Restoring voluntary control of locomotion after paralyzing spinal cord injury.
Half of human spinal cord injuries lead to chronic paralysis. Here, we introduce an electrochemical neuroprosthesis and a robotic postural interface designed to encourage supraspinally mediated movements in rats with paralyzing lesions. Despite the interruption of direct supraspinal pathways, the cortex regained the capacity to transform contextual information into task-specific commands to execute refined locomotion. This recovery relied on the extensive remodeling of cortical projections, including the formation of brainstem and intraspinal relays that restored qualitative control over electrochemically enabled lumbosacral circuitries. Automated treadmill-restricted training, which did not engage cortical neurons, failed to promote translesional plasticity and recovery. By encouraging active participation under functional states, our training paradigm triggered a cortex-dependent recovery that may improve function after similar injuries in humans.
Neurology Department, University of Zurich, CH-8008 Zurich, Switzerland.
Rubia
R
van den Brand
Janine
J
Heutschi
Quentin
Q
Barraud
Jack
J
DiGiovanna
Kay
K
Bartholdi
Michèle
M
Huerlimann
Lucia
L
Friedli
Isabel
I
Vollenweider
Eduardo Martin
EM
Moraud
Simone
S
Duis
Nadia
N
Dominici
Silvestro
S
Micera
Pavel
P
Musienko
Grégoire
G
Courtine
D000818:Animals; D001369:Axons / Q000502:physiology; D001933:Brain Stem / Q000502:physiology; D018491:Dopamine Agonists / Q000008:administration & dosage; D004558:Electric Stimulation; D005260:Female; D005684:Gait; D006614:Hindlimb / Q000502:physiology*; D008124:Locomotion; D009044:Motor Cortex / Q000502:physiology*; D009412:Nerve Fibers / Q000502:physiology; D009473:Neuronal Plasticity; D009474:Neurons / Q000502:physiology; D010243:Paralysis / Q000503:physiopathology / Q000534:rehabilitation*; D011712:Pyramidal Tracts / Q000166:cytology / Q000502:physiology*; D051381:Rats; D011917:Rats, Inbred Lew; D020127:Recovery of Function; D012371:Robotics; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage; D013116:Spinal Cord / Q000166:cytology / Q000502:physiology; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*
D018491:Dopamine Agonists; D017366:Serotonin Receptor Agonists