Closed-loop control of spinal cord stimulation to restore hand function after paralysis.
Closed-loop control of spinal cord stimulation to restore hand function after paralysis.
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DOI：
10.3389/fnins.2014.00087
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发表时间：
2014
影响因子：
4.3
通讯作者：
Jackson A
中科院分区：
文献类型：
--
作者：
Zimmermann JB;Jackson A
到目前为止，对于脊髓损伤或中风后运动通路受损导致的上肢瘫痪还没有治愈方法。最近，来自瘫痪个体的运动皮层的神经活动已被用于控制机器人手臂的运动，但恢复患者实际肢体的功能仍然是一个相当大的挑战。先前我们已经证明，电刺激麻醉猴子的颈髓可以引起上肢功能性运动，如伸手和抓握。在这里，我们表明，刺激可以控制清醒动物的皮质活动，绕过皮质脊髓系统的中断，恢复他们的能力，执行一个简单的上肢任务。训练猴子抓住并拉动弹簧手柄。在通过使用蝇蕈醇可逆性失活初级运动皮层诱导暂时性手麻痹后，腹侧运动前皮层的抓握相关单单位活动被转换为实时传递到颈脊髓灰质的刺激模式。在闭环刺激期间，任务调制肌电图、运动幅度和任务成功率相对于无刺激的交错控制期间得到改善。在某些会话中，来自弱活动肌肉的单个运动单元活动也被成功地用于控制刺激。这些结果是第一次使用神经假体来改善灵长类动物运动皮层中断后的手功能，并证明了脊髓刺激的闭环皮层控制使瘫痪肢体复活的潜力。
As yet, no cure exists for upper-limb paralysis resulting from the damage to motor pathways after spinal cord injury or stroke. Recently, neural activity from the motor cortex of paralyzed individuals has been used to control the movements of a robot arm but restoring function to patients' actual limbs remains a considerable challenge. Previously we have shown that electrical stimulation of the cervical spinal cord in anesthetized monkeys can elicit functional upper-limb movements like reaching and grasping. Here we show that stimulation can be controlled using cortical activity in awake animals to bypass disruption of the corticospinal system, restoring their ability to perform a simple upper-limb task. Monkeys were trained to grasp and pull a spring-loaded handle. After temporary paralysis of the hand was induced by reversible inactivation of primary motor cortex using muscimol, grasp-related single-unit activity from the ventral premotor cortex was converted into stimulation patterns delivered in real-time to the cervical spinal gray matter. During periods of closed-loop stimulation, task-modulated electromyogram, movement amplitude, and task success rate were improved relative to interleaved control periods without stimulation. In some sessions, single motor unit activity from weakly active muscles was also used successfully to control stimulation. These results are the first use of a neural prosthesis to improve the hand function of primates after motor cortex disruption, and demonstrate the potential for closed-loop cortical control of spinal cord stimulation to reanimate paralyzed limbs.
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影响因子：
64.8
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通讯作者：
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