Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia

Megan L. Gill, Peter J. Grahn, Jonathan S. Calvert, Margaux B. Linde, Igor A. Lavrov, Jeffrey A. Strommen, Lisa A. Beck, Dimitry G. Sayenko, Meegan G. Van Straaten, Dina I. Drubach, Daniel D. Veith, Andrew R. Thoreson, Cesar Lopez, Yury P. Gerasimenko, V. Reggie Edgerton, Kendall H Lee, Kristin D Zhao

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Spinal sensorimotor networks that are functionally disconnected from the brain because of spinal cord injury (SCI) can be facilitated via epidural electrical stimulation (EES) to restore robust, coordinated motor activity in humans with paralysis1–3. Previously, we reported a clinical case of complete sensorimotor paralysis of the lower extremities in which EES restored the ability to stand and the ability to control step-like activity while side-lying or suspended vertically in a body-weight support system (BWS)4. Since then, dynamic task-specific training in the presence of EES, termed multimodal rehabilitation (MMR), was performed for 43 weeks and resulted in bilateral stepping on a treadmill, independent from trainer assistance or BWS. Additionally, MMR enabled independent stepping over ground while using a front-wheeled walker with trainer assistance at the hips to maintain balance. Furthermore, MMR engaged sensorimotor networks to achieve dynamic performance of standing and stepping. To our knowledge, this is the first report of independent stepping enabled by task-specific training in the presence of EES by a human with complete loss of lower extremity sensorimotor function due to SCI.

Original languageEnglish (US)
JournalNature Medicine
DOIs
StateAccepted/In press - Jan 1 2018

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Paraplegia
Patient rehabilitation
Electric Stimulation
Aptitude
Rehabilitation
Spinal Cord Injuries
Exercise equipment
Body Weight
Brain
Hip
Lower Extremity
Motor Activity

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia. / Gill, Megan L.; Grahn, Peter J.; Calvert, Jonathan S.; Linde, Margaux B.; Lavrov, Igor A.; Strommen, Jeffrey A.; Beck, Lisa A.; Sayenko, Dimitry G.; Van Straaten, Meegan G.; Drubach, Dina I.; Veith, Daniel D.; Thoreson, Andrew R.; Lopez, Cesar; Gerasimenko, Yury P.; Edgerton, V. Reggie; Lee, Kendall H; Zhao, Kristin D.

In: Nature Medicine, 01.01.2018.

Research output: Contribution to journalArticle

Gill, ML, Grahn, PJ, Calvert, JS, Linde, MB, Lavrov, IA, Strommen, JA, Beck, LA, Sayenko, DG, Van Straaten, MG, Drubach, DI, Veith, DD, Thoreson, AR, Lopez, C, Gerasimenko, YP, Edgerton, VR, Lee, KH & Zhao, KD 2018, 'Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia', Nature Medicine. https://doi.org/10.1038/s41591-018-0175-7
Gill, Megan L. ; Grahn, Peter J. ; Calvert, Jonathan S. ; Linde, Margaux B. ; Lavrov, Igor A. ; Strommen, Jeffrey A. ; Beck, Lisa A. ; Sayenko, Dimitry G. ; Van Straaten, Meegan G. ; Drubach, Dina I. ; Veith, Daniel D. ; Thoreson, Andrew R. ; Lopez, Cesar ; Gerasimenko, Yury P. ; Edgerton, V. Reggie ; Lee, Kendall H ; Zhao, Kristin D. / Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia. In: Nature Medicine. 2018.
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