Targeted neurotechnology restores walking in humans with spinal cord injury
Targeted neurotechnology restores walking in humans with spinal cord injury
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DOI：
10.1038/s41586-018-0649-2
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发表时间：
2018-11-01
期刊：
影响因子：
64.8
通讯作者：
Courtine, Gregoire
中科院分区：
文献类型：
--
作者：
Wagner, Fabien B.;Mignardot, Jean-Baptiste;Courtine, Gregoire
脊髓损伤会导致严重的运动缺陷甚至腿部完全瘫痪。在这里，我们介绍有针对性的脊髓刺激神经技术，使四年多前遭受脊髓损伤、尽管经过广泛康复但仍出现永久性运动缺陷或完全瘫痪的个体能够自主控制行走。使用具有实时触发功能的植入式脉冲发生器，我们向腰骶脊髓提供一系列空间选择性刺激，其时间与预期运动一致。一周之内，这种时空刺激重新建立了地面行走过程中瘫痪肌肉的适应性控制。康复期间运动能力得到改善。几个月后，参与者在没有刺激的情况下重新获得了对先前瘫痪肌肉的自主控制，并且可以在时空刺激期间在生态环境中行走或骑自行车。这些结果建立了改善脊髓损伤后神经恢复和支持日常生活活动的技术框架。
Spinal cord injury leads to severe locomotor deficits or even complete leg paralysis. Here we introduce targeted spinal cord stimulation neurotechnologies that enabled voluntary control of walking in individuals who had sustained a spinal cord injury more than four years ago and presented with permanent motor deficits or complete paralysis despite extensive rehabilitation. Using an implanted pulse generator with real-time triggering capabilities, we delivered trains of spatially selective stimulation to the lumbosacral spinal cord with timing that coincided with the intended movement. Within one week, this spatiotemporal stimulation had re-established adaptive control of paralysed muscles during overground walking. Locomotor performance improved during rehabilitation. After a few months, participants regained voluntary control over previously paralysed muscles without stimulation and could walk or cycle in ecological settings during spatiotemporal stimulation. These results establish a technological framework for improving neurological recovery and supporting the activities of daily living after spinal cord injury.