Intraspinal Microstimulation for Multi-modal Rehabilitation

多模式康复的椎管内微刺激

• 批准号: 10517182
• 负责人: Jacob Graves McPherson
• 金额: $ 7.88万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10517182
• 关键词: Address; Biochemical; Chronic; Clinical; Combined Modality Therapy; Development; Electrophysiology (science); Goals; Impairment; Individual; Lead; Lesion; Motor; Motor Pathways; Motor output; Nervous System Trauma; Neurons; Neurotransmitters; Pain; Pathway interactions; Peripheral Nerves; Pharmacology; Population; Public Health; Rattus; Rehabilitation therapy; Sensory; Spinal; Spinal Cord; Spinal cord injury; Spine pain; Surface; Synaptic Transmission; Therapeutic; Time; Work; design; in vivo evaluation; intraspinal microstimulation; monoamine; motor control; motor impairment; motor recovery; motor rehabilitation; multimodality; neuroprosthesis; non-opioid analgesic; pain perception; pain processing; painful neuropathy; relating to nervous system; sex; transmission process

Spinal cord injury (SCI) often results in motor impairments and neuropathic pain. These conditions are related to changes in neural activity in regions of the spinal cord that control motor output and sensory processing. Generally, there is too little neural transmission in spinal motor pathways below the lesion, whereas there is excessive, inappropriate neural transmission in pain pathways below the lesion. It has previously been shown that delivery of small amounts of electrical current directly to motor regions of the spinal cord can increase neural transmission in motor pathways. This type of spinal stimulation is called therapeutic intraspinal microstimulation. Over time, intraspinal microstimulation can enhance motor recovery after SCI. The overall hypothesis of this proposal is that intraspinal microstimulation for motor rehabilitation can also be designed to reduce transmission in spinal pain pathways. If confirmed, this could lead to development of neuroprosthetic therapies for multimodal rehabilitation after SCI. The primary goal of this proposal is to determine the extent to which intraspinal microstimulation can reduce neural transmission in spinal pain pathways. These effects have not previously been characterized. It is known that intraspinal microstimulation activates a widespread network of non-pain-related sensory pathways that bridge the motor regions of the spinal cord and the pain-processing regions of the spinal cord. Activation of this network by peripheral nerve or spinal surface stimulation can reduce transmission in spinal pain pathways. This proposal will determine the extent to which intraspinal microstimulation can reduce transmission in pain pathways through activation of this network. This proposal will also determine whether intraspinal microstimulation promotes release and/or use of a class of natural neurotransmitters known as the monoamines. Monoamines have the unique ability to simultaneously reduce transmission in spinal pain pathways while increasing transmission in spinal motor pathways. Neurons that utilize monoamines have terminations throughout the network of neurons activated by intraspinal microstimulation. All hypotheses will be tested in vivo in anesthetized rats with chronic, motor- incomplete SCI and in rats without neurological injury. Rats of both sexes will be included. The approach includes electrophysiological, computational, pharmacological and biochemical analyses of neural activity. This proposal will advance the understanding of how intraspinal microstimulation impacts highly interconnected spinal sensorimotor networks. If support for the hypotheses is obtained, this proposal will have also identified a new strategy for neuroprosthetic therapies to deliver multimodal rehabilitation benefits. This would address two critical unmet needs of the SCI population: non-opioid treatments for SCI-related neuropathic pain and multimodal rehabilitation. It would also overcome a key limitation of clinically available spinal stimulators, which are parameterized for treatment of motor or sensory impairments alone.

脊髓损伤通常会导致运动障碍和神经性疼痛。这些条件是

项目成果

Precision neuromodulation: Promises and challenges of spinal stimulation for multi-modal rehabilitation.

• DOI: 10.3389/fresc.2023.1135593
• 发表时间: 2023
• 期刊: Frontiers in rehabilitation sciences
• 作者: Bandres MF;Gomes JL;Moreno Romero GN;Twyman AR;McPherson JG
• 通讯作者: McPherson JG

Motor-targeted spinal stimulation promotes concurrent rebalancing of pathologic nociceptive transmission in chronic spinal cord injury.

以运动为目标的脊髓刺激促进慢性脊髓损伤中病理性伤害性传递的同时重新平衡。

• DOI: 10.1101/2023.04.12.536477
• 发表时间: 2023
• 期刊: bioRxiv : the preprint server for biology
• 作者: Bandres,MariaF;Gomes,JeffersonL;McPherson,JacobG
• 通讯作者: McPherson,JacobG