Targeted neurotechnology restores walking in humans with spinal cord injury
Open accessAbstract
Spinal cord injury leads to severe locomotor deficits or even complete leg paralysis. Here we introduce targeted spinal cord stimulation neurotechnologies that enabled voluntary control of walking in individuals who had sustained a spinal cord injury more than four years ago and presented with permanent motor deficits or complete paralysis despite extensive rehabilitation. Using an implanted pulse generator with real-time triggering capabilities, we delivered trains of spatially selective stimulation to the lumbosacral spinal cord with timing that coincided with the intended movement. Within one week, this spatiotemporal stimulation had re-established adaptive control of paralysed muscles during overground walking. Locomotor performance improved during rehabilitation. After a few months, participants regained voluntary control over previously paralysed muscles without stimulation and could walk or cycle in ecological settings during spatiotemporal stimulation. These results establish a technological framework for improving neurological recovery and supporting the activities of daily living after spinal cord injury.
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The participant had previously participated in the STIMO clinical trial, which involved a five-month neurorehabilitation programme supported by targeted epidural electrical stimulation of the spinal cord.
“He had previously participated in the STIMO clinical trial (clinicaltrials.gov, NCT02936453), which involved a five-month neurorehabilitation programme supported by targeted epidural electrical stimulation of the spinal cord4,5.”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [4]
Recruiting dorsal root entry zones with preprogrammed spatiotemporal sequences replicates the physiological activation of leg motor pools underlying standing and walking.
“In turn, recruiting these dorsal root entry zones with preprogrammed spatiotemporal sequences replicates the physiological activation of leg motor pools underlying standing and walking4,5,11,13,14.”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [4]
The STIMO programme enabled the participant to regain the ability to step with the help of a front-wheel walker.
“This programme enabled him to regain the ability to step with the help of a front-wheel walker.”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [4]
Walking involves well-defined sequences of muscle activation patterns that support weight acceptance, propulsion and swing of the left and right lower limbs, and these sequences coincide with activation of motor pools located within well-segregated regions of the lumbosacral spinal cord.
“Walking involves well-defined sequences of muscle activation patterns that support weight acceptance, propulsion and swing of the left and right lower limbs. These sequences coincide with the activation of motor pools located within well-segregated regions of the lumbosacral spinal cord4,27.”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [4]
The physiological principles underlying targeted epidural electrical stimulation of the spinal cord have now been validated in nine out of nine treated individuals with incomplete and complete injuries.
“First, the physiological principles underlying targeted epidural electrical stimulation of the spinal cord have now been validated in nine out nine treated individuals with incomplete4 and complete5 injuries6.”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [4]
The chain of software and hardware enabled real-time control of stimulation protocols with a latency inferior to 150 ms.
“This chain of software and hardware enabled real-time control of stimulation protocols with a latency inferior to 150 ms (ref. 4).”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [4]
A grid search model was implemented to explore different electrode configurations and frequencies and to select configurations of cathodes and anodes that achieve maximum selectivity in the recruitment of the targeted muscle groups.
“We implemented a grid search model to explore the different electrode configurations and frequencies to select the configurations of cathodes and anodes to achieve maximum selectivity in the recruitment of the targeted muscle groups4.”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [4]
Application of EES during neurorehabilitation (EESREHAB) further improved recovery of walking, even when the stimulation was turned off.
“Application of EES during neurorehabilitation (EESREHAB) further improved recovery of walking, even when the stimulation was turned off1,21.”
From The neurons that restore walking after paralysis (2022) · cites this paper as [1]
Cites
Experience-dependent structural synaptic plasticity in the mammalian brain
Holtmaat, A., & Svoboda, K. (2009) · Nature Reviews Neuroscience · doi:10.1038/nrn2699 · Cited by 1,934 · see citing works
Restoring Voluntary Control of Locomotion after Paralyzing Spinal Cord Injury
van den Brand, R., Heutschi, J., Barraud, Q., DiGiovanna, J., Bartholdi, K., Huerlimann, M., Friedli, L., Vollenweider, I., Moraud, E. M., Duis, S., et al. (2012) · Science · doi:10.1126/science.1217416 · Cited by 767 · see citing works
Self-citationAngeli, C. A., Edgerton, V. R., Gerasimenko, Y. P., & Harkema, S. J. (2014) · Brain · doi:10.1093/brain/awu038 · Cited by 750 · see citing works
Recovery of Over-Ground Walking after Chronic Motor Complete Spinal Cord Injury
Angeli, C. A., Boakye, M., Morton, R. A., Vogt, J., Benton, K., Chen, Y., Ferreira, C. K., & Harkema, S. J. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1803588 · Cited by 670 · see citing works
A brain–spine interface alleviating gait deficits after spinal cord injury in primates
Capogrosso, M., Milekovic, T., Borton, D., Wagner, F., Moraud, E. M., Mignardot, J.-B., Buse, N., Gandar, J., Barraud, Q., Xing, D., et al. (2016) · Nature · doi:10.1038/nature20118 · Cited by 635 · see citing works
Self-citationSchieppati, M. (1987) · Progress in Neurobiology · doi:10.1016/0301-0082(87)90007-4 · Cited by 606 · see citing works
Gill, M. L., Grahn, P. J., Calvert, J. S., Linde, M. B., Lavrov, I. A., Strommen, J. A., Beck, L. A., Sayenko, D. G., Van Straaten, M. G., Drubach, D. I., et al. (2018) · Nature Medicine · doi:10.1038/s41591-018-0175-7 · Cited by 574 · see citing works
A Computational Model for Epidural Electrical Stimulation of Spinal Sensorimotor Circuits
Capogrosso, M., Wenger, N., Raspopovic, S., Musienko, P., Beauparlant, J., Bassi Luciani, L., Courtine, G., & Micera, S. (2013) · The Journal of Neuroscience · doi:10.1523/jneurosci.1688-13.2013 · Cited by 435 · see citing works
Self-citationFormento, E., Minassian, K., Wagner, F., Mignardot, J. B., Le Goff-Mignardot, C. G., Rowald, A., Bloch, J., Micera, S., Capogrosso, M., & Courtine, G. (2018) · Nature Neuroscience · doi:10.1038/s41593-018-0262-6 · Cited by 370 · see citing works
Self-citationWenger, N., Moraud, E. M., Gandar, J., Musienko, P., Capogrosso, M., Baud, L., Le Goff, C. G., Barraud, Q., Pavlova, N., Dominici, N., et al. (2016) · Nature Medicine · doi:10.1038/nm.4025 · Cited by 369 · see citing works
Self-citationvan Middendorp, J. J., Hosman, A. J. F., Donders, A. R. T., Pouw, M. H., Ditunno, J. F., Curt, A. E. P., Geurts, A. C. H., & van de Meent, H. (2011) · The Lancet · doi:10.1016/s0140-6736(10)62276-3 · Cited by 346 · see citing works
Asboth, L., Friedli, L., Beauparlant, J., Martinez-Gonzalez, C., Anil, S., Rey, E., Baud, L., Pidpruzhnykova, G., Anderson, M. A., Shkorbatova, P., et al. (2018) · Nature Neuroscience · doi:10.1038/s41593-018-0093-5 · Cited by 324 · see citing works
Self-citationTakeoka, A., Vollenweider, I., Courtine, G., & Arber, S. (2014) · Cell · doi:10.1016/j.cell.2014.11.019 · Cited by 318 · see citing works
Self-citationEdgerton, V. R., Courtine, G., Gerasimenko, Y., Lavrov, I. A., Ichiyama, R. M., Fong, A. J., Cai, L. L., Otoshi, C. K., Tillakaratne, N. J. K., Burdick, J. W., et al. (2007) · Brain Research Reviews · doi:10.1016/j.brainresrev.2007.09.002 · Cited by 316 · see citing works
Self-citationMinassian, K., Jilge, B., Rattay, F., Pinter, M. M., Binder, H., Gerstenbrand, F., & Dimitrijevic, M. R. (2004) · Spinal Cord · doi:10.1038/sj.sc.3101615 · Cited by 307 · see citing works
Self-citationField-Fote, E. C., & Roach, K. E. (2010) · Physical Therapy · doi:10.2522/ptj.20090359 · Cited by 299 · see citing works
Rattay, F., Minassian, K., & Dimitrijevic, M. (2000) · Spinal Cord · doi:10.1038/sj.sc.3101039 · Cited by 226 · see citing works
Self-citationMoraud, E. M., Capogrosso, M., Formento, E., Wenger, N., DiGiovanna, J., Courtine, G., & Micera, S. (2016) · Neuron · doi:10.1016/j.neuron.2016.01.009 · Cited by 220 · see citing works
Self-citationGrahn, P. J., Lavrov, I. A., Sayenko, D. G., Straaten, M. G. V., Gill, M. L., Strommen, J. A., Calvert, J. S., Drubach, D. I., Beck, L. A., Linde, M. B., et al. (2017) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2017.02.014 · Cited by 217 · see citing works
Gerasimenko, Y., Roy, R. R., & Edgerton, V. R. (2007) · Experimental Neurology · doi:10.1016/j.expneurol.2007.07.015 · Cited by 210 · see citing works
Wenger, N., Moraud, E. M., Raspopovic, S., Bonizzato, M., DiGiovanna, J., Musienko, P., Morari, M., Micera, S., & Courtine, G. (2014) · Science Translational Medicine · doi:10.1126/scitranslmed.3008325 · Cited by 209 · see citing works
Self-citationLow frequency depression of H-reflexes in humans with acute and chronic spinal-cord injury
Schindler-Ivens, S., & Shields, R. K. (2000) · Experimental Brain Research · doi:10.1007/s002210000377 · Cited by 201 · see citing works
Carhart, M. R., He, J., Herman, R. M., D'Luzansky, S., & Willis, W. T. (2004) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2003.822763 · Cited by 177 · see citing works
Spatiotemporal Activation of Lumbosacral Motoneurons in the Locomotor Step Cycle
Yakovenko, S., Mushahwar, V. K., VanderHorst, V., Holstege, G., & Procházka, A. (2002) · Journal of Neurophysiology · doi:10.1152/jn.00479.2001 · Cited by 176 · see citing works
Human spinal locomotor control is based on flexibly organized burst generators
Danner, S. M., Hofstoetter, U. S., Freundl, B., Binder, H., Mayr, W., Rattay, F., & Minassian, K. (2015) · Brain · doi:10.1093/brain/awu372 · Cited by 175 · see citing works
Self-citationTHE SEGMENTAL INNERVATION OF THE LOWER LIMB MUSCLES IN MAN.
Sharrard, W. J. W. (1964) · PubMed · Cited by 171 · see citing works
Locomotor Training Approaches for Individuals with Spinal Cord Injury
Field-Fote, E. C., Lindley, S. D., & Sherman, A. L. (2005) · Neurology Report · doi:10.1097/01.npt.0000282245.31158.09 · Cited by 171 · see citing works
Borton, D., Micera, S., Millán, J. D. R., & Courtine, G. (2013) · Science Translational Medicine · doi:10.1126/scitranslmed.3005968 · Cited by 171 · see citing works
Self-citationPatterned Sensory Stimulation Induces Plasticity in Reciprocal Ia Inhibition in Humans
Pérez, M. A., Field-Fote, E. C., & Floeter, M. K. (2003) · Journal of Neuroscience · doi:10.1523/jneurosci.23-06-02014.2003 · Cited by 165 · see citing works
Spike-Timing-Dependent Plasticity in Primate Corticospinal Connections Induced during Free Behavior
Nishimura, Y., Perlmutter, S. I., Eaton, R. W., & Fetz, E. E. (2013) · Neuron · doi:10.1016/j.neuron.2013.08.028 · Cited by 145 · see citing works
Behrman, A. L., Ardolino, E., & Harkema, S. J. (2017) · Neurology Report · doi:10.1097/npt.0000000000000184 · Cited by 139 · see citing works
Herrity, A. N., Williams, C. S., Angeli, C., Harkema, S. J., & Hubscher, C. H. (2018) · Scientific Reports · doi:10.1038/s41598-018-26602-2 · Cited by 126 · see citing works
Configuration of electrical spinal cord stimulation through real-time processing of gait kinematics
Capogrosso, M., Wagner, F. B., Gandar, J., Moraud, E. M., Wenger, N., Milekovic, T., Shkorbatova, P. Y., Pavlova, N., Евгеньевич, М. П., Bézard, E., et al. (2018) · Nature Protocols · doi:10.1038/s41596-018-0030-9 · Cited by 123 · see citing works
Self-citationCôté, M., Murray, M., & Lemay, M. A. (2016) · Journal of Neurotrauma · doi:10.1089/neu.2016.4577 · Cited by 113 · see citing works
Behavior of spinal neurons deprived of supraspinal input
Dietz, V. (2010) · Nature Reviews Neurology · doi:10.1038/nrneurol.2009.227 · Cited by 111 · see citing works
Jones, M. L., Evans, N. H., Tefertiller, C., Backus, D. A., Sweatman, M., Tansey, K. E., & Morrison, S. (2014) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2014.07.400 · Cited by 106 · see citing works
Dominici, N., Keller, U., Vallery, H., Friedli, L., van den Brand, R., Starkey, M. L., Евгеньевич, М. П., Riener, R., & Courtine, G. (2012) · Nature Medicine · doi:10.1038/nm.2845 · Cited by 105 · see citing works
Self-citationWest, C. R., Phillips, A. A., Squair, J. W., Williams, A. M., Walter, M., Lam, T., & Krassioukov, A. V. (2018) · JAMA Neurology · doi:10.1001/jamaneurol.2017.5055 · Cited by 103 · see citing works
Spike-timing-dependent plasticity in lower-limb motoneurons after human spinal cord injury
Urbin, M. A., Ozdemir, R. A., Tazoe, T., & Pérez, M. A. (2017) · Journal of Neurophysiology · doi:10.1152/jn.00111.2017 · Cited by 90 · see citing works
Minassian, K., McKay, W. B., Binder, H., & Hofstoetter, U. S. (2016) · Neurotherapeutics · doi:10.1007/s13311-016-0421-y · Cited by 89 · see citing works
Self-citationMigration of Motor Pool Activity in the Spinal Cord Reflects Body Mechanics in Human Locomotion
Cappellini, G., Ivanenko, Y. P., Dominici, N., Poppele, R. E., & Lacquaniti, F. (2010) · Journal of Neurophysiology · doi:10.1152/jn.00318.2010 · Cited by 61 · see citing works
Changes in movement-related β-band EEG signals in human spinal cord injury
Gourab, K., & Schmit, B. D. (2010) · Clinical Neurophysiology · doi:10.1016/j.clinph.2010.05.012 · Cited by 59 · see citing works
Mignardot, J.-B., Goff, C. G. L., van den Brand, R., Capogrosso, M., Fumeaux, N., Vallery, H., Anil, S., Lanini, J., Fodor, I., Eberle, G., et al. (2017) · Science Translational Medicine · doi:10.1126/scitranslmed.aah3621 · Cited by 58 · see citing works
Self-citationEnhancement of Voluntary Motor Function Following Spinal Cord Stimulation - Case Study
Barolat, G., Myklebust, J. B., & Wenninger, W. J. (1986) · Stereotactic and Functional Neurosurgery · doi:10.1159/000100160 · Cited by 49 · see citing works
Moraud, E. M., Zitzewitz, J. V., Miehlbradt, J., Wurth, S. M., Formento, E., DiGiovanna, J., Capogrosso, M., Courtine, G., & Micera, S. (2018) · Scientific Reports · doi:10.1038/s41598-017-18293-y · Cited by 39 · see citing works
Self-citationASANUMA, H., & Mackel, R. G. (1989) · The Japanese Journal of Physiology · doi:10.2170/jjphysiol.39.1 · Cited by 35 · see citing works
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Musk, E., & Neuralink (2019) · Journal of Medical Internet Research · doi:10.2196/16194 · Cited by 1,206 · see citing works
Spinal cord injury: molecular mechanisms and therapeutic interventions
Hu, X., Xu, W., Ren, Y., Wang, Z., He, X., Huang, R., Ma, B., Zhao, J., Zhu, R., & Cheng, L. (2023) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-023-01477-6 · Cited by 823 · see citing works
Hydrogel interfaces for merging humans and machines
Yuk, H., Wu, J., & Zhao, X. (2022) · Nature Reviews Materials · doi:10.1038/s41578-022-00483-4 · Cited by 683 · see citing works
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
“This brain–spine interface (BSI) consists of fully implanted recording and stimulation systems that establish a direct link between cortical signals 3 and the analogue modulation of epidural electrical stimulation targeting the spinal cord regions involved in the production of walking 4–6 .”
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Jiang, Y., Zhang, Z., Wang, Y.-X., Li, D., Coen, C., Hwaun, E., Chen, G., Wu, H., Zhong, D., Niu, S., et al. (2022) · Science · doi:10.1126/science.abj7564 · Cited by 631 · see citing works
Current principles of motor control, with special reference to vertebrate locomotion
Grillner, S., & El Manira, A. (2020) · Physiological Reviews · doi:10.1152/physrev.00015.2019 · Cited by 560 · see citing works
Spinal cord repair: advances in biology and technology
Courtine, G., & Sofroniew, M. V. (2019) · Nature Medicine · doi:10.1038/s41591-019-0475-6 · Cited by 508 · see citing works
Self-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
Self-citationFormento, E., Minassian, K., Wagner, F., Mignardot, J. B., Le Goff-Mignardot, C. G., Rowald, A., Bloch, J., Micera, S., Capogrosso, M., & Courtine, G. (2018) · Nature Neuroscience · doi:10.1038/s41593-018-0262-6 · Cited by 370 · see citing works
Self-citationWearable sensor-based real-time gait detection: A systematic review
Prasanth, H., Caban, M., Keller, U., Courtine, G., Ijspeert, A., Vallery, H., & von Zitzewitz, J. (2021) · Sensors · doi:10.3390/s21082727 · Cited by 348 · see citing works
Self-citationRegulation of axonal regeneration after mammalian spinal cord injury
Zheng, B., & Tuszynski, M. H. (2023) · Nature Reviews Molecular Cell Biology · doi:10.1038/s41580-022-00562-y · Cited by 328 · see citing works
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Miri, S., Saini, R., Davoodi, S. M., Pulicharla, R., Brar, S. K., & Magdouli, S. (2021) · Chemosphere · doi:10.1016/j.chemosphere.2021.131670 · Cited by 327 · see citing works
The translational landscape in spinal cord injury: focus on neuroplasticity and regeneration
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Kathe, C., Skinnider, M. A., Hutson, T. H., Regazzi, N., Gautier, M., Demesmaeker, R., Komi, S., Ceto, S., James, N. D., Cho, N., et al. (2022) · Nature · doi:10.1038/s41586-022-05385-7 · Cited by 304 · see citing works
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Self-citationProgression in translational research on spinal cord injury based on microenvironment imbalance
Fan, B., Wei, Z., & Feng, S. (2022) · Bone Research · doi:10.1038/s41413-022-00199-9 · Cited by 248 · see citing works
Zhang, M., Tang, Z., Liu, X., & Van der Spiegel, J. (2020) · Nature Electronics · doi:10.1038/s41928-020-0390-3 · Cited by 231 · see citing works
Biodegradation of different types of microplastics: Molecular mechanism and degradation efficiency
Thakur, B., Singh, J., Singh, J., Angmo, D., & Vig, A. P. (2023) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2023.162912 · Cited by 225 · see citing works
Therapeutic repair for spinal cord injury: combinatory approaches to address a multifaceted problem
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Self-citationGreiner, N., Barra, B., Schiavone, G., Lorach, H., James, N., Conti, S., Kaeser, M., Fallegger, F., Borgognon, S., Lacour, S., et al. (2021) · Nature Communications · doi:10.1038/s41467-020-20703-1 · Cited by 199 · see citing works
Self-citationRecent progress and challenges in the treatment of spinal cord injury
Tian, T., Zhang, S., & Yang, M. (2023) · Protein & Cell · doi:10.1093/procel/pwad003 · Cited by 196 · see citing works
Mobile cognition: imaging the human brain in the ‘real world’
Stangl, M., Maoz, S. L., & Suthana, N. (2023) · Nature reviews. Neuroscience · doi:10.1038/s41583-023-00692-y · Cited by 194 · see citing works
Moritz, C. T., Field-Fote, E. C., Tefertiller, C., van Nes, I. J. W., Trumbower, R. D., Kalsi‐Ryan, S., Purcell, M., Janssen, T. W. J., Krassioukov, A. V., Morse, L. R., et al. (2024) · Nature Medicine · doi:10.1038/s41591-024-02940-9 · Cited by 188 · see citing works
Self-citationNeurohybrid Memristive CMOS-Integrated Systems for Biosensors and Neuroprosthetics
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Kozielski, K., Jahanshahi, A., Gilbert, H. B., Yu, Y., Erin, Ö., Francisco, D., Alosaimi, F., Temel, Y., & Sitti, M. (2021) · Science Advances · doi:10.1126/sciadv.abc4189 · Cited by 183 · see citing works
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Miniaturised wireless power transfer systems for neurostimulation: a review
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Yao, G., Kang, L., Li, C., Chen, S., Wang, Q., Yang, J., Long, Y., Li, J., Zhao, K., Xu, W., et al. (2021) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2100772118 · Cited by 159 · see citing works
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Yao, G., Mo, X., Yin, C., Lou, W., Wang, Q., Huang, S., Mao, L., Chen, S., Zhao, K., Pan, T., et al. (2022) · Science Advances · doi:10.1126/sciadv.abl8379 · Cited by 152 · see citing works
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Hofstoetter, U. S., Freundl, B., Danner, S. M., Krenn, M. J., Mayr, W., Binder, H., & Minassian, K. (2019) · Journal of Neurotrauma · doi:10.1089/neu.2019.6588 · Cited by 150 · see citing works
Self-citationRapid prototyping of soft bioelectronic implants for use as neuromuscular interfaces
Afanasenkau, D., Kalinina, D., Lyakhovetskii, V., Tondera, C., Gorsky, O., Moosavi, S., Pavlova, N., Merkulyeva, N., Kalueff, A. V., Minev, I. R., et al. (2020) · Nature Biomedical Engineering · doi:10.1038/s41551-020-00615-7 · Cited by 148 · see citing works
Nagappan, P. G., Chen, H., & Wang, D. Y. (2020) · Military Medical Research · doi:10.1186/s40779-020-00259-3 · Cited by 148 · see citing works
Lo, L., Zhao, J., Aono, K., Li, W., Wen, Z., Pizzella, S., Wang, Y., Chakrabartty, S., & Wang, C. (2022) · ACS Nano · doi:10.1021/acsnano.2c04962 · Cited by 147 · see citing works
Yogev, D., Goldberg, T., Arami, A., Tejman‐Yarden, S., Winkler, T. E., & Maoz, B. M. (2023) · APL Bioengineering · doi:10.1063/5.0152290 · Cited by 143 · see citing works
Advanced Neurotechnologies for the Restoration of Motor Function
Micera, S., Caleo, M., Chisari, C., Hummel, F. C., & Pedrocchi, A. (2020) · Neuron · doi:10.1016/j.neuron.2020.01.039 · Cited by 140 · see citing works
Multimodal treatment for spinal cord injury: a sword of neuroregeneration upon neuromodulation
Zheng, Y., Mao, Y.-R., Yuan, T., Xu, D., & Cheng, L. (2020) · Neural Regeneration Research · doi:10.4103/1673-5374.274332 · Cited by 138 · see citing works
Flexible Electrodes for Brain–Computer Interface System
Wang, J., Wang, T., Liu, H., Wang, K., Kumi, M., Feng, Z., Li, P., & Huang, W. (2023) · Advanced Materials · doi:10.1002/adma.202211012 · Cited by 138 · see citing works
Wang, J., Wang, H., He, T., He, B., Thakor, N. V., & Lee, C. (2019) · Advanced Science · doi:10.1002/advs.201900149 · Cited by 137 · see citing works
Matson, K. J. E., Russ, D. E., Kathe, C., Hua, I., Maric, D., Ding, Y., Krynitsky, J., Pursley, R. H., Sathyamurthy, A., Squair, J. W., et al. (2022) · Nature Communications · doi:10.1038/s41467-022-33184-1 · Cited by 137 · see citing works
Self-citationDeep learning-based BCI for gait decoding from EEG with LSTM recurrent neural network
Tortora, S., Ghidoni, S., Chisari, C., Micera, S., & Artoni, F. (2020) · Journal of Neural Engineering · doi:10.1088/1741-2552/ab9842 · Cited by 134 · see citing works
The role of electrical stimulation for rehabilitation and regeneration after spinal cord injury
Karamian, B. A., Siegel, N. M., Nourie, B., Serruya, M. D., Heary, R. F., Harrop, J. S., & Vaccaro, A. R. (2022) · Journal of Orthopaedics and Traumatology · doi:10.1186/s10195-021-00623-6 · Cited by 133 · see citing works
Single-cell and spatial atlases of spinal cord injury in the Tabulae Paralytica
Skinnider, M. A., Gautier, M., Teo, A. Y. Y., Kathe, C., Hutson, T. H., Laskaratos, A., de Coucy, A., Regazzi, N., Aureli, V., James, N. D., et al. (2024) · Nature · doi:10.1038/s41586-024-07504-y · Cited by 131 · see citing works
Self-citationSelf-Assembling Hydrogel Structures for Neural Tissue Repair
Peressotti, S., Koehl, G. E., Goding, J. A., & Green, R. A. (2021) · ACS Biomaterials Science & Engineering · doi:10.1021/acsbiomaterials.1c00030 · Cited by 130 · see citing works
Wang, J., He, T., & Lee, C. (2019) · Nano Energy · doi:10.1016/j.nanoen.2019.104039 · Cited by 129 · see citing works
Strategies and prospects of effective neural circuits reconstruction after spinal cord injury
Yang, B., Zhang, F., Cheng, F., Ying, L., Wang, C., Shi, K., Wang, J., Xia, K., Gong, Z., Huang, X., et al. (2020) · Cell Death & Disease · doi:10.1038/s41419-020-2620-z · Cited by 128 · see citing works
Hutson, T. H., Kathe, C., Palmisano, I., Bartholdi, K., Hervera, A., Virgiliis, F. D., McLachlan, E., Zhou, L., Kong, G., Barraud, Q., et al. (2019) · Science Translational Medicine · doi:10.1126/scitranslmed.aaw2064 · Cited by 124 · see citing works
Self-citationNatural and targeted circuit reorganization after spinal cord injury
Anderson, M. A., Squair, J. W., Gautier, M., Hutson, T. H., Kathe, C., Barraud, Q., Bloch, J., & Courtine, G. (2022) · Nature Neuroscience · doi:10.1038/s41593-022-01196-1 · Cited by 124 · see citing works
Self-citationGuidelines to Study and Develop Soft Electrode Systems for Neural Stimulation
Schiavone, G., Kang, X., Fallegger, F., Gandar, J., Courtine, G., & Lacour, S. P. (2020) · Neuron · doi:10.1016/j.neuron.2020.10.010 · Cited by 119 · see citing works
Self-citationNizamis, K., Athanasiou, A., Almpani, S., Dimitrousis, C., & Astaras, A. (2021) · Sensors · doi:10.3390/s21062084 · Cited by 118 · see citing works
Li, X., Liu, D., Xiao, Z., Zhao, Y., Han, S., Chen, B., & Dai, J. (2019) · Biomaterials · doi:10.1016/j.biomaterials.2019.01.012 · Cited by 117 · see citing works
Soft, Implantable Bioelectronic Interfaces for Translational Research
Schiavone, G., Fallegger, F., Kang, X., Barra, B., Vachicouras, N., Roussinova, E., Furfaro, I., Jiguet, S., Seáñez, I., Borgognon, S., et al. (2020) · Advanced Materials · doi:10.1002/adma.201906512 · Cited by 116 · see citing works
Self-citationNanogenerators to Power Implantable Medical Systems
Yoon, H., & Kim, S. (2020) · Joule · doi:10.1016/j.joule.2020.05.003 · Cited by 116 · see citing works
Recent advances in bioelectronics chemistry
Fang, Y., Meng, L., Promiński, A., Schaumann, E. N., Seebald, M., & Tian, B. (2020) · Chemical Society Reviews · doi:10.1039/d0cs00333f · Cited by 115 · see citing works
Pathophysiology and Therapeutic Approaches for Spinal Cord Injury
Lima, R., Monteiro, A., Salgado, A. J., Monteiro, S., & Silva, N. A. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms232213833 · Cited by 115 · see citing works
Neuromorphic hardware for somatosensory neuroprostheses
Donati, E., & Valle, G. (2024) · Nature Communications · doi:10.1038/s41467-024-44723-3 · Cited by 115 · see citing works
Regenerative rehabilitation with conductive biomaterials for spinal cord injury
Kiyotake, E. A., Martin, M. D., & Detamore, M. S. (2020) · Acta Biomaterialia · doi:10.1016/j.actbio.2020.12.021 · Cited by 111 · see citing works
Comparative neuroanatomy of the lumbosacral spinal cord of the rat, cat, pig, monkey, and human
Toossi, A., Bergin, B., Marefatallah, M., Parhizi, B., Tyreman, N., Everaert, D. G., Rezaei, S., Seres, P., Gatenby, J. C., Perlmutter, S. I., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-81371-9 · Cited by 111 · see citing works
Electrical Stimulation Promotes Stem Cell Neural Differentiation in Tissue Engineering
Cheng, H., Huang, Y., Yue, H., & Fan, Y. (2021) · Stem Cells International · doi:10.1155/2021/6697574 · Cited by 109 · see citing works
Barra, B., Conti, S., Perich, M. G., Zhuang, K., Schiavone, G., Fallegger, F., Galan, K., James, N. D., Barraud, Q., Delacombaz, M., et al. (2022) · Nature Neuroscience · doi:10.1038/s41593-022-01106-5 · Cited by 109 · see citing works
Self-citationNeuroprosthetics: from sensorimotor to cognitive disorders
Gupta, A., Vardalakis, N., & Wagner, F. B. (2023) · Communications Biology · doi:10.1038/s42003-022-04390-w · Cited by 108 · see citing works
Self-citationBioelectronic medicine: Preclinical insights and clinical advances
Pavlov, V. A., & Tracey, K. J. (2022) · Neuron · doi:10.1016/j.neuron.2022.09.003 · Cited by 106 · see citing works
Xiong, W., Li, C., Kong, G., Zeng, Q., Wang, S., Yin, G., Gu, J., & Fan, J. (2022) · Journal of Nanobiotechnology · doi:10.1186/s12951-022-01724-y · Cited by 105 · see citing works
Bioelectronic Implantable Devices for Physiological Signal Recording and Closed‐Loop Neuromodulation
Oh, S., Jekal, J., Jia Liu, B., Kim, J., Park, J., Lee, T., & Jang, K. (2024) · Advanced Functional Materials · doi:10.1002/adfm.202403562 · Cited by 103 · see citing works
He, T., & Lee, C. (2021) · IEEE Open Journal of Circuits and Systems · doi:10.1109/ojcas.2021.3123272 · Cited by 97 · see citing works
Faster Gait Speeds Reduce Alpha and Beta EEG Spectral Power From Human Sensorimotor Cortex
Nordin, A. D., Hairston, W. D., & Ferris, D. P. (2019) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2019.2921766 · Cited by 96 · see citing works
Pino, I. P., Hoover, C., Venkatesh, S., Ahmadi, A., Sturtevant, D., Patrick, N., Freeman, D., Parr, A. M., Samadani, U., Balser, D. Y., et al. (2020) · Frontiers in Systems Neuroscience · doi:10.3389/fnsys.2020.00035 · Cited by 96 · see citing works
Phase 1 Safety Trial of Autologous Human Schwann Cell Transplantation in Chronic Spinal Cord Injury
Gant, K. L., Guest, J. D., Palermo, A. E., Vedantam, A., Jimsheleishvili, G., Bunge, M. B., Brooks, A. E., Anderson, K. D., Thomas, C. K., Santamaría, A. J., et al. (2021) · Journal of Neurotrauma · doi:10.1089/neu.2020.7590 · Cited by 96 · see citing works
Vose, A. K., Welch, J. F., Nair, J., Dale, E. A., Fox, E. J., Muir, G. D., Trumbower, R. D., & Mitchell, G. S. (2021) · Experimental Neurology · doi:10.1016/j.expneurol.2021.113891 · Cited by 96 · see citing works
Pukos, N., Goodus, M. T., Sahinkaya, F. R., & McTigue, D. M. (2019) · Glia · doi:10.1002/glia.23702 · Cited by 94 · see citing works
Dorrian, R. M., Berryman, C. F., Lauto, A., & Leonard, A. V. (2023) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2023.1095259 · Cited by 93 · see citing works
Yang, Y., Pang, M., Du, C., Liu, Z., Chen, Z., Wang, N., Zhang, L., Chen, Y.-Y., Mo, J., Dong, J., et al. (2020) · Cytotherapy · doi:10.1016/j.jcyt.2020.09.012 · Cited by 92 · see citing works
Control of Mammalian Locomotion by Somatosensory Feedback
Frigon, A., Akay, T., & Prilutsky, B. I. (2021) · Comprehensive physiology · doi:10.1002/cphy.c210020 · Cited by 91 · see citing works
Recent advances in the therapeutic uses of chondroitinase ABC
Muir, E. M., de Winter, F., Verhaagen, J., & Fawcett, J. W. (2019) · Experimental Neurology · doi:10.1016/j.expneurol.2019.113032 · Cited by 90 · see citing works
Hofer, A., & Schwab, M. E. (2019) · Current Opinion in Neurology · doi:10.1097/wco.0000000000000750 · Cited by 89 · see citing works
A prototype closed-loop brain–machine interface for the study and treatment of pain
Zhang, Q., Hu, S., Talay, R. S., Xiao, Z., Rosenberg, D., Liu, Y., Sun, G., Li, A., Caravan, B., Singh, A., et al. (2021) · Nature Biomedical Engineering · doi:10.1038/s41551-021-00736-7 · Cited by 89 · see citing works
Serotonergic mechanisms in spinal cord injury
Perrin, F. E., & Noristani, H. N. (2019) · Experimental Neurology · doi:10.1016/j.expneurol.2019.05.007 · Cited by 89 · see citing works
Recent advances in endogenous neural stem/progenitor cell manipulation for spinal cord injury repair
Li, J., Luo, W., Xiao, C., Zhao, J., Xiang, C., Liu, W., & Gu, R. (2023) · Theranostics · doi:10.7150/thno.84133 · Cited by 88 · see citing works
Kreydin, E. I., Zhong, H., Latack, K. R., Ye, S., Edgerton, V. R., & Gad, P. N. (2020) · Frontiers in Systems Neuroscience · doi:10.3389/fnsys.2020.00001 · Cited by 87 · see citing works
A spinal cord neuroprosthesis for locomotor deficits due to Parkinson’s disease
Milekovic, T., Moraud, E. M., Macellari, N., Moerman, C., Raschellà, F., Sun, S., Perich, M. G., Varescon, C., Demesmaeker, R., Bruel, A., et al. (2023) · Nature Medicine · doi:10.1038/s41591-023-02584-1 · Cited by 86 · see citing works
Self-citationCalvert, J. S., Grahn, P. J., Zhao, K. D., & Lee, K. H. (2019) · Neuromodulation Technology at the Neural Interface · doi:10.1111/ner.12938 · Cited by 84 · see citing works
Organic Neuroelectronics: From Neural Interfaces to Neuroprosthetics
Go, G., Lee, Y., Seo, D., & Lee, T. (2022) · Advanced Materials · doi:10.1002/adma.202201864 · Cited by 83 · see citing works
Hachmann, J. T., Yousak, A., Wallner, J. J., Gad, P. N., Edgerton, V. R., & Gorgey, A. S. (2021) · Journal of Neurophysiology · doi:10.1152/jn.00020.2021 · Cited by 82 · see citing works
On the reflex mechanisms of cervical transcutaneous spinal cord stimulation in human subjects
Milosevic, M., Masugi, Y., Sasaki, A., Sayenko, D. G., & Nakazawa, K. (2019) · Journal of Neurophysiology · doi:10.1152/jn.00802.2018 · Cited by 81 · see citing works
Multi-target approaches to CNS repair: olfactory mucosa-derived cells and heparan sulfates
Lindsay, S. L., McCanney, G. A., Willison, A., & Barnett, S. C. (2020) · Nature Reviews Neurology · doi:10.1038/s41582-020-0311-0 · Cited by 81 · see citing works
Bilchak, J. N., Caron, G., & Côté, M. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22094858 · Cited by 81 · see citing works
Advances in Conductive Hydrogel for Spinal Cord Injury Repair and Regeneration
Qin, C., Qi, Z., Pan, S., Xia, P., Kong, W., Sun, B., Du, H., Zhang, R., Zhu, L., Zhou, D., et al. (2023) · International Journal of Nanomedicine · doi:10.2147/ijn.s436111 · Cited by 80 · see citing works
Ijspeert, A. J., & Daley, M. A. (2023) · Journal of Experimental Biology · doi:10.1242/jeb.245784 · Cited by 79 · see citing works
Soft Bioelectronics for Therapeutics
Zhang, Z., Zhu, Z., Zhou, P., Zou, Y., Yang, J., Haick, H., & Wang, Y. (2023) · ACS Nano · doi:10.1021/acsnano.3c02513 · Cited by 79 · see citing works
Low‐Frequency Brain Oscillations Track Motor Recovery in Human Stroke
Bönstrup, M., Krawinkel, L. A., Schulz, R., Cheng, B., Feldheim, J. F., Thomalla, G., Cohen, L. G., & Gerloff, C. P. (2019) · Annals of Neurology · doi:10.1002/ana.25615 · Cited by 78 · see citing works
Antifibrotic strategies for medical devices
Welch, N. G., Winkler, D. A., & Thissen, H. W. (2020) · Advanced Drug Delivery Reviews · doi:10.1016/j.addr.2020.06.008 · Cited by 78 · see citing works
Laliberté, A. M., Goltash, S., Lalonde, N. R., & Bui, T. V. (2019) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2019.00512 · Cited by 77 · see citing works
Brommer, B., He, M., Zhang, Z., Yang, Z., Page, J. C., Su, J., Zhang, Y., Zhu, J., Gouy, E., Tang, J., et al. (2021) · Nature Communications · doi:10.1038/s41467-021-20980-4 · Cited by 76 · see citing works
Nanotechnology Enables Novel Modalities for Neuromodulation
Yang, X., McGlynn, E., Das, R., Pașca, S. P., Cui, B., & Heidari, H. (2021) · Advanced Materials · doi:10.1002/adma.202103208 · Cited by 76 · see citing works
Restoring neuronal iron homeostasis revitalizes neurogenesis after spinal cord injury
Geng, H., Li, Z., Li, Z., Zhang, Y., Gao, Z., Sun, L., Li, X., Cui, J., Ni, S., & Hao, J. (2023) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2220300120 · Cited by 76 · see citing works
Electronics with shape actuation for minimally invasive spinal cord stimulation
Woodington, B. J., Curto, V. F., Yu, Y.-L., Martínez-Domínguez, H., Coles, L., Malliaras, G. G., Proctor, C. M., & Barone, D. G. (2021) · Science Advances · doi:10.1126/sciadv.abg7833 · Cited by 75 · see citing works
- Authors
- Wagner, F. B., Mignardot, J.-B., Le Goff-Mignardot, C. G., Demesmaeker, R., Komi, S., Capogrosso, M., Rowald, A., Seáñez, I., Caban, M., Pirondini, E., Vat, M., McCracken, L. A., Heimgartner, R., Fodor, I., Watrin, A., Seguin, P., Paoles, E., Van Den Keybus, K., Eberle, G., Schurch, B., Pralong, E., Becce, F., Prior, J., Buse, N., Buschman, R., Neufeld, E., Kuster, N., Carda, S., von Zitzewitz, J., Delattre, V., Denison, T., Lambert, H., Minassian, K., Bloch, J., & Courtine, G.
- Affiliations
- Centre Hospitalier Universitaire Vaudois (CH)
- University of Fribourg (CH)
- École Polytechnique Fédérale de Lausanne (CH)
- University of Geneva (CH)
- Medtronic (United States) (US)
- Foundation for Research on Information Technologies in Society (CH)
- ETH Zurich (CH)
- Corresponding author
- Courtine, Grégoire
- ORCID
- Wagner, Fabien B.
- Mignardot, Jean-Baptiste
- Demesmaeker, Robin
- Komi, Salif
- Capogrosso, Marco
- Rowald, Andreas
- Seáñez, Ismael
- Caban, Miroslav
- Pirondini, Elvira
- McCracken, Laura A.
- Heimgartner, Roman
- Fodor, Isabelle
- Eberle, Grégoire
- Schurch, Brigitte
- Becce, Fabio
- Prior, John
- Buse, Nicholas
- Buschman, Rik
- Neufeld, Esra
- Kuster, Niels
- Carda, Stefano
- Minassian, Karen
- Bloch, Jocelyne
- Courtine, Grégoire
- Venue
- Nature
- Published
- 2018-10-31
- Volume
- 563
- Issue
- 7729
- Pages
- 65-71
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- OpenAlex
- W2898429451
- Cited by
- 1,087
- References
- 46
- Citations by year
- 2026: 110 · 2025: 160 · 2024: 117 · 2023: 153 · 2022: 152 · 2021: 176 · 2020: 125 · 2019: 81 · 2018: 10 · 2014: 1
- FWCI
- 74.13
- Type
- journal article
- Language
- en
- Open access
- green
- infoscience.epfl.ch
- Licence
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- spinal cord injury, spinal cord stimulation, neurotechnology, lumbosacral spinal cord, implanted pulse generator, voluntary motor control, paralysis, locomotor rehabilitation, neurological recovery, activities of daily living
- MeSH terms
- Activities of Daily Living, Computer Simulation, Electromyography, Electric Stimulation Therapy, Epidural Space, Humans, Leg, Locomotion, Male, Motor Neurons, Paralysis, Spinal Cord, Spinal Cord Injuries, Walking, Muscle, Skeletal, Biomedical Technology
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