Recruitment order of motor neurons promoted by epidural stimulation in individuals with spinal cord injury.
Recruitment order of motor neurons promoted by epidural stimulation in individuals with spinal cord injury.
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硬膜外刺激促进脊髓损伤个体运动神经元募集顺序。
DOI：
10.1152/japplphysiol.00293.2021
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发表时间：
2021-09-01
期刊：
影响因子：
--
通讯作者：
Rejc E
中科院分区：
文献类型：
--
作者：
Ibáñez J;Angeli CA;Harkema SJ;Farina D;Rejc E
脊髓硬膜外刺激（scES）联合基于活动的训练可以促进运动完全性脊髓损伤（SCI）患者的运动功能恢复。当scES促进运动功能时，影响运动控制不同方面的运动神经元募集特征仍然未知。在这里，我们招募了5名慢性运动完全性脊髓损伤患者，植入了一个scES单元，研究scES使站立时运动神经元的募集顺序。我们在股外侧肌上记录高密度肌电图（HD-EMG）信号，并根据sces诱发的肌电反应沿肌纤维的振幅和传导速度的关系推断运动神经元的募集顺序。sces诱发反应的传导速度随时间变化而变化，而刺激参数和状态保持不变，平均值在3.0±0.1 ~ 4.4±0.3 m/s之间。我们发现，接受硬膜外刺激的人脊髓回路可以促进运动神经元的有序募集（根据运动神经元的大小）和反向募集趋势，并且促进有节奏活动的脊髓网络的参与可能有利于有序募集趋势。相反，不同的恢复趋势似乎与损伤或scES植入后的时间无关，也与实现独立膝关节伸展的能力无关，也与传导速度值无关。该方法可用于研究刺激参数和训练诱导的神经可塑性对运动神经元募集顺序特征的影响，有助于提高对硬膜外刺激促进脊髓损伤后运动恢复的机制认识和有效性。运动完全性脊髓损伤后，接受硬膜外刺激的人脊髓可以促进运动神经元的有序募集和反向募集。参与产生节律性活动的脊髓网络似乎有利于有序的招募趋势。
Spinal cord epidural stimulation (scES) combined with activity-based training can promote motor function recovery in individuals with motor complete spinal cord injury (SCI). The characteristics of motor neuron recruitment, which influence different aspects of motor control, are still unknown when motor function is promoted by scES. Here, we enrolled five individuals with chronic motor complete SCI implanted with an scES unit to study the recruitment order of motor neurons during standing enabled by scES. We recorded high-density electromyography (HD-EMG) signals on the vastus lateralis muscle and inferred the order of recruitment of motor neurons from the relation between amplitude and conduction velocity of the scES-evoked EMG responses along the muscle fibers. Conduction velocity of scES-evoked responses was modulated over time, whereas stimulation parameters and standing condition remained constant, with average values ranging between 3.0 ± 0.1 and 4.4 ± 0.3 m/s. We found that the human spinal circuitry receiving epidural stimulation can promote both orderly (according to motor neuron size) and inverse trends of motor neuron recruitment, and that the engagement of spinal networks promoting rhythmic activity may favor orderly recruitment trends. Conversely, the different recruitment trends did not appear to be related with time since injury or scES implant, nor to the ability to achieve independent knees extension, nor to the conduction velocity values. The proposed approach can be implemented to investigate the effects of stimulation parameters and training-induced neural plasticity on the characteristics of motor neuron recruitment order, contributing to improve mechanistic understanding and effectiveness of epidural stimulation-promoted motor recovery after SCI. NEW & NOTEWORTHY After motor complete spinal cord injury, the human spinal cord receiving epidural stimulation can promote both orderly and inverse trends of motor neuron recruitment. The engagement of spinal networks involved in the generation of rhythmic activity seems to favor orderly recruitment trends.
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影响因子：
25
作者：
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影响因子：
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影响因子：
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