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. 2014 Feb 27:8:21.
doi: 10.3389/fnins.2014.00021. eCollection 2014.

Therapeutic intraspinal stimulation to generate activity and promote long-term recovery

Sarah E Mondello  1 , Michael R Kasten  2 , Philip J Horner  3 , Chet T Moritz  4
Affiliations

Therapeutic intraspinal stimulation to generate activity and promote long-term recovery

Sarah E Mondello et al. Front Neurosci. .

Abstract

Neuroprosthetic approaches have tremendous potential for the treatment of injuries to the brain and spinal cord by inducing appropriate neural activity in otherwise disordered circuits. Substantial work has demonstrated that stimulation applied to both the central and peripheral nervous system leads to immediate and in some cases sustained benefits after injury. Here we focus on cervical intraspinal microstimulation (ISMS) as a promising method of activating the spinal cord distal to an injury site, either to directly produce movements or more intriguingly to improve subsequent volitional control of the paretic extremities. Incomplete injuries to the spinal cord are the most commonly observed in human patients, and these injuries spare neural tissue bypassing the lesion that could be influenced by neural devices to promote recovery of function. In fact, recent results have demonstrated that therapeutic ISMS leads to modest but sustained improvements in forelimb function after an incomplete spinal cord injury (SCI). This therapeutic spinal stimulation may promote long-term recovery of function by providing the necessary electrical activity needed for neuron survival, axon growth, and synaptic stability.

Keywords: ISMS; electrical activity; neuroprosthesis; regenerative stimulation; spinal cord injury.

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Figures

Figure 1
Figure 1
Schematic illustrating the placement of intraspinal microstimulation (ISMS) electrodes and epidural stimulation electrodes caudal to a spinal cord injury. ISMS electrodes penetrate the spinal cord to target the intermediate and ventral gray matter for activation of local spinal circuits. Epidural stimulation electrodes reside on the dorsal surface of the spinal cord, most likely activating the dorsal root entry zones or dorsal columns.
Figure 2
Figure 2
Example of rapid recovery of forelimb reaching ability for one animal receiving therapeutic ISMS, compared to an unstimulated animal. After 5 weeks, stimulation was halted due to implant failure, allowing examination of sustained recovery with no further stimulation. Mean + SD for each animal.
See this image and copyright information in PMC

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