Electrical spinal cord stimulation must preserve proprioception to enable locomotion in humans with spinal cord injury
Formento E, Minassian K, Wagner F, Mignardot JB, Le Goff-Mignardot CG, Rowald A, Bloch J, Micera S, Capogrosso M, Courtine G (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 21
Pages Range: 1728-1741
Journal Issue: 12
DOI: 10.1038/s41593-018-0262-6
Abstract
Epidural electrical stimulation (EES) of the spinal cord restores locomotion in animal models of spinal cord injury but is less effective in humans. Here we hypothesized that this interspecies discrepancy is due to interference between EES and proprioceptive information in humans. Computational simulations and preclinical and clinical experiments reveal that EES blocks a significant amount of proprioceptive input in humans, but not in rats. This transient deafferentation prevents modulation of reciprocal inhibitory networks involved in locomotion and reduces or abolishes the conscious perception of leg position. Consequently, continuous EES can only facilitate locomotion within a narrow range of stimulation parameters and is unable to provide meaningful locomotor improvements in humans without rehabilitation. Simulations showed that burst stimulation and spatiotemporal stimulation profiles mitigate the cancellation of proprioceptive information, enabling robust control over motor neuron activity. This demonstrates the importance of stimulation protocols that preserve proprioceptive information to facilitate walking with EES.
Involved external institutions
École Polytechnique Fédérale de Lausanne (EPFL)
Switzerland (CH)
Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV)
Switzerland (CH)
University of Fribourg / Universitè de Fribourg
Switzerland (CH)
Switzerland (CH)
Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV)
Switzerland (CH)
University of Fribourg / Universitè de Fribourg
Switzerland (CH)
How to cite
APA:
Formento, E., Minassian, K., Wagner, F., Mignardot, J.B., Le Goff-Mignardot, C.G., Rowald, A.,... Courtine, G. (2018). Electrical spinal cord stimulation must preserve proprioception to enable locomotion in humans with spinal cord injury. Nature Neuroscience, 21(12), 1728-1741. https://doi.org/10.1038/s41593-018-0262-6
MLA:
Formento, Emanuele, et al. "Electrical spinal cord stimulation must preserve proprioception to enable locomotion in humans with spinal cord injury." Nature Neuroscience 21.12 (2018): 1728-1741.
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