Targeted intraspinal stimulation for restoration of limb movement following spina

有针对性的脊柱内刺激以恢复脊柱后的肢体运动

• 批准号: 8803824
• 负责人: Luis Lujan
• 金额: $ 19.88万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8803824
• 关键词: Address; Affect; Animal Model; Animals; Cannulas; Cell Nucleus; Clinical; Development; Disease; Electric Stimulation; Electrodes; Emerging Technologies; Engineering; Ensure; Family suidae; Fatigue; Flexor; Freedom; Goals; Hand functions; Health; Hip Joint; Hip region structure; Horns; Human; Implant; Individual; Injury; Intramuscular; Knee; Knee joint; Limb structure; Location; Lumbar spinal cord structure; Magnetic Resonance Imaging; Manuals; Maps; Mediating; Methods; Microelectrodes; Modeling; Motor; Motor Neurons; Movement; Muscle; Muscle Contraction; Muscle Fatigue; Navigation System; Nerve; Neuroanatomy; Neurologic; Neurons; Neurostimulation procedures of spinal cord tissue; Operative Surgical Procedures; Outcome; Paralysed; Peripheral Nerves; Population; Positioning Attribute; Quality of life; Resistance; Resolution; Sensory; Skeletal Muscle; Spinal; Spinal Cord; Spinal Injuries; Spinal cord grey matter structure; Spinal cord injury; Structure; Surgeon; System; Techniques; Technology; Therapeutic; Translating; Translations; Work; base; clinical efficacy; design; experience; functional restoration; image guided; improved; instrument; intraspinal microstimulation; joint mobilization; limb movement; meetings; microstimulation; millimeter; nonhuman primate; prevent; response; restoration; retinal rods; sample fixation; skills; success; targeted delivery

DESCRIPTION (provided by applicant): Restoration of limb movement following spinal cord injury (SCI) has been achieved using electrical stimulation of peripheral nerves and skeletal muscles. However, these stimulation techniques are limited by a rapid onset of muscle fatigue and by limited degrees of freedom that can be independently controlled using existing technology. Intraspinal microstimulation (ISMS) is an emerging technology that has shown significant potential for overcoming some of the limitations associated with electrical stimulation techniques. Specifically, intraspinal stimulation has been successful in evoking controlled limb movements in previously paralyzed limbs by directly activating motor neurons within the ventral gray matter of the spinal cord. State-of-the-art intraspinal microstimulation techniques rely on manual targeting of neuron populations and manual insertion of stimulating microelectrodes into the spinal cord. However, variance in neuroanatomy combined with differences in surgical strategy and skill can compromise clinical outcomes and prevent cross-study analysis. The goals of this proposal are to develop a targeting strategy for identifying motor neuron populations associated with specific target movements in a large animal model and demonstrate that targeted intraspinal stimulation can evoke controlled, reproducible, and sustained muscle contractions. In addition to evoking limb movements, the targeting and stimulation strategies proposed herein will allow characterization of spinal networks responsible for mediating motor function in a large animal. This in turn will allow optimization of stimulation paradigms for selective and coordinated recruitment of fatigue-resistant motor units. Moreover, it will allow ths technology to move closer to a clinical therapeutic system for human use.

描述（由申请人提供）：脊髓损伤（SCI）后肢体运动的恢复已通过外周神经和骨骼肌的电刺激实现。 然而，这些刺激技术受限于肌肉疲劳的快速发作以及受限于可使用现有技术独立控制的有限自由度。 椎管内微刺激（ISMS）是一种新兴的技术，已显示出克服与电刺激相关的一些限制的巨大潜力 技术. 具体地说，脊柱内刺激已经成功地通过直接激活脊髓腹侧灰质内的运动神经元，在先前瘫痪的肢体中唤起受控的肢体运动。 最先进的椎管内微刺激技术依赖于神经元群体的手动靶向和刺激微电极到脊髓中的手动插入。 然而，神经解剖结构的差异加上手术策略和技巧的差异可能会影响临床结局并妨碍交叉研究分析。 该提案的目标是开发一种靶向策略，用于在大型动物模型中识别与特定目标运动相关的运动神经元群体，并证明有针对性的椎管内刺激可以引起受控的、可再现的和持续的肌肉收缩。 除了唤起肢体运动之外，本文提出的靶向和刺激策略将允许表征负责介导大型动物中的运动功能的脊髓网络。 这反过来将允许优化刺激范例，以选择性和协调地募集抗疲劳运动单位。 此外，它将使该技术更接近人类使用的临床治疗系统。