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Targeted neurotechnology restores walking in humans with spinal cord injury

Author

Listed:
  • Fabien B. Wagner

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV))

  • Jean-Baptiste Mignardot

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV))

  • Camille G. Le Goff-Mignardot

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV))

  • Robin Demesmaeker

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV))

  • Salif Komi

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV))

  • Marco Capogrosso

    (University of Fribourg)

  • Andreas Rowald

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV))

  • Ismael Seáñez

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV))

  • Miroslav Caban

    (GTXmedical
    Swiss Federal Institute of Technology (EPFL))

  • Elvira Pirondini

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV)
    University of Geneva)

  • Molywan Vat

    (Lausanne University Hospital (CHUV))

  • Laura A. McCracken

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV))

  • Roman Heimgartner

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV))

  • Isabelle Fodor

    (Lausanne University Hospital (CHUV))

  • Anne Watrin

    (GTXmedical)

  • Perrine Seguin

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV))

  • 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)
    Swiss Federal Institute of Technology (ETHZ))

  • Stefano Carda

    (Lausanne University Hospital (CHUV))

  • Joachim Zitzewitz

    (GTXmedical)

  • Vincent Delattre

    (GTXmedical)

  • Tim Denison

    (Medtronic
    University of Oxford)

  • Hendrik Lambert

    (GTXmedical)

  • Karen Minassian

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV))

  • Jocelyne Bloch

    (Lausanne University Hospital (CHUV)
    Lausanne University Hospital (CHUV)
    University of Lausanne (UNIL))

  • Grégoire Courtine

    (Swiss Federal Institute of Technology (EPFL)
    Lausanne University Hospital (CHUV)
    Lausanne University Hospital (CHUV)
    University of Lausanne (UNIL))

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.

Suggested Citation

  • 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 & Mol, 2018. "Targeted neurotechnology restores walking in humans with spinal cord injury," Nature, Nature, vol. 563(7729), pages 65-71, November.
    • Handle: RePEc:nat:nature:v:563:y:2018:i:7729:d:10.1038_s41586-018-0649-2
    DOI: 10.1038/s41586-018-0649-2
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    Citations

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    Cited by:

    1. Kai Zhou & Wei Wei & Dan Yang & Hui Zhang & Wei Yang & Yunpeng Zhang & Yingnan Nie & Mingming Hao & Pengcheng Wang & Hang Ruan & Ting Zhang & Shouyan Wang & Yaobo Liu, 2024. "Dual electrical stimulation at spinal-muscular interface reconstructs spinal sensorimotor circuits after spinal cord injury," Nature Communications, Nature, vol. 15(1), pages 1-26, December.
    2. Kaya J. E. Matson & Daniel E. Russ & Claudia Kathe & Isabelle Hua & Dragan Maric & Yi Ding & Jonathan Krynitsky & Randall Pursley & Anupama Sathyamurthy & Jordan W. Squair & Boaz P. Levi & Gregoire Co, 2022. "Single cell atlas of spinal cord injury in mice reveals a pro-regenerative signature in spinocerebellar neurons," Nature Communications, Nature, vol. 13(1), pages 1-16, December.
    3. Maxime Lemieux & Narges Karimi & Frederic Bretzner, 2024. "Functional plasticity of glutamatergic neurons of medullary reticular nuclei after spinal cord injury in mice," Nature Communications, Nature, vol. 15(1), pages 1-15, December.
    4. Ashraf S. Gorgey & Robert Trainer & Tommy W. Sutor & Jacob A. Goldsmith & Ahmed Alazzam & Lance L. Goetz & Denise Lester & Timothy D. Lavis, 2023. "A case study of percutaneous epidural stimulation to enable motor control in two men after spinal cord injury," Nature Communications, Nature, vol. 14(1), pages 1-13, December.
    5. Elisa Donati & Giacomo Valle, 2024. "Neuromorphic hardware for somatosensory neuroprostheses," Nature Communications, Nature, vol. 15(1), pages 1-18, December.
    6. Giacomo Valle & Natalija Katic Secerovic & Dominic Eggemann & Oleg Gorskii & Natalia Pavlova & Francesco M. Petrini & Paul Cvancara & Thomas Stieglitz & Pavel Musienko & Marko Bumbasirevic & Stanisa R, 2024. "Biomimetic computer-to-brain communication enhancing naturalistic touch sensations via peripheral nerve stimulation," Nature Communications, Nature, vol. 15(1), pages 1-18, December.

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