title: Therapeutic intraspinal stimulation to generate activity and promote long-term recovery.
abstract: Neuroprosthetic approaches have tremendous potential for the treatment of injuries to the brain and spinal cord by inducing appropriate neural activity in otherwise disordered circuits. Substantial work has demonstrated that stimulation applied to both the central and peripheral nervous system leads to immediate and in some cases sustained benefits after injury. Here we focus on cervical intraspinal microstimulation (ISMS) as a promising method of activating the spinal cord distal to an injury site, either to directly produce movements or more intriguingly to improve subsequent volitional control of the paretic extremities. Incomplete injuries to the spinal cord are the most commonly observed in human patients, and these injuries spare neural tissue bypassing the lesion that could be influenced by neural devices to promote recovery of function. In fact, recent results have demonstrated that therapeutic ISMS leads to modest but sustained improvements in forelimb function after an incomplete spinal cord injury (SCI). This therapeutic spinal stimulation may promote long-term recovery of function by providing the necessary electrical activity needed for neuron survival, axon growth, and synaptic stability.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington Seattle, WA, USA ; Department of Neurological Surgery, University of Washington Seattle, WA, USA ; Center for Sensorimotor Neural Engineering, University of Washington Seattle, WA, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Mondello
authors.affiliation: Department of Rehabilitation Medicine, University of Washington Seattle, WA, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Kasten
authors.affiliation: Department of Neurological Surgery, University of Washington Seattle, WA, USA ; Graduate Program in Neurobiology and Behavior, University of Washington Seattle, WA, USA.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Horner
authors.affiliation: Department of Rehabilitation Medicine, University of Washington Seattle, WA, USA ; Center for Sensorimotor Neural Engineering, University of Washington Seattle, WA, USA ; Graduate Program in Neurobiology and Behavior, University of Washington Seattle, WA, USA ; Department of Physiology and Biophysics, University of Washington Seattle, WA, USA.
authors.forename: Chet T
authors.initials: CT
authors.lastname: Moritz
keywords: ISMS; electrical activity; neuroprosthesis; regenerative stimulation; spinal cord injury