Targeted neurotechnology restores walking in humans with spinal cord injury

被引：623

作者：

Wagner, Fabien B. ^{[1
,2
]}

Mignardot, Jean-Baptiste ^{[1
,2
]}

Le Goff-Mignardot, Camille G. ^{[1
,2
]}

Demesmaeker, Robin ^{[1
,2
]}

Komi, Salif ^{[1
,2
]}

Capogrosso, Marco ^{[3
]}

Rowald, Andreas ^{[1
,2
]}

Seanez, Ismael ^{[1
,2
]}

Caban, Miroslav ^{[4
,5
]}

Pirondini, Elvira ^{[1
,2
,6
]}

Vat, Molywan ^{[7
]}

McCracken, Laura A. ^{[1
,2
]}

Heimgartner, Roman ^{[1
,2
]}

Fodor, Isabelle ^{[2
]}

Watrin, Anne ^{[4
]}

Seguin, Perrine ^{[1
,2
]}

Paoles, Edoardo ^{[4
]}

Van Den Keybus, Katrien ^{[2
]}

Eberle, Gregoire ^{[2
]}

Schurch, Brigitte ^{[2
]}

Pralong, Etienne ^{[7
]}

Becce, Fabio ^{[8
]}

Prior, John ^{[9
]}

Buse, Nicholas ^{[10
]}

Buschman, Rik ^{[10
]}

Neufeld, Esra ^{[11
]}

Kuster, Niels ^{[11
,12
]}

Carda, Stefano ^{[2
]}

von Zitzewitz, Joachim ^{[4
]}

Delattre, Vincent ^{[4
]}

Denison, Tim ^{[10
,13
]}

Lambert, Hendrik ^{[4
]}

Minassian, Karen ^{[1
,2
]}

Bloch, Jocelyne ^{[2
,7
,14
]}

Courtine, Gregoire ^{[1
,2
,7
,14
]}

机构：

[1] Swiss Fed Inst Technol EPFL, Sch Life Sci, Ctr Neuroprosthet & Brain Mind Inst, Lausanne, Switzerland

[2] Lausanne Univ Hosp CHUV, Dept Clin Neurosci, Lausanne, Switzerland

[3] Univ Fribourg, Dept Neurosci & Movement Sci, Platform Translat Neurosci, Fribourg, Switzerland

[4] GTXmedical, Lausanne, Switzerland

[5] Swiss Fed Inst Technol EPFL, Inst Bioengn, Lausanne, Switzerland

[6] Univ Geneva, Dept Radiol & Med Informat, Geneva, Switzerland

[7] Lausanne Univ Hosp CHUV, Dept Neurosurg, Lausanne, Switzerland

[8] Lausanne Univ Hosp CHUV, Dept Diagnost & Intervent Radiol, Lausanne, Switzerland

[9] Lausanne Univ Hosp CHUV, Dept Nucl Med & Mol Imaging, Lausanne, Switzerland

[10] Medtronic, Minneapolis, MN USA

[11] Fdn Res Informat Technol Soc ITIS, Zurich, Switzerland

[12] Swiss Fed Inst Technol ETHZ, Dept Informat Technol & Elect Engn, Zurich, Switzerland

[13] Univ Oxford, Dept Engn Sci, Oxford, England

[14] Univ Lausanne UNIL, Fac Biol & Med, Lausanne, Switzerland

来源：

NATURE | 2018年 / 563卷 / 7729期

基金：

欧盟地平线“2020”;

关键词：

EPIDURAL ELECTRICAL-STIMULATION; RANDOMIZED CLINICAL-TRIAL; ACTIVITY-BASED THERAPY; CIRCUIT REORGANIZATION; MOTOR FUNCTION; RECOVERY; LOCOMOTION; NEUROMODULATION; PLASTICITY; EXCITABILITY;

D O I：

10.1038/s41586-018-0649-2

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Spinal cord injury leads to severe locomotor deficits or even complete leg paralysis. Here we introduce targeted spinal cord stimulation neurotechnologies that enabled voluntary control of walking in individuals who had sustained a spinal cord injury more than four years ago and presented with permanent motor deficits or complete paralysis despite extensive rehabilitation. Using an implanted pulse generator with real-time triggering capabilities, we delivered trains of spatially selective stimulation to the lumbosacral spinal cord with timing that coincided with the intended movement. Within one week, this spatiotemporal stimulation had re-established adaptive control of paralysed muscles during overground walking. Locomotor performance improved during rehabilitation. After a few months, participants regained voluntary control over previously paralysed muscles without stimulation and could walk or cycle in ecological settings during spatiotemporal stimulation. These results establish a technological framework for improving neurological recovery and supporting the activities of daily living after spinal cord injury.

引用

页码：65 / +

页数：25

共 50 条

[1] Targeted neurotechnology restores walking in humans with spinal cord injury
Fabien B. Wagner
Jean-Baptiste Mignardot
Camille G. Le Goff-Mignardot
Robin Demesmaeker
Salif Komi
Marco Capogrosso
Andreas Rowald
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Elvira Pirondini
Molywan Vat
Laura A. McCracken
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[J]. Nature, 2018, 563 : 65 - 71
[2] Targeted Neurotechnology RestoresWalking in Humans with Spinal Cord Injury
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