Epidural and transcutaneous spinal cord stimulation facilitates descending inputs to upper-limb motoneurons in monkeys.
Epidural and transcutaneous spinal cord stimulation facilitates descending inputs to upper-limb motoneurons in monkeys.
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DOI：
10.1088/1741-2552/abe358
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发表时间：
2021-03-22
影响因子：
4
通讯作者：
Jackson A
中科院分区：
文献类型：
--
作者：
Guiho T;Baker SN;Jackson A
目标。硬膜外和经皮脊髓刺激(SCS)作为脊髓损伤后的一种治疗方法重新引起了人们的兴趣，既可以恢复瘫痪的肌肉，也可以加强对运动的削弱的意志控制。然而，到目前为止，大多数工作都集中在腰椎SCS恢复运动功能上。因此，我们在麻醉的、神经功能正常的猴子身上检测了不同频率的颈椎SCS输送到不同的硬膜外和经皮部位的上肢肌肉反应和对脊柱上诱发运动的调节。接近。硬膜外SCS通过放置在颈髓背侧和腹侧表面的新型多电极袖带传递，而经皮SCS通过表面电极使用高载波频率传递。主要结果。腹侧硬膜外SCS在电流强度比背侧部位更低的情况下引发强劲的运动，诱发的运动单位电位甚至可靠地跟随高频列车。相比之下，肌肉对背侧SCS的反应需要更高的电流强度，并在整个训练过程中减弱。然而，背侧硬膜外SCS和经皮SCS在促进脊髓上诱发反应方面是有效的，特别是在中等刺激频率下。背侧SCS效应的时间和频率依赖性可以用一个简单的模型来解释，即运动神经元的跨突触兴奋是通过突触前机制被先前刺激所门控的。意义重大。我们的结果表明，允许进入背侧和腹侧硬膜外部位的多接触电极可能有利于联合治疗目的，并且在优化SCS辅助康复时应考虑直接、突触和突触前效应的相互作用。
Objective. There is renewed interest in epidural and transcutaneous spinal cord stimulation (SCS) as a therapy following spinal cord injury, both to reanimate paralyzed muscles as well as to potentiate weakened volitional control of movements. However, most work to date has focussed on lumbar SCS for restoration of locomotor function. Therefore, we examined upper-limb muscle responses and modulation of supraspinal-evoked movements by different frequencies of cervical SCS delivered to various epidural and transcutaneous sites in anaesthetized, neurologically intact monkeys. Approach. Epidural SCS was delivered via a novel multielectrode cuff placed around both dorsal and ventral surfaces of the cervical spinal cord, while transcutaneous SCS was delivered using a high carrier frequency through surface electrodes. Main results. Ventral epidural SCS elicited robust movements at lower current intensities than dorsal sites, with evoked motor unit potentials that reliably followed even high-frequency trains. By contrast, the muscle responses to dorsal SCS required higher current intensities and were attenuated throughout the train. However, dorsal epidural SCS and, to a lesser extent, transcutaneous SCS were effective at facilitating supraspinal-evoked responses, especially at intermediate stimulation frequencies. The time- and frequency-dependence of dorsal SCS effects could be explained by a simple model in which transynaptic excitation of motoneurons was gated by prior stimuli through presynaptic mechanisms. Significance. Our results suggest that multicontact electrodes allowing access to both dorsal and ventral epidural sites may be beneficial for combined therapeutic purposes, and that the interaction of direct, synaptic and presynaptic effects should be considered when optimising SCS-assisted rehabilitation.
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影响因子：
4.2
作者：
Gad, Parag;Lee, Sujin;Edgerton, V. Reggie
通讯作者：
Edgerton, V. Reggie
DOI：
10.1073/pnas.1505383112
发表时间：
2015-09-29
影响因子：
11.1
作者：
McPherson, Jacob G.;Miller, Robert R.;Perlmutter, Steve I.
通讯作者：
Perlmutter, Steve I.
影响因子：
5.5
作者：
ECCLES, JC;WILLIS, WD;MAGNI, F
通讯作者：
MAGNI, F
影响因子：
2.5
作者：
BURKE, RE
通讯作者：
BURKE, RE
影响因子：
4
作者：
Sharpe AN;Jackson A
通讯作者：
Jackson A