Transcutaneous electrical spinal-cord stimulation in humans.
Transcutaneous electrical spinal-cord stimulation in humans.
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DOI：
10.1016/j.rehab.2015.05.003
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发表时间：
2015-09
影响因子：
4.6
通讯作者：
Edgerton, V. Reggie
中科院分区：
文献类型：
--
作者：
Gerasimenko, Yury;Gorodnichev, Ruslan;Moshonkina, Tatiana;Sayenko, Dimitry;Gad, Parag;Edgerton, V. Reggie
关键词：
运动行为由主要位于腰骶脊髓的称为中枢模式发生器的特定神经回路控制。这些与运动相关的神经元回路具有高度的自动化性；也就是说，在没有脊髓上和/或外周传入输入的情况下，它们可以产生肌电图（EMG）上也可以看到的“步进”运动模式。这些回路可以通过硬膜外脊髓刺激和/或药物干预来调节。此类干预措施已用于对运动完全性脊髓损伤（SCI）患者的神经元回路进行神经调节，以促进姿势和运动调整并重新获得自主运动控制。在这里，我们描述了一种新型无痛经皮电驱动运动控制（pcEmc）的非侵入性刺激策略，以神经调节脊髓的生理状态。该技术可以促进未受伤受试者的腿部处于重力中性位置的迈步表现。多部位脊髓刺激比单部位脊髓刺激更有效地诱导步进运动。根据这些结果，开发了多电极表面阵列技术。我们的初步数据表明，使用多电极表面阵列可以微调运动行为的控制。此外，pcEmc策略结合外骨骼技术可有效改善SCI瘫痪患者的运动功能。使用 pcEmc 神经调节脊髓回路的潜在影响对于进一步了解控制运动的机制以及即使在严重 SCI 后恢复感觉运动功能也具有重大意义。
Locomotor behavior is controlled by specific neural circuits called central pattern generators primarily located at the lumbosacral spinal cord. These locomotor-related neuronal circuits have a high level of automaticity; that is, they can produce a “stepping” movement pattern also seen on electromyography (EMG) in the absence of supraspinal and/or peripheral afferent inputs. These circuits can be modulated by epidural spinal-cord stimulation and/or pharmacological intervention. Such interventions have been used to neuromodulate the neuronal circuits in patients with motor-complete spinal-cord injury (SCI) to facilitate postural and locomotor adjustments and to regain voluntary motor control. Here, we describe a novel non-invasive stimulation strategy of painless transcutaneous electrical enabling motor control (pcEmc) to neuromodulate the physiological state of the spinal cord. The technique can facilitate a stepping performance in non-injured subjects with legs placed in a gravity-neutral position. The stepping movements were induced more effectively with multi-site than single-site spinal-cord stimulation. From these results, a multielectrode surface array technology was developed. Our preliminary data indicate that use of the multielectrode surface array can fine-tune the control of the locomotor behavior. As well, the pcEmc strategy combined with exoskeleton technology is effective for improving motor function in paralyzed patients with SCI. The potential impact of using pcEmc to neuromodulate the spinal circuitry has significant implications for furthering our understanding of the mechanisms controlling locomotion and for rehabilitating sensorimotor function even after severe SCI.
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影响因子：
5.5
作者：
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通讯作者：
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影响因子：
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Maier, Irin C.;Ichiyama, Ronaldo M.;Schwab, Martin E.
通讯作者：
Schwab, Martin E.
影响因子：
2.5
作者：
Gerasimenko, Yury;Gorodnichev, Ruslan;Edgerton, V. Reggie
通讯作者：
Edgerton, V. Reggie
影响因子：
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作者：
Fong AJ;Roy RR;Ichiyama RM;Lavrov I;Courtine G;Gerasimenko Y;Tai YC;Burdick J;Edgerton VR
通讯作者：
Edgerton VR
影响因子：
2.5
作者：
de Leon, RD;Hodgson, JA;Edgerton, VR
通讯作者：
Edgerton, VR