Targeted, activity-dependent spinal stimulation produces long-lasting motor recovery in chronic cervical spinal cord injury
Targeted, activity-dependent spinal stimulation produces long-lasting motor recovery in chronic cervical spinal cord injury
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DOI：
10.1073/pnas.1505383112
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发表时间：
2015-09-29
影响因子：
11.1
通讯作者：
Perlmutter, Steve I.
中科院分区：
文献类型：
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作者：
McPherson, Jacob G.;Miller, Robert R.;Perlmutter, Steve I.
神经依赖性运动疗法可导致神经损伤后运动功能的部分恢复。我们试图通过开发一种神经假体干预来改善恢复，该干预通过指导备用运动通路中的尖峰时间依赖性可塑性来增强运动治疗。使用一个经常性的神经计算机接口在大鼠颈挫伤的脊髓，我们同步脊髓内微刺激损伤以下的功能相关的意志运动命令的到来，在受损的前肢肌肉活动发出信号。在前肢行为的身体再训练期间和全天3个月内提供刺激。与接受有针对性但开环脊髓刺激的动物和仅接受身体再训练的大鼠相比，接受这种有针对性的活动依赖性脊髓刺激（TADSS）的大鼠表现出明显增强的恢复。在前肢伸展和抓握任务中，TADSS动物恢复了63%的损伤前能力，是其他治疗组所达到的性能水平的两倍多。治疗增益保持了额外的一周没有刺激。结果表明，活动依赖性脊髓刺激可以诱导神经可塑性，改善脊髓损伤后的行为恢复。
Use-dependent movement therapies can lead to partial recovery of motor function after neurological injury. We attempted to improve recovery by developing a neuroprosthetic intervention that enhances movement therapy by directing spike timing-dependent plasticity in spared motor pathways. Using a recurrent neural-computer interface in rats with a cervical contusion of the spinal cord, we synchronized intraspinal microstimulation below the injury with the arrival of functionally related volitional motor commands signaled by muscle activity in the impaired forelimb. Stimulation was delivered during physical retraining of a forelimb behavior and throughout the day for 3 mo. Rats receiving this targeted, activity-dependent spinal stimulation (TADSS) exhibited markedly enhanced recovery compared with animals receiving targeted but open-loop spinal stimulation and rats receiving physical retraining alone. On a forelimb reach and grasp task, TADSS animals recovered 63% of their preinjury ability, more than two times the performance level achieved by the other therapy groups. Therapeutic gains were maintained for (additional wk without stimulation. The results suggest that activity-dependent spinal stimulation can induce neural plasticity that improves behavioral recovery after spinal cord injury.