A computational model for epidural electrical stimulation of spinal sensorimotor circuits. Mechanisms of electrical stimulation with neural prostheses. Spinal cord reflexes induced by epidural spinal cord stimulation in normal awake rats. Epidural spinal cord stimulation facilitates immediate restoration of dormant motor and autonomic supraspinal pathways after chronic neurologically complete spinal cord injury. Evidence for a spinal central pattern generator in humans. Enhancement of voluntary motor function following spinal cord stimulation: case study. Spinal cord stimulation facilitates functional walking in a chronic, incomplete spinal cord injured. Herman, R., He, J., D’Luzansky, S., Willis, W. Electrical spinal cord stimulation must preserve proprioception to enable locomotion in humans with spinal cord injury. Human spinal locomotor control is based on flexibly organized burst generators. Recovery of over-ground walking after chronic motor complete spinal cord injury. Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study. Targeted neurotechnology restores walking in humans with spinal cord injury. Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia. Cortico–reticulo–spinal circuit reorganization enables functional recovery after severe spinal cord contusion. Restoring voluntary control of locomotion after paralyzing spinal cord injury. Spatiotemporal neuromodulation therapies engaging muscle synergies improve motor control after spinal cord injury. Closed-loop neuromodulation of spinal sensorimotor circuits controls refined locomotion after complete spinal cord injury. Transformation of nonfunctional spinal circuits into functional states after the loss of brain input. Step training reinforces specific spinal locomotor circuitry in adult spinal rats. Neurorehabilitation mediated sufficient improvement to restore these activities in community settings, opening a realistic path to support everyday mobility with EES in people with SCI. Within a single day, activity-specific stimulation programs enabled these three individuals to stand, walk, cycle, swim and control trunk movements. We tested these neurotechnologies in three individuals with complete sensorimotor paralysis as part of an ongoing clinical trial ( identifier NCT02936453). We also developed software supporting the rapid configuration of activity-specific stimulation programs that reproduced the natural activation of motor neurons underlying each activity. To test this hypothesis, we established a computational framework that informed the optimal arrangement of electrodes on a new paddle lead and guided its neurosurgical positioning. Here, we hypothesized that an arrangement of electrodes targeting the ensemble of dorsal roots involved in leg and trunk movements would result in superior efficacy, restoring more diverse motor activities after the most severe SCI. However, EES is delivered with multielectrode paddle leads that were originally designed to target the dorsal column of the spinal cord. Nature Medicine volume 28, pages 260–271 ( 2022) Cite this articleĮpidural electrical stimulation (EES) targeting the dorsal roots of lumbosacral segments restores walking in people with spinal cord injury (SCI). Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis
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