The DOI matches its Crossref record; 43 of the 43 references it cites were found in a registry or an index.
Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia
Abstract
Spinal sensorimotor networks that are functionally disconnected from the brain because of spinal cord injury (SCI) can be facilitated via epidural electrical stimulation (EES) to restore robust, coordinated motor activity in humans with paralysis 1-3. Previously, we reported a clinical case of complete sensorimotor paralysis of the lower extremities in which EES restored the ability to stand and the ability to control step-like activity while side-lying or suspended vertically in a body-weight support system (BWS)4. Since then, dynamic task-specific training in the presence of EES, termed multimodal rehabilitation (MMR), was performed for 43 weeks and resulted in bilateral stepping on a treadmill, independent from trainer assistance or BWS. Additionally, MMR enabled independent stepping over ground while using a front-wheeled walker with trainer assistance at the hips to maintain balance. Furthermore, MMR engaged sensorimotor networks to achieve dynamic performance of standing and stepping. To our knowledge, this is the first report of independent stepping enabled by task-specific training in the presence of EES by a human with complete loss of lower extremity sensorimotor function due to SCI.
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In the citing paper
“This recovery has been documented in various independent studies, including in participants with complete sensorimotor paralysis5,6,30–34.”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [33]
In the citing paper
“The delivery of epidural electrical stimulation over the lumbar spinal cord has enabled many individuals with spinal cord injury to regain adaptive control over the activity of otherwise paralysed muscles.”
From Walking naturally after spinal cord injury using a brain–spine interface (2023) · cites this paper as [33]
Citations
Cites
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Self-citationEvidence for a Spinal Central Pattern Generator in Humans a
Dimitrijevic, M. R., Gerasimenko, Y. P., & Pinter, M. M. (1998) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1998.tb09062.x · Cited by 800
Self-citationRestoring 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
Angeli, C. A., Edgerton, V. R., Gerasimenko, Y. P., & Harkema, S. J. (2014) · Brain · doi:10.1093/brain/awu038 · Cited by 750
Self-citationA 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
Locomotor Training After Human Spinal Cord Injury: A Series of Case Studies
Behrman, A. L., & Harkema, S. J. (2000) · Physical Therapy · doi:10.1093/ptj/80.7.688 · Cited by 597
Weight-supported treadmill vs over-ground training for walking after acute incomplete SCI
Dobkin, B. H., Apple, D. F., Barbeau, H., Basso, M., Behrman, A. L., Deforge, D., Ditunno, J. F., Dudley, G., Elashoff, R. E., Fugate, L. P., et al. (2006) · Neurology · doi:10.1212/01.wnl.0000202600.72018.39 · Cited by 474
Weight-supported treadmill vs over-ground training for walking after acute incomplete SCI
Wernig, A. (2006) · Neurology · doi:10.1212/01.wnl.0000249079.73112.38 · Cited by 414
Wenger, 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
Noninvasive Reactivation of Motor Descending Control after Paralysis
Gerasimenko, Y., Lu, D. C.-T., Modaber, M., Zdunowski, S., Gad, P. N., Sayenko, D. G., Morikawa, E., Haakana, P., Ferguson, A. R., Roy, R. R., et al. (2015) · Journal of Neurotrauma · doi:10.1089/neu.2015.4008 · Cited by 319
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Cited by
Sorted by citations
Targeted neurotechnology restores walking in humans with spinal cord injury
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., et al. (2018) · Nature · doi:10.1038/s41586-018-0649-2 · Cited by 1,087
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
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
Rowald, 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
Drug delivery to the central nervous system
Nance, E. A., Pun, S. H., Saigal, R., & Sellers, D. L. (2021) · Nature Reviews Materials · doi:10.1038/s41578-021-00394-w · Cited by 442
Metadata
- Authors
- 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., Veith, D. D., Thoreson, A. R., Lopez, C., Gerasimenko, Y. P., Edgerton, V. R., Lee, K. H., & Zhao, K. D.
- Affiliations
- Mayo Clinic (US)
- Houston Methodist (US)
- Russian Academy of Sciences (RU)
- University of California, Los Angeles (US)
- Corresponding author
- Lee, Kendall H.
- Zhao, Kristin D.
- ORCID
- Venue
- Nature Medicine
- Published
- 2018-09-24
- Volume
- 24
- Issue
- 11
- Pages
- 1677-1682
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- OpenAlex
- W2892074957
- Cited by
- 574
- References
- 43
- Citations by year
- 2026: 51 · 2025: 63 · 2024: 58 · 2023: 81 · 2022: 87 · 2021: 94 · 2020: 72 · 2019: 50 · 2018: 16
- FWCI
- 44.13
- Type
- journal article
- Language
- en
- Update notices
- correction (2018-10-23)
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Nature
- Topics
- Health Sciences › Medicine › Clinical Neurology › Spinal Cord Injury Research
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Physical Sciences › Engineering › Biomedical Engineering › Prosthetics and Rehabilitation Robotics
- Keywords
- spinal cord injury, complete paraplegia, epidural stimulation, multimodal rehabilitation, task-oriented training, body weight support, standing, paraplegia
- MeSH terms
- Adult, Electric Stimulation, Transcutaneous Electric Nerve Stimulation, Electromyography, Humans, Male, Motor Activity, Nerve Net, Paralysis, Paraplegia, Spinal Cord Injuries, Muscle, Skeletal
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