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, Ismael Seáñez, Miroslav Caban, Elvira Pirondini, Molywan Vat, Laura A. McCracken, Roman Heimgartner, Isabelle Fodor, Anne Watrin, Perrine Seguin, Edoardo Paoles, Katrien Keybus, Grégoire Eberle, Brigitte Schurch, Etienne Pralong, Fabio Becce, John Prior, Nicholas Buse, Rik Buschman, Esra Neufeld, Niels Kuster, Stefano Carda, Joachim Zitzewitz, Vincent Delattre, Tim Denison, Hendrik Lambert, Karen Minassian, Jocelyne Bloch and Grégoire Courtine ()
Additional contact information
Fabien B. Wagner: Swiss Federal Institute of Technology (EPFL)
Jean-Baptiste Mignardot: Swiss Federal Institute of Technology (EPFL)
Camille G. Le Goff-Mignardot: Swiss Federal Institute of Technology (EPFL)
Robin Demesmaeker: Swiss Federal Institute of Technology (EPFL)
Salif Komi: Swiss Federal Institute of Technology (EPFL)
Marco Capogrosso: University of Fribourg
Andreas Rowald: Swiss Federal Institute of Technology (EPFL)
Ismael Seáñez: Swiss Federal Institute of Technology (EPFL)
Miroslav Caban: GTXmedical
Elvira Pirondini: Swiss Federal Institute of Technology (EPFL)
Molywan Vat: Lausanne University Hospital (CHUV)
Laura A. McCracken: Swiss Federal Institute of Technology (EPFL)
Roman Heimgartner: Swiss Federal Institute of Technology (EPFL)
Isabelle Fodor: Lausanne University Hospital (CHUV)
Anne Watrin: GTXmedical
Perrine Seguin: Swiss Federal Institute of Technology (EPFL)
Edoardo Paoles: GTXmedical
Katrien Keybus: Lausanne University Hospital (CHUV)
Grégoire Eberle: Lausanne University Hospital (CHUV)
Brigitte Schurch: Lausanne University Hospital (CHUV)
Etienne Pralong: Lausanne University Hospital (CHUV)
Fabio Becce: Lausanne University Hospital (CHUV)
John Prior: Lausanne University Hospital (CHUV)
Nicholas Buse: Medtronic
Rik Buschman: Medtronic
Esra Neufeld: Foundation for Research on Information Technologies in Society (IT’IS)
Niels Kuster: Foundation for Research on Information Technologies in Society (IT’IS)
Stefano Carda: Lausanne University Hospital (CHUV)
Joachim Zitzewitz: GTXmedical
Vincent Delattre: GTXmedical
Tim Denison: Medtronic
Hendrik Lambert: GTXmedical
Karen Minassian: Swiss Federal Institute of Technology (EPFL)
Jocelyne Bloch: Lausanne University Hospital (CHUV)
Grégoire Courtine: Swiss Federal Institute of Technology (EPFL)

Nature, 2018, vol. 563, issue 7729, 65-71

Abstract: Abstract 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.

Keywords: Overground Walking; Spatial Selectivity; Severe Locomotor Deficits; Posterior Root; Motoneuron Pool (search for similar items in EconPapers)
Date: 2018
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Citations: View citations in EconPapers (7)

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DOI: 10.1038/s41586-018-0649-2

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