Recruitment of upper-limb motoneurons with epidural electrical stimulation of the cervical spinal cord
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Abstract
Epidural electrical stimulation (EES) of lumbosacral sensorimotor circuits improves leg motor control in animals and humans with spinal cord injury (SCI). Upper-limb motor control involves similar circuits, located in the cervical spinal cord, suggesting that EES could also improve arm and hand movements after quadriplegia. However, the ability of cervical EES to selectively modulate specific upper-limb motor nuclei remains unclear. Here, we combined a computational model of the cervical spinal cord with experiments in macaque monkeys to explore the mechanisms of upper-limb motoneuron recruitment with EES and characterize the selectivity of cervical interfaces. We show that lateral electrodes produce a segmental recruitment of arm motoneurons mediated by the direct activation of sensory afferents, and that muscle responses to EES are modulated during movement. Intraoperative recordings suggested similar properties in humans at rest. These modelling and experimental results can be applied for the development of neurotechnologies designed for the improvement of arm and hand control in humans with quadriplegia.
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Optimized configurations of anodes and cathodes can steer electric fields towards specific subsets of dorsal root entry zones to modulate well-defined ensembles of motor neuron pools.
“In turn, optimized configurations of anodes and cathodes can steer electric fields towards specific subsets of dorsal root entry zones to modulate well-defined ensembles of motor neuron pools5,9,25.”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [25]
The Results (‘Design of cervical spinal implants’; page not available) report that lateral electrodes can target fibers of an individual dorsal root, potentially allowing selective modulation of its associated motoneurons. The Discussion (‘Stimulation specificity and lead design’; page not available) treats current steering as an option still to be explored, not as a demonstrated effect of optimized anode–cathode configurations targeting subsets of dorsal root entry zones. (LLM, conf=0.88)
Experimental — accuracy not yet measuredEpidural electrical stimulation of the spinal cord can modulate specific ensembles of motor pools through recruitment of dorsal root entry zones projecting to the spinal cord regions wherein these motor pools reside.
“Epidural electrical stimulation of the spinal cord can modulate specific ensembles of motor pools through the recruitment of the dorsal root entry zones projecting to the spinal cord regions wherein these motor pools reside9,25.”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [25]
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Walking naturally after spinal cord injury using a brain–spine interface
Lorach, H., Galvez, A., Spagnolo, V., Martel, F., Karakas, S., Intering, N., Vat, M., Faivre, O., Harte, C., Komi, S., et al. (2023) · Nature · doi:10.1038/s41586-023-06094-5 · Cited by 631 · see citing works
“Epidural electrical stimulation of the spinal cord can modulate specific ensembles of motor pools through the recruitment of the dorsal root entry zones projecting to the spinal cord regions wherein these motor pools reside 9,25 .”
BackgroundSelf-citationRowald, A., Komi, S., Demesmaeker, R., Baaklini, E., Hernandez-Charpak, S. D., Paoles, E., Montanaro, H., Cassara, A., Becce, F., Lloyd, B., et al. (2022) · Nature Medicine · doi:10.1038/s41591-021-01663-5 · Cited by 455 · see citing works
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- Authors
- Greiner, N., Barra, B., Schiavone, G., Lorach, H., James, N., Conti, S., Kaeser, M., Fallegger, F., Borgognon, S., Lacour, S., Bloch, J., Courtine, G., & Capogrosso, M.
- Affiliations
- University of Fribourg (CH)
- École Polytechnique Fédérale de Lausanne (CH)
- Centre Hospitalier Universitaire Vaudois (CH)
- Corresponding author
- Greiner, Nathan
- ORCID
- Venue
- Nature Communications
- Published
- 2021-01-19
- Volume
- 12
- Issue
- 1
- Pages
- 435-435
- ISSN
- 2041-1723 (ISSN-L)
- PMC
- PMC7815834
- OpenAlex
- W3124816372
- Cited by
- 199
- References
- 75
- Citations by year
- 2026: 37 · 2025: 43 · 2024: 31 · 2023: 30 · 2022: 32 · 2021: 22 · 2020: 4
- FWCI
- 19.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Nature Communications (publishedVersion, cc-by)
- bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- SERVAL (Université de Lausanne) (publishedVersion, cc-by)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
- IRIS (submittedVersion, cc-by)
- HAL (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (167912)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Life Sciences › Neuroscience › Cognitive Neuroscience › EEG and Brain-Computer Interfaces
- Keywords
- epidural stimulation, cervical spinal cord, motoneuron recruitment, tetraplegia, spinal cord injury, macaque, intraoperative recording, neuroprosthetics
- MeSH terms
- Afferent Pathways, Animals, Computer Simulation, Disease Models, Animal, Electrodes, Implanted, Epidural Space, Female, Ganglia, Spinal, Humans, Macaca fascicularis, Magnetic Resonance Imaging, Male, Models, Neurological, Motor Neurons, Quadriplegia, Recruitment, Neurophysiological, Spinal Cord Injuries, Muscle, Skeletal, Upper Extremity, Spinal Cord Stimulation, Cervical Cord
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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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