlight the rhythmogenesis capacity of cervical neuronal circuitries, complementing the growing body of work on the quadrupedal nature of human gait.
Collapse
Affiliation(s)
- I A Solopova
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia;
| | - V A Selionov
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia
| | - D S Zhvansky
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia
| | - V S Gurfinkel
- Biomedical Engineering Department, Oregon Health and Science University, Portland, Oregon; and
| | - Y Ivanenko
- Laboratory of Neuromotor Physiology, Fondazione Santa Lucia, Rome, Italy
| |
Collapse
|
44
|
Petrosyan HA, Alessi V, Sniffen J, Sisto SA, Fiore S, Davis R, Kaufman M, Arvanian VL. Safety of titanium rods used for spinal stabilization during repetitive magnetic stimulation. Clin Neurophysiol 2015; 126:2405-6. [DOI: 10.1016/j.clinph.2015.02.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 02/26/2015] [Indexed: 10/23/2022]
|
45
|
Petrosyan HA, Alessi V, Hunanyan AS, Sisto SA, Arvanian VL. Spinal electro-magnetic stimulation combined with transgene delivery of neurotrophin NT-3 and exercise: novel combination therapy for spinal contusion injury. J Neurophysiol 2015; 114:2923-40. [PMID: 26424579 DOI: 10.1152/jn.00480.2015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 09/29/2015] [Indexed: 12/12/2022] Open
Abstract
Our recent terminal experiments revealed that administration of a single train of repetitive spinal electromagnetic stimulation (sEMS; 35 min) enhanced synaptic plasticity in spinal circuitry following lateral hemisection spinal cord injury. In the current study, we have examined effects of repetitive sEMS applied as a single train and chronically (5 wk, every other day) following thoracic T10 contusion. Chronic studies involved examination of systematic sEMS administration alone and combined with exercise training and transgene delivery of neurotrophin [adeno-associated virus 10-neurotrophin 3 (AAV10-NT3)]. Electrophysiological intracellular/extracellular recordings, immunohistochemistry, behavioral testing, and anatomical tracing were performed to assess effects of treatments. We found that administration of a single sEMS train induced transient facilitation of transmission through preserved lateral white matter to motoneurons and hindlimb muscles in chronically contused rats with effects lasting for at least 2 h. These physiological changes associated with increased immunoreactivity of GluR1 and GluR2/3 glutamate receptors in lumbar neurons. Systematic administration of sEMS alone for 5 wk, however, was unable to induce cumulative improvements of transmission in spinomuscular circuitry or improve impaired motor function following thoracic contusion. Encouragingly, chronic administration of sEMS, followed by exercise training (running in an exercise ball and swimming), induced the following: 1) sustained strengthening of transmission to lumbar motoneurons and hindlimb muscles, 2) better retrograde transport of anatomical tracer, and 3) improved locomotor function. Greatest improvements were seen in the group that received exercise combined with sEMS and AAV-NT3.
Collapse
Affiliation(s)
- Hayk A Petrosyan
- Northport Veterans Affairs Medical Center, Northport, New York; Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, New York; and
| | - Valentina Alessi
- Northport Veterans Affairs Medical Center, Northport, New York; Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, New York; and
| | | | - Sue A Sisto
- Department of Physical Therapy, Division of Rehabilitation Sciences, Stony Brook University, Stony Brook, New York
| | - Victor L Arvanian
- Northport Veterans Affairs Medical Center, Northport, New York; Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, New York; and
| |
Collapse
|
46
|
Strategies and lessons in spinal cord injury rehabilitation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2015. [DOI: 10.1007/s40141-015-0096-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
47
|
Gerasimenko YP, Lu DC, Modaber M, Zdunowski S, Gad P, Sayenko DG, Morikawa E, Haakana P, Ferguson AR, Roy RR, Edgerton VR. Noninvasive Reactivation of Motor Descending Control after Paralysis. J Neurotrauma 2015; 32:1968-80. [PMID: 26077679 DOI: 10.1089/neu.2015.4008] [Citation(s) in RCA: 176] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The present prognosis for the recovery of voluntary control of movement in patients diagnosed as motor complete is generally poor. Herein we introduce a novel and noninvasive stimulation strategy of painless transcutaneous electrical enabling motor control and a pharmacological enabling motor control strategy to neuromodulate the physiological state of the spinal cord. This neuromodulation enabled the spinal locomotor networks of individuals with motor complete paralysis for 2-6 years American Spinal Cord Injury Association Impairment Scale (AIS) to be re-engaged and trained. We showed that locomotor-like stepping could be induced without voluntary effort within a single test session using electrical stimulation and training. We also observed significant facilitation of voluntary influence on the stepping movements in the presence of stimulation over a 4-week period in each subject. Using these strategies we transformed brain-spinal neuronal networks from a dormant to a functional state sufficiently to enable recovery of voluntary movement in five out of five subjects. Pharmacological intervention combined with stimulation and training resulted in further improvement in voluntary motor control of stepping-like movements in all subjects. We also observed on-command selective activation of the gastrocnemius and soleus muscles when attempting to plantarflex. At the end of 18 weeks of weekly interventions the mean changes in the amplitude of voluntarily controlled movement without stimulation was as high as occurred when combined with electrical stimulation. Additionally, spinally evoked motor potentials were readily modulated in the presence of voluntary effort, providing electrophysiological evidence of the re-establishment of functional connectivity among neural networks between the brain and the spinal cord.
Collapse
Affiliation(s)
- Yury P Gerasimenko
- 1 Department of Integrative Biology and Physiology, University of California , Los Angeles, Los Angeles, California.,2 Pavlov Institute of Physiology , St. Petersburg, Russia .,3 Institute of Fundamental Medicine and Biology, Kazan Federal University , Kazan, Russia
| | - Daniel C Lu
- 4 Department of Neurosurgery, University of California , Los Angeles, Los Angeles, California.,5 Neuromotor Recovery and Rehabilitation Center, David Geffen School of Medicine, University of California , Los Angeles, Los Angeles, California
| | - Morteza Modaber
- 4 Department of Neurosurgery, University of California , Los Angeles, Los Angeles, California.,5 Neuromotor Recovery and Rehabilitation Center, David Geffen School of Medicine, University of California , Los Angeles, Los Angeles, California
| | - Sharon Zdunowski
- 1 Department of Integrative Biology and Physiology, University of California , Los Angeles, Los Angeles, California
| | - Parag Gad
- 1 Department of Integrative Biology and Physiology, University of California , Los Angeles, Los Angeles, California
| | - Dimitry G Sayenko
- 1 Department of Integrative Biology and Physiology, University of California , Los Angeles, Los Angeles, California
| | - Erika Morikawa
- 4 Department of Neurosurgery, University of California , Los Angeles, Los Angeles, California.,5 Neuromotor Recovery and Rehabilitation Center, David Geffen School of Medicine, University of California , Los Angeles, Los Angeles, California
| | - Piia Haakana
- 4 Department of Neurosurgery, University of California , Los Angeles, Los Angeles, California.,5 Neuromotor Recovery and Rehabilitation Center, David Geffen School of Medicine, University of California , Los Angeles, Los Angeles, California
| | - Adam R Ferguson
- 6 Brain and Spinal Injury Center, Department of Neurological Surgery, University of California , San Francisco, San Francisco, California
| | - Roland R Roy
- 1 Department of Integrative Biology and Physiology, University of California , Los Angeles, Los Angeles, California.,7 Brain Research Institute, University of California , Los Angeles, Los Angeles, California
| | - V Reggie Edgerton
- 1 Department of Integrative Biology and Physiology, University of California , Los Angeles, Los Angeles, California.,4 Department of Neurosurgery, University of California , Los Angeles, Los Angeles, California.,7 Brain Research Institute, University of California , Los Angeles, Los Angeles, California
| |
Collapse
|
48
|
Dose F, Deumens R, Forget P, Taccola G. Staggered multi-site low-frequency electrostimulation effectively induces locomotor patterns in the isolated rat spinal cord. Spinal Cord 2015; 54:93-101. [DOI: 10.1038/sc.2015.106] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/22/2015] [Accepted: 05/27/2015] [Indexed: 11/09/2022]
|
49
|
Giszter SF. Spinal primitives and intra-spinal micro-stimulation (ISMS) based prostheses: a neurobiological perspective on the "known unknowns" in ISMS and future prospects. Front Neurosci 2015; 9:72. [PMID: 25852454 PMCID: PMC4367173 DOI: 10.3389/fnins.2015.00072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 02/18/2014] [Indexed: 11/13/2022] Open
Abstract
The current literature on Intra-Spinal Micro-Stimulation (ISMS) for motor prostheses is reviewed in light of neurobiological data on spinal organization, and a neurobiological perspective on output motor modularity, ISMS maps, stimulation combination effects, and stability. By comparing published data in these areas, the review identifies several gaps in current knowledge that are crucial to the development of effective intraspinal neuroprostheses. Gaps can be categorized into a lack of systematic and reproducible details of: (a) Topography and threshold for ISMS across the segmental motor system, the topography of autonomic recruitment by ISMS, and the coupling relations between these two types of outputs in practice. (b) Compositional rules for ISMS motor responses tested across the full range of the target spinal topographies. (c) Rules for ISMS effects' dependence on spinal cord state and neural dynamics during naturally elicited or ISMS triggered behaviors. (d) Plasticity of the compositional rules for ISMS motor responses, and understanding plasticity of ISMS topography in different spinal cord lesion states, disease states, and following rehabilitation. All these knowledge gaps to a greater or lesser extent require novel electrode technology in order to allow high density chronic recording and stimulation. The current lack of this technology may explain why these prominent gaps in the ISMS literature currently exist. It is also argued that given the "known unknowns" in the current ISMS literature, it may be prudent to adopt and develop control schemes that can manage the current results with simple superposition and winner-take-all interactions, but can also incorporate the possible plastic and stochastic dynamic interactions that may emerge in fuller analyses over longer terms, and which have already been noted in some simpler model systems.
Collapse
Affiliation(s)
- Simon F Giszter
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Drexel University Philadelphia, PA, USA ; School of Biomedical Engineering and Health Systems, Drexel University Philadelphia, PA, USA
| |
Collapse
|
50
|
Solopova IA, Selionov VA, Sylos-Labini F, Gurfinkel VS, Lacquaniti F, Ivanenko YP. Tapping into rhythm generation circuitry in humans during simulated weightlessness conditions. Front Syst Neurosci 2015; 9:14. [PMID: 25741250 PMCID: PMC4332337 DOI: 10.3389/fnsys.2015.00014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/27/2015] [Indexed: 12/25/2022] Open
Abstract
An ability to produce rhythmic activity is ubiquitous for locomotor pattern generation and modulation. The role that the rhythmogenesis capacity of the spinal cord plays in injured populations has become an area of interest and systematic investigation among researchers in recent years, despite its importance being long recognized by neurophysiologists and clinicians. Given that each individual interneuron, as a rule, receives a broad convergence of various supraspinal and sensory inputs and may contribute to a vast repertoire of motor actions, the importance of assessing the functional state of the spinal locomotor circuits becomes increasingly evident. Air-stepping can be used as a unique and important model for investigating human rhythmogenesis since its manifestation is largely facilitated by a reduction of external resistance. This article aims to provide a review on current issues related to the “locomotor” state and interactions between spinal and supraspinal influences on the central pattern generator (CPG) circuitry in humans, which may be important for developing gait rehabilitation strategies in individuals with spinal cord and brain injuries.
Collapse
Affiliation(s)
- Irina A Solopova
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Russian Academy of Science Moscow, Russia
| | - Victor A Selionov
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Russian Academy of Science Moscow, Russia
| | - Francesca Sylos-Labini
- Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia Rome, Italy ; Centre of Space Bio-medicine, University of Rome Tor Vergata Rome, Italy
| | - Victor S Gurfinkel
- Biomedical Engineering Department, Oregon Health and Science University Portland, OR, USA
| | - Francesco Lacquaniti
- Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia Rome, Italy ; Centre of Space Bio-medicine, University of Rome Tor Vergata Rome, Italy ; Department of Systems Medicine, University of Rome Tor Vergata Rome, Italy
| | - Yuri P Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia Rome, Italy
| |
Collapse
|