Movements elicited by electrical stimulation of muscles, nerves, intermediate spinal cord, and spinal roots in anesthetized and decerebrate cats
Movements elicited by electrical stimulation of muscles, nerves, intermediate spinal cord, and spinal roots in anesthetized and decerebrate cats
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DOI：
10.1109/tnsre.2003.823268
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发表时间：
2004-03-01
影响因子：
4.9
通讯作者：
Prochazka, A
中科院分区：
文献类型：
--
作者：
Aoyagi, Y;Mushahwar, VK;Prochazka, A
电刺激提供了恢复脊髓损伤或中风后瘫痪肢体运动功能的可能性，但很少有数据可以比较可能的刺激部位，如肌肉、神经、脊根或脊髓。本研究的目的是在麻醉和中脑去大脑的猫的这些部位建立刺激的一些特征。后肢被约束在矢状面上运动，以对抗弹簧载荷。前根刺激只产生向下和向后的运动；方向系统地向后移动，受刺激的根越向后。相比之下，背根刺激只产生向上和向前的运动。因此，仅靠这两种方法都不能产生完整的正常动作。肌肉、神经和脊椎内灰质中间区域的刺激产生了在广泛方向上的离散的、选择性的运动。肌肉刺激需要多一个数量级的电流。位于脊髓灰质的单个微丝电极可以激活一组协同的肌肉，一般具有渐变的募集曲线，但随着刺激强度的增加，运动方向有时会发生突变。神经刺激对弹簧载荷产生最大的运动(80%的被动运动范围)，并且从动物到动物的重复性最强。然而，神经刺激下的募集曲线相当陡峭，因此精细控制运动可能很困难。肌肉、神经和脊髓似乎都是恢复运动功能的可行部位。这项研究的利弊有助于确定特定应用的最佳部位，但还需要对长期横断的脊髓进行进一步的测试，以评估这些结果对人类患者的适用性。
Electrical stimulation offers the possibility of restoring motor function of paralyzed limbs after spinal-cord injury or stroke, but few data are available to compare possible sites of stimulation, such as muscle, nerve, spinal roots, or spinal cord. The aim of this study was to establish some characteristics of stimulation at these sites in the anesthetized and midcollicular decerebrate cat. The hind limb was constrained to move in the sagittal plane against a spring load. Ventral-root stimulation only produced movements down and back; the direction moved systematically backward the more caudal the stimulated roots. In contrast, dorsal-root stimulation only produced movements up and forward. Thus, neither method alone could produce the full range of normal movements. Muscle, nerve, and intraspinal stimulation within the intermediate regions of the gray matter generated discrete, selective movements in a wide range of directions. Muscle stimulation required an order of magnitude more current. Single microwire electrodes located in the spinal gray matter could activate a synergistic group of muscles, and generally had graded recruitment curves, but the direction of movement occasionally changed abruptly as stimulus strength increased. Nerve stimulation produced the largest movements against the spring load (>80% of the passive range of motion) and was the most reproducible from animal to animal. However, recruitment curves with nerve stimulation were quite steep, so fine control of movement might be difficult. The muscle, nerve, and spinal cord all seem to be feasible sites to restore motor function. The pros and cons from this study mail be helpful in deciding the best site for a particular application, but further tests are needed in the chronically transected spinal cord to assess the applicability of these results to human patients.