Targeted neurotechnology restores walking in humans with spinal cord injury - PubMed (original) (raw)

. 2018 Nov;563(7729):65-71.

doi: 10.1038/s41586-018-0649-2. Epub 2018 Oct 31.

Jean-Baptiste Mignardot # 1 2, Camille G Le Goff-Mignardot # 1 2, Robin Demesmaeker 1 2, Salif Komi 1 2, Marco Capogrosso 3, Andreas Rowald 1 2, Ismael Seáñez 1 2, Miroslav Caban 4 5, Elvira Pirondini 1 2 6, Molywan Vat 7, Laura A McCracken 1 2, Roman Heimgartner 1 2, Isabelle Fodor 2, Anne Watrin 4, Perrine Seguin 1 2, Edoardo Paoles 4, Katrien Van Den Keybus 2, Grégoire Eberle 2, Brigitte Schurch 2, Etienne Pralong 7, Fabio Becce 8, John Prior 9, Nicholas Buse 10, Rik Buschman 10, Esra Neufeld 11, Niels Kuster 11 12, Stefano Carda 2, Joachim von Zitzewitz 4, Vincent Delattre 4, Tim Denison 10 13, Hendrik Lambert 4, Karen Minassian # 1 2, Jocelyne Bloch # 2 7 14, Grégoire Courtine # 15 16 17 18

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Targeted neurotechnology restores walking in humans with spinal cord injury

Fabien B Wagner et al. Nature. 2018 Nov.

Abstract

Spinal cord injury leads to severe locomotor deficits or even complete leg paralysis. Here we introduce targeted spinal cord stimulation neurotechnologies that enabled voluntary control of walking in individuals who had sustained a spinal cord injury more than four years ago and presented with permanent motor deficits or complete paralysis despite extensive rehabilitation. Using an implanted pulse generator with real-time triggering capabilities, we delivered trains of spatially selective stimulation to the lumbosacral spinal cord with timing that coincided with the intended movement. Within one week, this spatiotemporal stimulation had re-established adaptive control of paralysed muscles during overground walking. Locomotor performance improved during rehabilitation. After a few months, participants regained voluntary control over previously paralysed muscles without stimulation and could walk or cycle in ecological settings during spatiotemporal stimulation. These results establish a technological framework for improving neurological recovery and supporting the activities of daily living after spinal cord injury.

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