Mechanisms Underlying the Neuromodulation of Spinal Circuits for Correcting Gait and Balance Deficits after Spinal Cord Injury
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Epidural electrical stimulation of lumbar segments facilitates standing and walking in animal models and humans with spinal cord injury. However, the mechanisms through which this neuromodulation therapy engages spinal circuits remain enigmatic. Using computer simulations and behavioral experiments, we provide evidence that epidural electrical stimulation interacts with muscle spindle feedback circuits to modulate muscle activity during locomotion. Hypothesis-driven strategies emerging from simulations steered the design of stimulation protocols that adjust bilateral hindlimb kinematics throughout gait execution. These stimulation strategies corrected subject-specific gait and balance deficits in rats with incomplete and complete spinal cord injury. The conservation of muscle spindle feedback circuits across mammals suggests that the same mechanisms may facilitate motor control in humans. These results provide a conceptual framework to improve stimulation protocols for clinical applications.
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Epidural electrical stimulation targeting individual dorsal root entry zones of the lumbosacral spinal cord enables modulation of specific leg motor pools.
“We previously showed that epidural electrical stimulation targeting the individual dorsal root entry zones of the lumbosacral spinal cord enables the modulation of specific leg motor pools9–12.”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [12]
The section “Exploiting Spinal Circuit Dynamics” (p. 5) reports that phase-specific epidural stimulation selectively modulated extensor and flexor muscle activity, supporting modulation of distinct leg motor circuits. But the Surgical Procedures (p. 13) place stimulation electrodes at the spinal midline at L2 and S1; the cited passages do not establish targeting of individual dorsal root entry zones. (LLM, conf=0.86)
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“We previously showed that epidural electrical stimulation targeting the individual dorsal root entry zones of the lumbosacral spinal cord enables the modulation of specific leg motor pools 9–12 .”
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Self-citationIntrathecal Therapeutics: Device Design, Access Methods, and Complication Mitigation
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Intrinsic Axonal Growth and the Drive for Regeneration
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Physiological effects of cathodal electrode configuration for transspinal stimulation in humans
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A wireless spinal stimulation system for ventral activation of the rat cervical spinal cord
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Self-citationIn vivoelectrophysiological mechanisms underlying cervical epidural stimulation in adult rats
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Control of Mammalian Locomotion by Somatosensory Feedback
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Self-citationMolecular Determinants of Mechanical Itch Sensitization in Chronic Itch
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Spinal stimulation for motor rehabilitation immediately modulates nociceptive transmission
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Self-citationCurated Model Development Using NEUROiD: A Web-Based NEUROmotor Integration and Design Platform
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Spinal sensory circuits in motion
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- Authors
- Moraud, E. M., Capogrosso, M., Formento, E., Wenger, N., DiGiovanna, J., Courtine, G., & Micera, S.
- Affiliations
- École Polytechnique Fédérale de Lausanne (CH)
- Scuola Superiore Sant'Anna (IT)
- Corresponding author
- Courtine, Grégoire
- Micera, Silvestro
- ORCID
- Venue
- Neuron
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 89
- Issue
- 4
- Pages
- 814-828
- ISSN
- 0896-6273 (ISSN-L)
- OpenAlex
- W2255557036
- Cited by
- 220
- References
- 56
- Citations by year
- 2026: 19 · 2025: 30 · 2024: 29 · 2023: 18 · 2022: 26 · 2021: 28 · 2020: 21 · 2019: 15 · 2018: 14 · 2017: 12 · 2016: 8
- FWCI
- 14.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Neuron (publishedVersion)
- PubMed (publishedVersion)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion)
- CINECA IRIS Institutional Research Information System (Sant'Anna School of Advanced Studies) (submittedVersion)
- Funders
- Fondation Bertarelli
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (269921)
- Berlin Institute of Health
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- epidural stimulation, spinal cord injury, gait rehabilitation, balance deficits, spinal cord circuits, locomotion, hindlimb kinematics, incomplete spinal cord injury, complete spinal cord injury
- MeSH terms
- Analysis of Variance, Animals, Biomechanical Phenomena, Computer Simulation, Electromyography, Electric Stimulation Therapy, Postural Balance, Female, Hindlimb, Locomotion, Models, Neurological, Motor Neurons, Nerve Net, Rats, Inbred Lew, Sensation Disorders, Spinal Cord Injuries, Gait Disorders, Neurologic, Feedback, Physiological, Rats
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