Spatiotemporal neuromodulation therapies engaging muscle synergies improve motor control after spinal cord injury

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Nikolaus Wenger - , Swiss Federal Institute of Technology Lausanne (EPFL), Charité – Universitätsmedizin Berlin (Author)
  • Eduardo Martin Moraud - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Jerome Gandar - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Pavel Musienko - , Swiss Federal Institute of Technology Lausanne (EPFL), RAS - Pavlov Institute of Physiology, St. Petersburg State University, Institute of Physiopulmonology (Author)
  • Marco Capogrosso - , Swiss Federal Institute of Technology Lausanne (EPFL), Sant'Anna School of Advanced Studies (Author)
  • Laetitia Baud - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Camille G. Le Goff - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Quentin Barraud - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Natalia Pavlova - , Swiss Federal Institute of Technology Lausanne (EPFL), RAS - Pavlov Institute of Physiology (Author)
  • Nadia Dominici - , Swiss Federal Institute of Technology Lausanne (EPFL), Vrije Universiteit Amsterdam (VU) (Author)
  • Ivan R. Minev - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Leonie Asboth - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Arthur Hirsch - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Simone Duis - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Julie Kreider - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Andrea Mortera - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Oliver Haverbeck - , Micromotive GmbH (Author)
  • Silvio Kraus - , Micromotive GmbH (Author)
  • Felix Schmitz - , Fraunhofer Institute for Microengineering and Microsystems (Author)
  • Jack DiGiovanna - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Rubia Van Den Brand - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Jocelyne Bloch - , University of Lausanne (Author)
  • Peter Detemple - , Fraunhofer Institute for Microengineering and Microsystems (Author)
  • Stéphanie P. Lacour - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Erwan Bézard - , Motac Neuroscience, Université de Bordeaux (Author)
  • Silvestro Micera - , Swiss Federal Institute of Technology Lausanne (EPFL), Sant'Anna School of Advanced Studies (Author)
  • Grégoire Courtine - , Swiss Federal Institute of Technology Lausanne (EPFL), University of Lausanne (Author)

Abstract

Electrical neuromodulation of lumbar segments improves motor control after spinal cord injury in animal models and humans. However, the physiological principles underlying the effect of this intervention remain poorly understood, which has limited the therapeutic approach to continuous stimulation applied to restricted spinal cord locations. Here we developed stimulation protocols that reproduce the natural dynamics of motoneuron activation during locomotion. For this, we computed the spatiotemporal activation pattern of muscle synergies during locomotion in healthy rats. Computer simulations identified optimal electrode locations to target each synergy through the recruitment of proprioceptive feedback circuits. This framework steered the design of spatially selective spinal implants and real-time control software that modulate extensor and flexor synergies with precise temporal resolution. Spatiotemporal neuromodulation therapies improved gait quality, weight-bearing capacity, endurance and skilled locomotion in several rodent models of spinal cord injury. These new concepts are directly translatable to strategies to improve motor control in humans.

Details

Original languageEnglish
Pages (from-to)138-145
Number of pages8
JournalNature medicine
Volume22
Issue number2
Publication statusPublished - 1 Feb 2016
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 26779815

Keywords