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Cheung VCK, Ha SCW, Zhang-Lea JH, Chan ZYS, Teng Y, Yeung G, Wu L, Liang D, Cheung RTH. Motor patterns of patients with spinal muscular atrophy suggestive of sensory and corticospinal contributions to the development of locomotor muscle synergies. J Neurophysiol 2024; 131:338-359. [PMID: 38230872 DOI: 10.1152/jn.00513.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/18/2024] Open
Abstract
Complex locomotor patterns are generated by combination of muscle synergies. How genetic processes, early sensorimotor experiences, and the developmental dynamics of neuronal circuits contribute to the expression of muscle synergies remains elusive. We shed light on the factors that influence development of muscle synergies by studying subjects with spinal muscular atrophy (SMA, types II/IIIa), a disorder associated with degeneration and deafferentation of motoneurons and possibly motor cortical and cerebellar abnormalities, from which the afflicted would have atypical sensorimotor histories around typical walking onset. Muscle synergies of children with SMA were identified from electromyographic signals recorded during active-assisted leg motions or walking, and compared with those of age-matched controls. We found that the earlier the SMA onset age, the more different the SMA synergies were from the normative. These alterations could not just be explained by the different degrees of uneven motoneuronal losses across muscles. The SMA-specific synergies had activations in muscles from multiple limb compartments, a finding reminiscent of the neonatal synergies of typically developing infants. Overall, while the synergies shared between SMA and control subjects may reflect components of a core modular infrastructure determined early in life, the SMA-specific synergies may be developmentally immature synergies that arise from inadequate activity-dependent interneuronal sculpting due to abnormal sensorimotor experience and other factors. Other mechanisms including SMA-induced intraspinal changes and altered cortical-spinal interactions may also contribute to synergy changes. Our interpretation highlights the roles of the sensory and descending systems to the typical and abnormal development of locomotor modules.NEW & NOTEWORTHY This is likely the first report of locomotor muscle synergies of children with spinal muscular atrophy (SMA), a subject group with atypical developmental sensorimotor experience. We found that the earlier the SMA onset age, the more the subjects' synergies deviated from those of age-matched controls. This result suggests contributions of the sensory/corticospinal activities to the typical expression of locomotor modules, and how their disruptions during a critical period of development may lead to abnormal motor modules.
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Affiliation(s)
- Vincent C K Cheung
- School of Biomedical Sciences, and Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong, Hong Kong, China
- Joint Laboratory of Bioresources and Molecular Research of Common Diseases, The Chinese University of Hong Kong and Kunming Institute of Zoology of the Chinese Academy of Sciences, Hong Kong, China
| | - Sophia C W Ha
- School of Biomedical Sciences, and Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong, Hong Kong, China
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Janet H Zhang-Lea
- School of Nursing and Human Physiology, Gonzaga University, Spokane, Washington, United States
| | - Zoe Y S Chan
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Yanling Teng
- State Key Laboratory of Medical Genetics and School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Geshi Yeung
- School of Biomedical Sciences, and Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong, Hong Kong, China
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Lingqian Wu
- State Key Laboratory of Medical Genetics and School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Desheng Liang
- State Key Laboratory of Medical Genetics and School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Roy T H Cheung
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
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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.
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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
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