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Mechanisms Underlying the Neuromodulation of Spinal Circuits for Correcting Gait and Balance Deficits after Spinal Cord Injury
Open accessAbstract
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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“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]
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Self-citationWalking naturally after spinal cord injury using a brain–spine interface
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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 .”
BackgroundSelf-citationA brain–spine interface alleviating gait deficits after spinal cord injury in primates
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Metadata
- 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 › Clinical Neurology › 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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