title: Cervical intraspinal microstimulation evokes robust forelimb movements before and after injury.
abstract: OBJECTIVE
  Intraspinal microstimulation (ISMS) is a promising method for reanimating paralyzed limbs following neurological injury. ISMS within the cervical and lumbar spinal cord is capable of evoking a variety of highly-functional movements prior to injury, but the ability of ISMS to evoke forelimb movements after cervical spinal cord injury is unknown. Here we examine the forelimb movements and muscles activated by cervical ISMS both before and after contusion injury.
  
  
  METHODS
  We documented the forelimb muscles activated and movements evoked via systematic stimulation of the rodent cervical spinal cord both before injury and three, six and nine weeks following a moderate C4/C5 lateralized contusion injury. Animals were anesthetized with isoflurane to permit construction of somatotopic maps of evoked movements and quantify evoked muscle synergies between cervical segments C3 and T1.
  
  
  RESULTS
  When ISMS was delivered to the cervical spinal cord, a variety of responses were observed at 68% of locations tested, with a spatial distribution that generally corresponded to the location of motor neuron pools. Stimulus currents required to achieve movement and the number of sites where movements could be evoked were unchanged by spinal cord injury. A transient shift toward extension-dominated movements and restricted muscle synergies were observed at three and six weeks following injury, respectively. By nine weeks after injury, however, ISMS-evoked patterns were similar to spinally-intact animals.
  
  
  CONCLUSIONS
  The results demonstrate the potential for cervical ISMS to reanimate hand and arm function following spinal cord injury. Robust forelimb movements can be evoked both before and during the chronic stages of recovery from a clinically relevant and sustained cervical contusion injury.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Sunshine
authors.forename: Frances S
authors.initials: FS
authors.lastname: Cho
authors.forename: Danielle R
authors.initials: DR
authors.lastname: Lockwood
authors.forename: Amber S
authors.initials: AS
authors.lastname: Fechko
authors.forename: Michael R
authors.initials: MR
authors.lastname: Kasten
authors.forename: Chet T
authors.initials: CT
authors.lastname: Moritz
mesh_terms: D000818:Animals; D002574:Cervical Vertebrae / Q000503:physiopathology; D005260:Female; D005552:Forelimb / Q000294:innervation* / Q000503:physiopathology*; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010243:Paralysis / Q000503:physiopathology* / Q000534:rehabilitation*; D051381:Rats; D020318:Rats, Long-Evans; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation*; D062187:Spinal Cord Stimulation; D016896:Treatment Outcome
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