A case study of percutaneous epidural stimulation to enable motor control in two men after spinal cord injury.
A case study of percutaneous epidural stimulation to enable motor control in two men after spinal cord injury.
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经皮硬膜外刺激的案例研究，使两名男性在脊髓损伤后能够控制运动。
DOI：
10.1038/s41467-023-37845-7
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发表时间：
2023-04-12
影响因子：
16.6
通讯作者：
Lavis, Timothy D.
中科院分区：
文献类型：
--
作者：
Gorgey, Ashraf S.;Trainer, Robert;Sutor, Tommy W.;Goldsmith, Jacob A.;Alazzam, Ahmed;Goetz, Lance L.;Lester, Denise;Lavis, Timothy D.
两名患有慢性运动性完全脊髓损伤 (SCI) 的患者被植入经皮脊髓硬膜外刺激 (SCES) 导线，以实现损伤水平以下的运动控制 (NCT04782947)。在暂时性 SCES 植入和永久性 SCES 植入期间，进行脊柱测绘主要是为了优化配置，以实现运动的意志控制以及站立和行走训练作为次要结果。在两名参与者中，SCES 都可以自愿增加受伤部位以下的肌肉激活和运动，并减少外骨骼辅助行走期间的辅助。永久植入后，两名参与者自愿调节感应扭矩，但并不总是在预期方向上。在一名参与者中，经肌电图证实，经皮 SCES 在临时植入一天后能够实现损伤下方的运动控制。同一参与者通过最少的上肢自我平衡辅助、双杠独立行走以及借助助行器在地上行走实现了独立站立。通过经皮导线进行的 SCES 有望增强 SCI 患者的康复能力并实现运动功能。在麦奎尔 IRB 委员会批准的一项试验中，经皮脊髓硬膜外刺激 (SCES) 导线被植入两名脊髓损伤 (SCI) 患者体内。 SCES 减少了外骨骼所需的辅助。一名参与者通过 SCES 实现了双杠站立和踏步，以及借助助行器进行地面行走。
Two persons with chronic motor complete spinal cord injury (SCI) were implanted with percutaneous spinal cord epidural stimulation (SCES) leads to enable motor control below the injury level (NCT04782947). Through a period of temporary followed by permanent SCES implantation, spinal mapping was conducted primarily to optimize configurations enabling volitional control of movement and training of standing and stepping as a secondary outcome. In both participants, SCES enabled voluntary increased muscle activation and movement below the injury and decreased assistance during exoskeleton-assisted walking. After permanent implantation, both participants voluntarily modulated induced torques but not always in the intended directions. In one participant, percutaneous SCES enabled motor control below the injury one-day following temporary implantation as confirmed by electromyography. The same participant achieved independent standing with minimal upper extremity self-balance assistance, independent stepping in parallel bars and overground ambulation with a walker. SCES via percutaneous leads holds promise for enhancing rehabilitation and enabling motor functions for people with SCI. Percutaneous spinal cord epidural stimulation (SCES) leads were implanted in two men with spinal cord injury (SCI) in an approved trial by the McGuire IRB committee. SCES decreased the assistance required from the exoskeleton. In one participant, SCES enabled standing and stepping in parallel bars and overground ambulation with a walker.
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