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Targeted neurotechnology restores walking in humans with spinal cord injury.
Journal article

Targeted neurotechnology restores walking in humans with spinal cord injury.

  • Wagner FB Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Mignardot JB Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Le Goff-Mignardot CG Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Demesmaeker R Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Komi S Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Capogrosso M Platform of Translational Neuroscience, Department of Neuroscience and Movement Science, University of Fribourg, Fribourg, Switzerland.
  • Rowald A Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Seáñez I Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Caban M GTXmedical, Lausanne, Switzerland.
  • Pirondini E Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Vat M Department of Neurosurgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
  • McCracken LA Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Heimgartner R Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Fodor I Department of Clinical Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
  • Watrin A GTXmedical, Lausanne, Switzerland.
  • Seguin P Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Paoles E GTXmedical, Lausanne, Switzerland.
  • Van Den Keybus K Department of Clinical Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
  • Eberle G Department of Clinical Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
  • Schurch B Department of Clinical Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
  • Pralong E Department of Neurosurgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
  • Becce F Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
  • Prior J Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
  • Buse N Medtronic, Minneapolis, MN, USA.
  • Buschman R Medtronic, Minneapolis, MN, USA.
  • Neufeld E Foundation for Research on Information Technologies in Society (IT'IS), Zurich, Switzerland.
  • Kuster N Foundation for Research on Information Technologies in Society (IT'IS), Zurich, Switzerland.
  • Carda S Department of Clinical Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
  • von Zitzewitz J GTXmedical, Lausanne, Switzerland.
  • Delattre V GTXmedical, Lausanne, Switzerland.
  • Denison T Medtronic, Minneapolis, MN, USA.
  • Lambert H GTXmedical, Lausanne, Switzerland.
  • Minassian K Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Bloch J Department of Clinical Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
  • Courtine G Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland. gregoire.courtine@epfl.ch.
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  • 2018-11-02
Published in:
  • Nature. - 2018
Activities of Daily Living
Biomedical Technology
Computer Simulation
Electric Stimulation Therapy
Electromyography
Epidural Space
Humans
Leg
Locomotion
Male
Motor Neurons
Muscle, Skeletal
Paralysis
Spinal Cord
Spinal Cord Injuries
Walking
English 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.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/136933
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