Closed-loop neuromodulation of spinal sensorimotor circuits controls refined locomotion after complete spinal cord injury.
Open accessAbstract
Neuromodulation of spinal sensorimotor circuits improves motor control in animal models and humans with spinal cord injury. With common neuromodulation devices, electrical stimulation parameters are tuned manually and remain constant during movement. We developed a mechanistic framework to optimize neuromodulation in real time to achieve high-fidelity control of leg kinematics during locomotion in rats. We first uncovered relationships between neuromodulation parameters and recruitment of distinct sensorimotor circuits, resulting in predictive adjustments of leg kinematics. Second, we established a technological platform with embedded control policies that integrated robust movement feedback and feed-forward control loops in real time. These developments allowed us to conceive a neuroprosthetic system that controlled a broad range of foot trajectories during continuous locomotion in paralyzed rats. Animals with complete spinal cord injury performed more than 1000 successive steps without failure, and were able to climb staircases of various heights and lengths with precision and fluidity. Beyond therapeutic potential, these findings provide a conceptual and technical framework to personalize neuromodulation treatments for other neurological disorders.
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- Authors
- Wenger, N., Moraud, E. M., Raspopovic, S., Bonizzato, M., DiGiovanna, J., Musienko, P., Morari, M., Micera, S., & Courtine, G.
- Affiliations
- École Polytechnique Fédérale de Lausanne (CH)
- ETH Zurich (CH)
- Translational Neural Engineering Lab, Center for Neuroprosthetics and Institute of Bioengineering, School of Bioengineering, Swiss Federal Institute of Technology (EPFL), Lausanne CH-1015, Switzerland.
- International Paraplegic Foundation Chair in Spinal Cord Repair, Center for Neuroprosthetics and Brain Mind Institute, Swiss Federal Institute of Technology (EPFL), Lausanne CH-1015, Switzerland.
- Scuola Superiore Sant'Anna (IT)
- Corresponding author
- Wenger, Nikolaus
- Moraud, Eduardo Martin
- Micera, Silvestro
- Courtine, Grégoire
- ORCID
- Venue
- Science Translational Medicine
- Published
- 2014-09-24
- Volume
- 6
- Issue
- 255
- Pages
- 255ra133-255ra133
- ISSN
- 1946-6234 (ISSN-L)
- 1946-6242
- OpenAlex
- W2105594224
- Cited by
- 209
- References
- 44
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 17 · 2023: 19 · 2022: 18 · 2021: 29 · 2020: 14 · 2019: 19 · 2018: 25 · 2017: 13 · 2016: 22 · 2015: 13 · 2014: 1
- FWCI
- 12.15
- Type
- journal article
- Language
- en
- Open access
- green
- infoscience.epfl.ch
- Licence
- cc-by-nc-nd
- Locations
- Science Translational Medicine (publishedVersion)
- PubMed (publishedVersion)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion)
- PolyPublie (École Polytechnique de Montréal) (submittedVersion)
- CINECA IRIS Institutional Research Information System (Sant'Anna School of Advanced Studies) (submittedVersion)
- Funders
- National Science Foundation
- Fondation Bertarelli
- European Commission (258654)
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- FP7 Ideas: European Research Council (261247)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- spinal cord injury, neuromodulation, feedback control, sensorimotor circuits, locomotion, leg kinematics, neural prostheses, feedforward control, movement feedback, personalized neuromodulation, paralysis, stair climbing
- MeSH terms
- Animals, Biomechanical Phenomena, Disease Models, Animal, Extremities, Female, Gait, Locomotion, Motor Neurons, Prosthesis Design, Rats, Inbred Lew, Spinal Cord Injuries, Spinal Nerves, Time Factors, Muscle Fatigue, Recovery of Function, Feedback, Sensory, Neural Prostheses, Neurofeedback
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