Engaging Spinal Networks to Mitigate Supraspinal Dysfunction After CP

Edgerton, V. Reggie; Hastings, Susan; Gad, Parag

doi:10.3389/fnins.2021.643463

Cited by 16 publications

(18 citation statements)

References 30 publications

(31 reference statements)

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“…In other applications of spinal neuromodulation, it was noted that stimulation improves not only motor activity, but also sensory function in patients with SCI ( Gerasimenko et al, 2016 ; Gad P. N. et al, 2018 ), stroke and multiple sclerosis ( Kreydin et al, 2020 ), and children with cerebral palsy ( Edgerton et al, 2021 ; Gad et al, 2021a ). Here we observed a similar phenomenon, whereby rectal sensation changed during application of stimulation, enabling two of the three participants to sense inflation of a rectal balloon at a lower volume than in the absence of stimulation.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Non-invasive Spinal Cord Stimulation on Anorectal Function in Individuals With Spinal Cord Injury: A Case Series

et al. 2022

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Spinal cord injury (SCI) is a devastating condition that impacts multiple organ systems. Neurogenic bowel dysfunction (NBD) frequently occurs after a SCI leading to reduced sensation of bowel fullness and bowel movement often leading to constipation or fecal incontinence. Spinal Neuromodulation has been proven to be a successful modality to improve sensorimotor and autonomic function in patients with spinal cord injuries. The pilot data presented here represents the first demonstration of using spinal neuromodulation to activate the anorectal regions of patients with spinal cord injuries and the acute and chronic effects of stimulation. We observed that spinal stimulation induces contractions as well as changes in sensation and pressure profiles along the length of the anorectal region. In addition, we present a case report of a patient with a SCI and the beneficial effect of spinal neuromodulation on the patient’s bowel program.

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Section: Discussionmentioning

confidence: 99%

The Effect of Non-invasive Spinal Cord Stimulation on Anorectal Function in Individuals With Spinal Cord Injury: A Case Series

et al. 2022

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“…Additionally, fUSI could play a major role in identifying the MOA through which functional bidirectional connectivity across a functionally “complete” spinal injury can be reestablished with spinal neuromodulation techniques 4 . Specifically, in the reorganization of neural networks that mediate spinal-supraspinal connectivity in children with cerebral palsy in response to spinal neuromodulation 73 , and in the improvement of bladder function after paralysis 74 . Overall, our study provides a high-resolution imaging technique to study the MOA of ESCS, and a tool to improve the efficacy of electrical stimulation by optimizing stimulation parameters based on the stimulation-evoked spinal cord hemodynamic signal.…”

Section: Discussionmentioning

confidence: 99%

Functional Ultrasound Imaging of the Human Spinal Cord

Agyeman

Lee

Russin

et al. 2022

Preprint

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The integration of functional responses in the human spinal cord into the nervous system is not well understood. Herein we demonstrate the first in-human functional ultrasound imaging (fUSI) of spinal cord response to epidural electrical stimulation. fUSI is a minimally invasive neuroimaging technique that can record blood flow at a level of spatial and temporal precision not previously achieved in the human spinal cord. By leveraging fUSI and epidural electrical spinal cord stimulation in patients who underwent surgery, we recorded and characterized for the first-time hemodynamic responses of the human spinal cord to an electrical neuromodulatory intervention commonly used for treating pain, and increasingly used for sensory-motor and autonomic functions. We found that the hemodynamic response to epidural stimulation reflects a spatiotemporal modulation of the spinal cord circuitry not previously recognized. The impact of this analytical capability is significant for several reasons. It offers a mechanism to assess blood flow changes with a new level of precision which can be obtained in real time under in vivo conditions. Additionally, we demonstrate that fUSI can successfully decode the spinal cord state in a single trial, which is of fundamental importance for developing real-time closed-loop neuromodulation systems. Also, we show that spinal cord hemodynamic changes due to epidural electrical stimulation occur primarily at the level of small vessels. Overall, our work is a critical step towards developing a vital technique to study spinal cord function and understand the potential effects of clinical neuromodulation for spinal cord and other neurological disorders.

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“…The lower values of APLV and AAC in the trunk under the EC condition may respond to the reduction of visual information to increase the input of other sensory systems (e.g., somatosensory) to control the structural redundancy of the trunk. The sensory system is thought to provide the central nervous system with redundant information to maintain body position, and the control system responds to changes caused by a decrease in some sensory information by increasing other sensory inputs and appropriate muscle contractions 51 . This type of neuroscientific mechanism is known as sensory-re-weighting 52 – 56 .…”

Section: Discussionmentioning

confidence: 99%

Control of structural redundancy from the head to trunk in the human upright standing revealed using a data-driven approach

Tanaka

Fujiki

Atomi

et al. 2022

Sci Rep

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The human being dynamically and highly controls the head–trunk with redundant mechanical structures to maintain a stable upright standing position that is inherently unstable. The posture control strategies are also affected by the differences in the conditions of sensory inputs. However, it is unclear how the head–trunk segmental properties are altered to respond to situations that require appropriate changes in standing posture control strategies. We used a data-driven approach to conduct a multipoint measurement of head–trunk sway control in a quiet standing position with differences in the conditions of sensory inputs. Healthy young subjects with 22 accelerometers attached to their backs were evaluated for head–trunk vibration during quiet standing under two conditions: one with open eyes and one with closed eyes. The synchronization of the acceleration and the instantaneous phase was then calculated. The results showed that the synchronization of acceleration and instantaneous phase varied depending on the visual condition, and there were some continuous coherent patterns in each condition. Findings were that the structural redundancy of the head–trunk, which is multi-segmental and has a high mass ratio in the whole body, must be adjusted adaptively according to the conditions to stabilize upright standing in human-specific bipeds.

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Engaging Spinal Networks to Mitigate Supraspinal Dysfunction After CP

Cited by 16 publications

References 30 publications

The Effect of Non-invasive Spinal Cord Stimulation on Anorectal Function in Individuals With Spinal Cord Injury: A Case Series

The Effect of Non-invasive Spinal Cord Stimulation on Anorectal Function in Individuals With Spinal Cord Injury: A Case Series

Functional Ultrasound Imaging of the Human Spinal Cord

Control of structural redundancy from the head to trunk in the human upright standing revealed using a data-driven approach

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