A Theranostic Tool to Assess and Enable Spared Spinal Motor Function After SCI

一种用于评估和启用 SCI 后备用脊髓运动功能的治疗诊断工具

• 批准号: 8648234
• 负责人: REGGIE EDGERTON
• 金额: $ 34.62万
• 依托单位: NEUROENABLING TECHNOLOGIES, INC.
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-20 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8648234
• 关键词: Address; Age-Years; Algorithms; American; Ankle; Bypass; Caring; Cervical; Cervical spinal cord injury; Chest; Chronic; Clinic; Clinical; Clinical Trials; Data; Devices; Diagnosis; Diagnostic; Electric Stimulation; Electrodes; Enrollment; Evaluation; Felis catus; Financial cost; Goals; Hip region structure; Human; Implant; Implanted Electrodes; Individual; Injury; Intervention; Joints; Knee; Leg; Life; Limb structure; Lower Extremity; Lumbar spinal cord structure; Machine Learning; Measurement; Medical; Modality; Motor; Movement; Nervous System Physiology; Neurologic; Neurostimulation procedures of spinal cord tissue; Outpatients; Painless; Paralysed; Paraplegia; Patients; Pharmaceutical Preparations; Phase; Physiological; Productivity; Protocols documentation; Rattus; Recovery; Residual state; Site; Skin; Speed; Spinal; Spinal Cord; Spinal Cord Part; Spinal Injuries; Spinal cord injury; Spinal cord injury patients; Stroke; Surface; Techniques; Technology; Testing; Therapeutic; Thoracic spinal cord structure; Time; Toes; Training; Transcutaneous Electric Nerve Stimulation; Translating; Upper Extremity; Weight-Bearing state; design; human subject; human subject protection; implantation; improved; improved functioning; injured; life time cost; meetings; motor control; motor function improvement; neural circuit; neuroregulation; prototype; public health relevance; response; theranostics; tool; transcutaneous stimulation

A Theranostic Tool to Assess and Enable Spared Spinal Motor Function After SCI NeuroEnabling Technologies, Inc. RESEARCH & RELATED Other Project Information 7. PROJECT SUMMARY Of the approximately 10 million people in the US living with paralysis, 15,000 are the result of spinal cord injury each year. The first year of care can range from $322,000-$986,000, with lifetime costs of $1.4-4M for someone injured at 25 years of age. In addition to potentially devastating sensorimotor disturbances, there is a huge financial cost, estimated to be $13.55B in medical care, therapy, and lost productivity nationwide. Until very recently, the recovery from spinal cord injury (SCI) was bleak, with little hope of restoring motor function. To address this we have demonstrated that the physiological state of the spinal circuitry of rats and cats can be modulated with epidural stimulation to generate voluntary limb motor function over a range of speeds, loads, and directions, a finding we have extended to humans. Three years post-injury, a motor complete spinal cord injured human subject was implanted with an epidural electrode array over the lumbosacral spinal cord. In less than one month after implantation, the subject could stand independently, and after 7 months of daily epidural stimulation and motor training, voluntary control of both legs was evident in the presence of epidural stimulation, whereas complete paralysis remained in absence of epidural stimulation. We will advance these discoveries with the use of non-invasive stimulation of the lumbosacral cord to improve lower limb function following SCI. Central to this proposal is our discovery of a painless electrical multi-channel (stimulation of multiple parts of the spinal cord) theranostic tool that can be applied to the surface of the skin, termed transcutaneous spinal cord electrical stimulation (TESCS), bypassing the need for a surgically-implanted electrode array. In the first phase of this proposal we will demonstrate proof-of-principle that stimulation of the lumbosacral spinal cord can assess spared spinal motor function by: 1) Testing responses to transcutaneous electrical stimulation in subjects with spinal cord injury; and 2) defining the operational parameters of electrical stimulation that that are most effective using a machine-learning protocol, and 3) produce a multi-channel commercial prototype. This commercial product will undergo testing similar to the proof-of- principle device. This device will then be tested in subjects with cervicothoracic spinal cord injury and evaluated with a machine-learning protocol. This Phase I proposal will deliver a device that can painlessly and non-invasively aid in the assessment and recovery of SCI by delivering a specific electrical stimulation paradigm to the lumbosacral cord that improves use of the lower limbs.

一种评估和激活脊髓损伤后脊髓运动功能的治疗工具