Recruitment of upper-limb motoneurons with epidural electrical stimulation of the cervical spinal cord

Nathan Greiner (), Beatrice Barra, Giuseppe Schiavone, Henri Lorach, Nicholas James, Sara Conti, Melanie Kaeser, Florian Fallegger, Simon Borgognon, Stéphanie Lacour, Jocelyne Bloch, Grégoire Courtine and Marco Capogrosso ()
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Nathan Greiner: Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL)
Beatrice Barra: University of Fribourg
Giuseppe Schiavone: Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronics Interface, Institute of Microengineering, Institute of Bioengineering, Centre for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne
Henri Lorach: Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL)
Nicholas James: Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL)
Sara Conti: University of Fribourg
Melanie Kaeser: University of Fribourg
Florian Fallegger: Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronics Interface, Institute of Microengineering, Institute of Bioengineering, Centre for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne
Simon Borgognon: Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL)
Stéphanie Lacour: Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronics Interface, Institute of Microengineering, Institute of Bioengineering, Centre for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne
Jocelyne Bloch: Defitech Center for Interventional Neurotherapies (NeuroRestore)
Grégoire Courtine: Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL)
Marco Capogrosso: University of Fribourg

Nature Communications, 2021, vol. 12, issue 1, 1-19

Abstract: Abstract Epidural electrical stimulation (EES) of lumbosacral sensorimotor circuits improves leg motor control in animals and humans with spinal cord injury (SCI). Upper-limb motor control involves similar circuits, located in the cervical spinal cord, suggesting that EES could also improve arm and hand movements after quadriplegia. However, the ability of cervical EES to selectively modulate specific upper-limb motor nuclei remains unclear. Here, we combined a computational model of the cervical spinal cord with experiments in macaque monkeys to explore the mechanisms of upper-limb motoneuron recruitment with EES and characterize the selectivity of cervical interfaces. We show that lateral electrodes produce a segmental recruitment of arm motoneurons mediated by the direct activation of sensory afferents, and that muscle responses to EES are modulated during movement. Intraoperative recordings suggested similar properties in humans at rest. These modelling and experimental results can be applied for the development of neurotechnologies designed for the improvement of arm and hand control in humans with quadriplegia.

Date: 2021
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DOI: 10.1038/s41467-020-20703-1

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