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Epidural and transcutaneous spinal cord stimulation facilitates descending inputs to upper-limb motoneurons in monkeys
Objective. There is renewed interest in epidural and transcutaneous spinal cord stimulation (SCS) as a therapy following spinal cord injury, both to reanimate paralyzed muscles as well as to potentiate weakened volitional control of movements. However, most work to date has focussed on lumbar SCS fo...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
IOP Publishing
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208633/ https://www.ncbi.nlm.nih.gov/pubmed/33540399 http://dx.doi.org/10.1088/1741-2552/abe358 |
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author | Guiho, Thomas Baker, Stuart N Jackson, Andrew |
author_facet | Guiho, Thomas Baker, Stuart N Jackson, Andrew |
author_sort | Guiho, Thomas |
collection | PubMed |
description | Objective. There is renewed interest in epidural and transcutaneous spinal cord stimulation (SCS) as a therapy following spinal cord injury, both to reanimate paralyzed muscles as well as to potentiate weakened volitional control of movements. However, most work to date has focussed on lumbar SCS for restoration of locomotor function. Therefore, we examined upper-limb muscle responses and modulation of supraspinal-evoked movements by different frequencies of cervical SCS delivered to various epidural and transcutaneous sites in anaesthetized, neurologically intact monkeys. Approach. Epidural SCS was delivered via a novel multielectrode cuff placed around both dorsal and ventral surfaces of the cervical spinal cord, while transcutaneous SCS was delivered using a high carrier frequency through surface electrodes. Main results. Ventral epidural SCS elicited robust movements at lower current intensities than dorsal sites, with evoked motor unit potentials that reliably followed even high-frequency trains. By contrast, the muscle responses to dorsal SCS required higher current intensities and were attenuated throughout the train. However, dorsal epidural SCS and, to a lesser extent, transcutaneous SCS were effective at facilitating supraspinal-evoked responses, especially at intermediate stimulation frequencies. The time- and frequency-dependence of dorsal SCS effects could be explained by a simple model in which transynaptic excitation of motoneurons was gated by prior stimuli through presynaptic mechanisms. Significance. Our results suggest that multicontact electrodes allowing access to both dorsal and ventral epidural sites may be beneficial for combined therapeutic purposes, and that the interaction of direct, synaptic and presynaptic effects should be considered when optimising SCS-assisted rehabilitation. |
format | Online Article Text |
id | pubmed-8208633 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | IOP Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-82086332021-06-17 Epidural and transcutaneous spinal cord stimulation facilitates descending inputs to upper-limb motoneurons in monkeys Guiho, Thomas Baker, Stuart N Jackson, Andrew J Neural Eng Paper Objective. There is renewed interest in epidural and transcutaneous spinal cord stimulation (SCS) as a therapy following spinal cord injury, both to reanimate paralyzed muscles as well as to potentiate weakened volitional control of movements. However, most work to date has focussed on lumbar SCS for restoration of locomotor function. Therefore, we examined upper-limb muscle responses and modulation of supraspinal-evoked movements by different frequencies of cervical SCS delivered to various epidural and transcutaneous sites in anaesthetized, neurologically intact monkeys. Approach. Epidural SCS was delivered via a novel multielectrode cuff placed around both dorsal and ventral surfaces of the cervical spinal cord, while transcutaneous SCS was delivered using a high carrier frequency through surface electrodes. Main results. Ventral epidural SCS elicited robust movements at lower current intensities than dorsal sites, with evoked motor unit potentials that reliably followed even high-frequency trains. By contrast, the muscle responses to dorsal SCS required higher current intensities and were attenuated throughout the train. However, dorsal epidural SCS and, to a lesser extent, transcutaneous SCS were effective at facilitating supraspinal-evoked responses, especially at intermediate stimulation frequencies. The time- and frequency-dependence of dorsal SCS effects could be explained by a simple model in which transynaptic excitation of motoneurons was gated by prior stimuli through presynaptic mechanisms. Significance. Our results suggest that multicontact electrodes allowing access to both dorsal and ventral epidural sites may be beneficial for combined therapeutic purposes, and that the interaction of direct, synaptic and presynaptic effects should be considered when optimising SCS-assisted rehabilitation. IOP Publishing 2021-08 2021-03-22 /pmc/articles/PMC8208633/ /pubmed/33540399 http://dx.doi.org/10.1088/1741-2552/abe358 Text en © 2021 The Author(s). Published by IOP Publishing Ltd https://creativecommons.org/licenses/by/4.0/ Original content from this work may be used under the terms of the Creative Commons Attribution 4.0 license (https://creativecommons.org/licenses/by/4.0/) . Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI. |
spellingShingle | Paper Guiho, Thomas Baker, Stuart N Jackson, Andrew Epidural and transcutaneous spinal cord stimulation facilitates descending inputs to upper-limb motoneurons in monkeys |
title | Epidural and transcutaneous spinal cord stimulation facilitates descending inputs to upper-limb motoneurons in monkeys |
title_full | Epidural and transcutaneous spinal cord stimulation facilitates descending inputs to upper-limb motoneurons in monkeys |
title_fullStr | Epidural and transcutaneous spinal cord stimulation facilitates descending inputs to upper-limb motoneurons in monkeys |
title_full_unstemmed | Epidural and transcutaneous spinal cord stimulation facilitates descending inputs to upper-limb motoneurons in monkeys |
title_short | Epidural and transcutaneous spinal cord stimulation facilitates descending inputs to upper-limb motoneurons in monkeys |
title_sort | epidural and transcutaneous spinal cord stimulation facilitates descending inputs to upper-limb motoneurons in monkeys |
topic | Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208633/ https://www.ncbi.nlm.nih.gov/pubmed/33540399 http://dx.doi.org/10.1088/1741-2552/abe358 |
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