Altering spinal cord excitability enables voluntary movements after chronic complete paralysis in humans
- PMID: 24713270
- PMCID: PMC3999714
- DOI: 10.1093/brain/awu038
Altering spinal cord excitability enables voluntary movements after chronic complete paralysis in humans
Erratum in
- Brain. 2015 Feb;138(Pt 2):e330
Abstract
Previously, we reported that one individual who had a motor complete, but sensory incomplete spinal cord injury regained voluntary movement after 7 months of epidural stimulation and stand training. We presumed that the residual sensory pathways were critical in this recovery. However, we now report in three more individuals voluntary movement occurred with epidural stimulation immediately after implant even in two who were diagnosed with a motor and sensory complete lesion. We demonstrate that neuromodulating the spinal circuitry with epidural stimulation, enables completely paralysed individuals to process conceptual, auditory and visual input to regain relatively fine voluntary control of paralysed muscles. We show that neuromodulation of the sub-threshold motor state of excitability of the lumbosacral spinal networks was the key to recovery of intentional movement in four of four individuals diagnosed as having complete paralysis of the legs. We have uncovered a fundamentally new intervention strategy that can dramatically affect recovery of voluntary movement in individuals with complete paralysis even years after injury.
Keywords: epidural stimulation; human spinal cord injury; voluntary movement.
Figures
Comment in
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Enabling motor control in chronic spinal cord injury: found in translation.Brain. 2014 May;137(Pt 5):1277-80. doi: 10.1093/brain/awu087. Brain. 2014. PMID: 24771399 No abstract available.
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Complete spinal cord injury: an indication for spinal cord stimulation?Neurosurgery. 2014 Oct;75(4):N23-4. doi: 10.1227/01.neu.0000454764.67990.cb. Neurosurgery. 2014. PMID: 25232793 No abstract available.
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No dawn yet of a new age in spinal cord rehabilitation.Brain. 2015 Jul;138(Pt 7):e362. doi: 10.1093/brain/awu371. Epub 2014 Dec 23. Brain. 2015. PMID: 25539903 No abstract available.
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