Strategies to advance intraspinal microstimulation toward therapeutic application for restoring function following spinal cord injury.

摘要

Conventional techniques for restoring functional motor control following spinal cord injury rely on electrical stimulation of peripheral nerves and skeletal muscles. However, these techniques have been restricted by practical limitations such as reverse motor recruitment and rapid fatigue onset. The activation of effector motor neurons through intraspinal microstimulation (ISMS) has shown promise for overcoming some of these limitations. However, despite a promising outlook, existing ISMS techniques are not yet suitable for use outside a controlled laboratory environment. Perhaps the most significant barriers have been the inability to target and deliver stimulating electrodes into specific regions of the spinal cord with a high degree of precision and accuracy. Therefore I hypothesized that technology could be developed to move intraspinal microstimulation toward clinical translation as a therapeutic option following spinal cord injury.;The address this hypothesis, I set out to accomplish three aims: 1) to establish wireless control of ISMS to evoke controlled motor function in a rodent model of spinal cord injury; 2) to develop novel spinal cord interface technology for improved surgical targeting, electrode delivery, and selective activation of intraspinal circuitry; and 3) characterize the spatial activation effects of targeted stimulation on neuronal populations within the spinal cord in an in-vivo porcine model of ISMS. Although clinical restoration of functional movement via ISMS remains distant, the technology presented herein represents the first step toward functional independence for individuals with chronic spinal cord injury.