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Optimizing the restoration and rehabilitation of function using cortically-controlled FES following SCI

SCI 后使用皮质控制的 FES 优化功能恢复和康复

基本信息

批准号：
10613441
负责人：
Matthew Tresch
金额：
$ 51.98万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-01 至 2025-04-30
项目状态：
未结题

项目摘要

Despite the long-term promise of stem-cell and other biological approaches, current options to improve function following spinal cord injury (SCI) remain quite limited. However, brain machine interfaces (BMIs) that use cortical activity to drive functional electrical stimulation (FES) of muscles or the spinal cord have great promise not only for the restoration of motor ability when using the BMI, but also for improved functional rehabilitation so that their performance is improved when the BMI is removed. The overall goal of our research is to identify strategies that maximize both of these potential strengths of cortically-controlled FES. A system using cortical activity to drive stimulation of individual muscles might maximize the restoration of motor function: by enabling users to vary the amplitude and timing of individual muscles, movements can potentially be adapted as necessary to achieve task demands. Alternate strategies of producing movement, such as activation of muscle groups or of sites in the spinal cord producing limb flexion or extension, will reduce the range of possible movements. Although these strategies might be simpler to learn after SCI than control of individual muscles, they clearly limit the level of motor function that can be restored. In order to achieve the greatest functional rehabilitation, however, spinal stimulation might be a more promising strategy than muscle stimulation. Repeated spinal stimulation might maintain the function of spinal pathways involved in the production of movement and enable restoration of connections from descending systems through associative plasticity. Conversely, since muscle stimulation does not activate spinal pathways to produce movement, it might produce less functional rehabilitation. There is therefore a potential tradeoff between muscle and spinal stimulation: muscle stimulation enables high levels of motor ability but might limit functional rehabilitation, while spinal stimulation might enhance rehabilitation but limit flexibility. Our research will investigate this tradeoff, with the goal of designing a hybrid system that combines spinal and muscle stimulation to achieve high levels of both motor ability and functional rehabilitation. We will perform these experiments in rats, implanting electrodes in the cortex to record neural activity and in the spinal cord and muscles to produce movements. We will then train rats to use these systems after SCI, evaluating whether they can improve motor ability and functional rehabilitation. In Aim 1, we will evaluate whether animals can produce high levels of motor ability with a system using cortical activity to control activation of individual muscles. In Aim 2, we will evaluate whether animals using cortical activity to control activation of spinal stimulation have better functional rehabilitation. Finally, in Aim 3 we will evaluate whether a hybrid system that controls activation of both muscle and spinal stimulation, exploits the advantages of each approach to produce movement, resulting in high levels of both motor ability and of functional rehabilitation.

尽管干细胞和其他生物方法具有长期前景，但目前的改进选择脊髓损伤 (SCI) 后的功能仍然相当有限。然而，脑机接口 (BMI) 利用皮质活动来驱动肌肉或脊髓的功能性电刺激 (FES)，具有很好的效果不仅可以在使用 BMI 时恢复运动能力，还可以改善功能康复，以便在去除 BMI 后提高他们的表现。我们研究的总体目标的目的是确定最大化皮质控制 FES 的这两种潜在优势的策略。使用皮质活动来驱动个体肌肉刺激的系统可能会最大限度地恢复运动功能：通过使用户能够改变单个肌肉的幅度和时间，运动可以可能会根据需要进行调整以实现任务要求。产生运动的替代策略，例如激活肌肉群或脊髓中产生肢体弯曲或伸展的部位，将减少可能的运动范围。尽管这些策略在 SCI 后学习起来可能比控制个体肌肉，它们显然限制了可以恢复的运动功能的水平。然而，为了实现最大的功能康复，脊柱刺激可能是一个更重要的方法。比肌肉刺激更有希望的策略。重复的脊柱刺激可能会维持脊柱的功能参与运动产生并能够恢复下行连接的路径通过关联可塑性的系统。相反，由于肌肉刺激不会激活脊髓通路为了产生运动，它可能会产生较少的功能康复。因此，肌肉刺激和脊髓刺激之间存在潜在的权衡：肌肉刺激可以使高水平的运动能力，但可能会限制功能康复，而脊柱刺激可能会增强康复但限制灵活性。我们的研究将调查这种权衡，目标是设计一种混合动力该系统结合了脊柱和肌肉刺激，以实现高水平的运动能力和功能康复。我们将在老鼠身上进行这些实验，在皮层中植入电极来记录神经活动并在脊髓和肌肉中产生运动。然后我们将训练老鼠使用这些系统 SCI，评估它们是否可以提高运动能力和功能康复。在目标 1 中，我们将评估动物是否可以通过使用皮质活动控制激活的系统产生高水平的运动能力个体肌肉。在目标 2 中，我们将评估动物是否使用皮质活动来控制大脑皮层的激活脊柱刺激有更好的功能康复作用。最后，在目标 3 中，我们将评估混合系统是否控制肌肉和脊柱刺激的激活，利用每种方法的优点产生运动，从而实现高水平的运动能力和功能康复。