Cited by 220Spinal Cord Injury ResearchNeuroscience and Neural EngineeringStroke Rehabilitation and Recovery

Mechanisms Underlying the Neuromodulation of Spinal Circuits for Correcting Gait and Balance Deficits after Spinal Cord Injury

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Moraud, Eduardo Martin, Capogrosso, Marco, Formento, Emanuele, Wenger, Nikolaus, DiGiovanna, Jack, Courtine, Grégoire, Micera, Silvestro·2016·Neuron

Abstract

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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Crossref · 10.1016/j.neuron.2016.01.009

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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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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
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
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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