Targeted, activity-dependent spinal stimulation produces long-lasting motor recovery in chronic cervical spinal cord injury

Use-dependent movement therapies can lead to partial recovery of motor function after neurological injury. We attempted to improve recovery by developing a neuroprosthetic intervention that enhances movement therapy by directing spike timing-dependent plasticity in spared motor pathways. Using a rec...

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Bibliographic Details
Published in:Proceedings of the National Academy of Sciences - PNAS 2015-09, Vol.112 (39), p.12193-12198
Main Authors: McPherson, Jacob G., Miller, Robert R., Perlmutter, Steve I.
Format: Article
Language:English
Subjects:
Animals
Biological Sciences
Biomechanics
Cervical Cord - injuries
Comparative analysis
Electric Stimulation
Electromyography
Motor ability
Neurology
Neuronal Plasticity - physiology
Physical Therapy Modalities
Rats
Recovery of Function - physiology
Rodents
Spinal cord injuries
Spinal Cord Injuries - rehabilitation
Spinal Cord Injuries - therapy
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Summary:Use-dependent movement therapies can lead to partial recovery of motor function after neurological injury. We attempted to improve recovery by developing a neuroprosthetic intervention that enhances movement therapy by directing spike timing-dependent plasticity in spared motor pathways. Using a recurrent neural–computer interface in rats with a cervical contusion of the spinal cord, we synchronized intraspinal microstimulation below the injury with the arrival of functionally related volitional motor commands signaled by muscle activity in the impaired forelimb. Stimulation was delivered during physical retraining of a forelimb behavior and throughout the day for 3 mo. Rats receiving this targeted, activity-dependent spinal stimulation (TADSS) exhibited markedly enhanced recovery compared with animals receiving targeted but open-loop spinal stimulation and rats receiving physical retraining alone. On a forelimb reach and grasp task, TADSS animals recovered 63% of their preinjury ability, more than two times the performance level achieved by the other therapy groups. Therapeutic gains were maintained for 3 additional wk without stimulation. The results suggest that activitydependent spinal stimulation can induce neural plasticity that improves behavioral recovery after spinal cord injury.
ISSN:0027-8424
1091-6490
DOI:10.1073/pnas.1505383112