Automated Tools to Improve Spinal Cord Injury Outcomes with Epidural Stimulation

The Spinal Cord Injury (SCI) patient population suffers not only from severe restrictions of sensory and motor function, but also impacts on a range of autonomic nervous system functions. This can include orthostatic hypotension and reduced bladder function. The significant health issues in this pop...

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Bibliographic Details
Main Authors: Johnson, Erik C., Matelsky, Jordan K., Cooke, Christa, Christie, Breanne, Jones, Khalid, Ledbetter, Harley, Wang, Siqi, Forrest, Gail, Torgerson, Nathan, Angeli, Claudia A., Harkema, Susan J., Tenore, Francesco V.
Format: Conference Proceeding
Language:English
Subjects:
automatic seg-mentation
Bladder
epidural stimulation
Modulation
Neural engineering
Prototypes
real-time control
Real-time systems
Sociology
spinal cord injury
Visualization
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Summary:The Spinal Cord Injury (SCI) patient population suffers not only from severe restrictions of sensory and motor function, but also impacts on a range of autonomic nervous system functions. This can include orthostatic hypotension and reduced bladder function. The significant health issues in this population require technological developments in order to im-prove patient outcomes and restore key healthy functions. Spinal cord epidural stimulation (scES), a new approach, has the potential to regulate systolic blood pressure, improve bladder function, and restore sensory and motor activity in people with SCI through targeted modulation of neural populations in the spinal cord. Here, we present two innovative tools for improving efficacy of scES. The first is a technique for automatic segmen-tation and visualization to aid in individualized placement of epidural stimulation electrodes. The second is a system for closed loop control of stimulation parameters for epidural stimulation, capable of implementing real-time control algorithms based on sensory measurements to modify therapy parameters. This is implemented as an application on a tablet for future clinical and at home testing. Preliminary prototypes of each system are described and demonstrated, to motivate future closed-loop studies in a clinical setting. Taken together, these novel visualization and control tools can overcome critical barriers to improve outcomes for SCI patients using scES.
ISSN:1948-3554
DOI:10.1109/NER52421.2023.10123805