Closed-loop neuromodulation of spinal sensorimotor circuits controls refined locomotion after complete spinal cord injury

Neuromodulation of spinal sensorimotor circuits improves motor control in animal models and humans with spinal cord injury. With common neuromodulation devices, electrical stimulation parameters are tuned manually and remain constant during movement. We developed a mechanistic framework to optimize...

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Bibliographic Details
Published inScience translational medicine Vol. 6; no. 255; p. 255ra133
Main Authors Wenger, Nikolaus, Moraud, Eduardo Martin, Raspopovic, Stanisa, Bonizzato, Marco, DiGiovanna, Jack, Musienko, Pavel, Morari, Manfred, Micera, Silvestro, Courtine, Grégoire
Format Journal Article
LanguageEnglish
Published United States 24.09.2014
Subjects
Animals
Biomechanical Phenomena
Disease Models, Animal
Extremities - innervation
Feedback, Sensory
Female
Gait
Locomotion
Motor Neurons
Muscle Fatigue
Neural Prostheses
Neurofeedback - instrumentation
Prosthesis Design
Rats, Inbred Lew
Recovery of Function
Spinal Cord Injuries - physiopathology
Spinal Cord Injuries - therapy
Spinal Nerves - physiopathology
Time Factors
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Summary:Neuromodulation of spinal sensorimotor circuits improves motor control in animal models and humans with spinal cord injury. With common neuromodulation devices, electrical stimulation parameters are tuned manually and remain constant during movement. We developed a mechanistic framework to optimize neuromodulation in real time to achieve high-fidelity control of leg kinematics during locomotion in rats. We first uncovered relationships between neuromodulation parameters and recruitment of distinct sensorimotor circuits, resulting in predictive adjustments of leg kinematics. Second, we established a technological platform with embedded control policies that integrated robust movement feedback and feed-forward control loops in real time. These developments allowed us to conceive a neuroprosthetic system that controlled a broad range of foot trajectories during continuous locomotion in paralyzed rats. Animals with complete spinal cord injury performed more than 1000 successive steps without failure, and were able to climb staircases of various heights and lengths with precision and fluidity. Beyond therapeutic potential, these findings provide a conceptual and technical framework to personalize neuromodulation treatments for other neurological disorders.
ISSN:1946-6242
DOI:10.1126/scitranslmed.3008325