Department of Neurosciences and Groupe de recherche sur le système nerveux central (GRSNC), Université de Montréal, Montréal, Québec H3T 1N8, Canada.
CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Québec H4J 1C5, Canada.
Sci Transl Med. 2021 Mar 24;13(586). doi: 10.1126/scitranslmed.abb4422.
Most rehabilitation interventions after spinal cord injury (SCI) only target the sublesional spinal networks, peripheral nerves, and muscles. However, mammalian locomotion is not a mere act of rhythmic pattern generation. Recovery of cortical control is essential for voluntary movement and modulation of gait. We developed an intracortical neuroprosthetic intervention to SCI, with the goal to condition cortical locomotor control. Neurostimulation delivered in phase coherence with ongoing locomotion immediately alleviated primary SCI deficits, such as leg dragging, in rats with incomplete SCI. Cortical neurostimulation achieved high fidelity and markedly proportional online control of leg trajectories in both healthy and SCI rats. Long-term neuroprosthetic training lastingly improved cortical control of locomotion, whereas short training held transient improvements. We performed longitudinal awake cortical motor mapping, unveiling that recovery of cortico-spinal transmission tightly parallels return of locomotor function in rats. These results advocate directly targeting the motor cortex in clinical neuroprosthetic approaches.
大多数脊髓损伤 (SCI) 后的康复干预措施仅针对亚损伤脊髓网络、外周神经和肌肉。然而，哺乳动物的运动不仅仅是一种节律模式的产生。皮质控制的恢复对于自主运动和步态调节至关重要。我们开发了一种针对 SCI 的皮质内神经假体干预措施，旨在调节皮质运动控制。与正在进行的运动同步传递的神经刺激立即缓解了不完全性 SCI 大鼠的主要 SCI 缺陷，如腿部拖拽。皮质神经刺激在健康大鼠和 SCI 大鼠中实现了腿部轨迹的高保真度和显著的在线比例控制。长期神经假体训练可持久改善皮质对运动的控制，而短期训练则具有短暂的改善效果。我们进行了纵向清醒皮质运动映射，揭示出皮质脊髓传递的恢复与大鼠运动功能的恢复紧密相关。这些结果提倡在临床神经假体方法中直接针对运动皮层。
