Cited by 455Spinal Cord Injury ResearchNeuroscience and Neural EngineeringStroke Rehabilitation and Recovery

The DOI matches its Crossref record; 74 of the 74 references it cites were found in a registry or an index.

Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis

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Abstract

Epidural electrical stimulation (EES) targeting the dorsal roots of lumbosacral segments restores walking in people with spinal cord injury (SCI). However, EES is delivered with multielectrode paddle leads that were originally designed to target the dorsal column of the spinal cord. Here, we hypothesized that an arrangement of electrodes targeting the ensemble of dorsal roots involved in leg and trunk movements would result in superior efficacy, restoring more diverse motor activities after the most severe SCI. To test this hypothesis, we established a computational framework that informed the optimal arrangement of electrodes on a new paddle lead and guided its neurosurgical positioning. We also developed software supporting the rapid configuration of activity-specific stimulation programs that reproduced the natural activation of motor neurons underlying each activity. We tested these neurotechnologies in three individuals with complete sensorimotor paralysis as part of an ongoing clinical trial ( www.clinicaltrials.gov identifier NCT02936453). Within a single day, activity-specific stimulation programs enabled these three individuals to stand, walk, cycle, swim and control trunk movements. Neurorehabilitation mediated sufficient improvement to restore these activities in community settings, opening a realistic path to support everyday mobility with EES in people with SCI.

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Metadata

Authors
Rowald, A., Komi, S., Demesmaeker, R., Baaklini, E., Hernandez-Charpak, S. D., Paoles, E., Montanaro, H., Cassara, A., Becce, F., Lloyd, B., Newton, T., Ravier, J., Kinany, N., D’Ercole, M., Paley, A., Hankov, N., Varescon, C., McCracken, L., Vat, M., Caban, M., Watrin, A., Jacquet, C., Bole-Feysot, L., Harte, C., Lorach, H., Galvez, A., Tschopp, M., Herrmann, N., Wacker, M., Geernaert, L., Fodor, I., Radevich, V., Van Den Keybus, K., Eberle, G., Pralong, E., Roulet, M., Ledoux, J.-B., Fornari, E., Mandija, S., Mattera, L., Martuzzi, R., Nazarian, B., Benkler, S., Callegari, S., Greiner, N., Fuhrer, B., Froeling, M., Buse, N., Denison, T., Buschman, R., Wende, C., Ganty, D., Bakker, J., Delattre, V., Lambert, H., Minassian, K., van den Berg, C. A. T., Kavounoudias, A., Micera, S., Van De Ville, D., Barraud, Q., Kurt, E., Kuster, N., Neufeld, E., Capogrosso, M., Asboth, L., Wagner, F. B., Bloch, J., & Courtine, G.
Affiliations
  • Centre Hospitalier Universitaire Vaudois (CH)
  • ETH Zurich (CH)
  • Foundation for Research on Information Technologies in Society (CH)
  • Scuola Superiore Sant'Anna (IT)
  • École Polytechnique Fédérale de Lausanne (CH)
  • University Medical Center Utrecht (NL)
  • Centre National de la Recherche Scientifique (FR)
  • Medtronic (United States) (US)
  • Technical University of Munich (DE)
  • Medical University of Vienna (AT)
  • Radboud University Medical Center (NL)
  • University of Fribourg (CH)
Corresponding author
  • Bloch, Jocelyne
  • Courtine, Grégoire
Venue
Nature Medicine
Published
2022-02
Volume
28
Issue
2
Pages
260-271
ISSN
  • 1078-8956 (ISSN-L)
  • 1546-170X
OpenAlex
W4210917455
Cited by
455
References
72
Citations by year
2026: 83 · 2025: 113 · 2024: 94 · 2023: 93 · 2022: 72
FWCI
62.99
Type
journal article
Language
en
Open access
Locations
  • Nature Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
  • IRIS (submittedVersion)
  • mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
  • SERVAL (Université de Lausanne) (submittedVersion)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
  • CINECA IRIS Institutional Research Information System (Sant'Anna School of Advanced Studies) (submittedVersion)
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, complete paralysis, dorsal root stimulation, neurorehabilitation, swimming, standing
MeSH terms
Humans, Leg, Paralysis, Spinal Cord, Spinal Cord Injuries, Walking, Spinal Cord Stimulation

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