Rehabilitation from Spinal Cord Injury Using Targeted, Activity-Dependent Intraspinal Stimulation

项目摘要 拟议项目的目标是继续该实验室的发展， 神经假体治疗，使用有针对性的活动依赖性脊柱刺激来改善手臂 颈脊髓损伤（SCI）后手运动功能恢复。该项目旨在推进 临床实践中，通过使用脑机接口技术， 神经可塑性的机制 运动缺陷严重影响SCI患者的生活质量，但目前的治疗方法 对运动能力的改善有限。最近的临床和实验证据 表明，神经系统的电刺激可以是一种有效的治疗方法， 各种神经系统疾病在这里，我们将扩展研究的一个新的应用， 刺激用于颈脊髓损伤大鼠模型中前肢运动缺陷的康复。战略 旨在通过引导赫布可塑性来增强备用神经通路的功能 通过有针对性地刺激意志激活的神经回路。结果将奠定 为将来在人类受试者中使用脊髓刺激进行临床试验奠定了基础。 以前的数据证明了多通道椎管内刺激的有效性 由前肢肌肉活动触发，以改善慢性SCI大鼠的运动表现。 具体目标1旨在完成刺激和 身体康复，以建立综合治疗的原则。具体目标2 将研究导致女性和男性在恢复方面存在巨大差异的可能原因。 用闭环刺激处理的大鼠。具体目标3将确定活动依赖性 硬膜外刺激，一种侵入性更小且更容易转化为临床实践的方法 与椎管内刺激相比，在促进恢复方面同样有效。

Project Summary The objective of the proposed project is to continue the laboratory’s development of a neuroprosthetic therapy that uses targeted, activity-dependent spinal stimulation to improve arm and hand motor recovery after cervical spinal cord injury (SCI). The project seeks to advance clinical practice through the use of brain-computer-interface technology to harness physiological mechanisms of neural plasticity. Motor deficits severely impact the quality of life of people with SCI, yet current treatments produce limited improvements in movement abilities. Recent clinical and experimental evidence suggests that electrical stimulation of the nervous system can be an effective therapy for a variety of neurological disorders. Here we will extend study of a novel application of electrical stimulation for rehabilitation of forelimb motor deficits in a rat model of cervical SCI. The strategy is designed to enhance the function of spared neural pathways by directing Hebbian plasticity through targeted stimulation of volitionally activated neural circuits. Results will lay the foundation for a future clinical trial using spinal stimulation in human subjects. Previous data demonstrated the effectiveness of multi-channel, intraspinal stimulation triggered by activity of forelimb muscles to improve motor performance in rats with chronic SCI. Specific Aim 1 seeks to complete the characterization of the interplay between stimulation and physical rehabilitation in order to establish principles for combining the therapies. Specific Aim 2 will examine possible causes underlying dramatic differences in recovery in female and male rats treated with the closed-loop stimulation. Specific Aim 3 will determine if activity-dependent epidural stimulation, a much less invasive and easier to translate to clinical practice approach than intraspinal stimulation, is as effective in facilitating recovery.