Publisher Correction: Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia

Gill, Megan L.; Grahn, Peter J.; Calvert, Jonathan S.; Linde, Margaux B.; Lavrov, Igor; Strommen, Jeffrey A.; Beck, Lisa A.; Sayenko, Dimitry G.; Straaten, Meegan G. Van; Drubach, Dina I.; Veith, Daniel D.; Thoreson, Andrew R.; Lopez, Cesar; Gerasimenko, Yury; Edgerton, V. Reggie; Lee, Kendall H.; Zhao, Kristin D.

doi:10.1038/s41591-018-0248-7

Cited by 16 publications

(10 citation statements)

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“…Hofstoetter et al, 2019;Sayenko et al, 2019). Epidural stimulation has been effective in treating both autonomic (Harkema et al, 2018;Herrity et al, 2018;Hubscher et al, 2018) and motor functions (Grahn et al, 2017;Angeli et al, 2018;Gill et al, 2018;Wagner et al, 2018) while maintaining the overall location of the implant even though the scope of the neural networks being neuromodulated may be more limited compared to transcutaneous stimulation. Evidence to date suggest that the transcutaneous approach in general has a greater advantage because of a more encompassing combination of networks that can be modulated to multiple organ systems.…”

Section: Discussion Neuromodulation Enables Restoration Of Sensation mentioning

confidence: 99%

Transcutaneous Electrical Spinal Cord Neuromodulator (TESCoN) Improves Symptoms of Overactive Bladder

Kreydin

Zhong

Latack

et al. 2020

Front. Syst. Neurosci.

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Neuromodulation is a therapeutic technique that is well-established in the treatment of idiopathic Lower urinary tract (LUT) dysfunction such as overactive bladder (OAB). We have recently developed a novel neuromodulation approach, Transcutaneous Electrical Spinal Cord Neuromodulation (TESCoN) and demonstrated its acute effects on LUT dysfunction after spinal cord injury (SCI) during urodynamic studies. We found that TESCoN can promote urinary storage and induce urinary voiding when delivered during urodynamic studies. The objective of this study was to determine whether TESCoN can retrain the spinal neural networks to induce chronic improvement in the LUT, such that positive changes can persist even in the absence of stimulation. In addition, we wished to examine the effect of TESCoN on LUT dysfunction due to multiple pathologies. To achieve this objective, 14 patients [SCI = 5, stroke = 5, multiple sclerosis (MS) = 3, and idiopathic OAB (iOAB) = 1] completed 24 sessions of TESCoN over the course of 8 weeks. Patients completed urodynamic studies before and after undergoing TESCoN therapy. Additionally, each subject completed a voiding diary and the Neurogenic Bladder Symptom Score questionnaire before and after receiving TESCoN therapy. We found that TESCoN led to decreased detrusor overactivity, improved continence, and enhanced LUT sensation across the different pathologies underlying LUT dysfunction. This study serves as a pilot in preparation for a rigorous randomized placebo-controlled trial designed to demonstrate the effect of TESCoN on LUT function in neurogenic and non-neurogenic conditions. NEW AND NOTEWORTHY Non-Surgical modality to reduce incidence of urinary incontinence and improve neurogenic bladder symptom scores (NBSS) in individuals with neurogenic bladder due to spinal cord injury or stroke.

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Section: Discussion Neuromodulation Enables Restoration Of Sensation mentioning

confidence: 99%

Transcutaneous Electrical Spinal Cord Neuromodulator (TESCoN) Improves Symptoms of Overactive Bladder

Kreydin

Zhong

Latack

et al. 2020

Front. Syst. Neurosci.

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“…[4][5][6][7] Finally, the same point of importance applies in the recovery of balance during standing as the foundation for regaining the ability to walk, [8][9][10][11] including stepping assisted by robotic devices. 12,13 Having observed the recovery of standing, stepping, and voluntary control of lower limb movements with epidural stimulation, [14][15][16][17][18][19][20][21] one can predict that similar results could be achieved with a non-invasive and more readily adaptable approach. For example, it is feasible to neuromodulate excitability at multiple levels of the spinal neuraxis, ranging from the cervical to the coccygeal cord levels, to facilitate motor function using transcutaneous electrical spinal cord stimulation (tSCS).…”

Section: Introductionmentioning

confidence: 99%

Self-Assisted Standing Enabled by Non-Invasive Spinal Stimulation after Spinal Cord Injury

Sayenko¹,

Rath

Ferguson

et al. 2019

Journal of Neurotrauma

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Neuromodulation of spinal networks can improve motor control after spinal cord injury (SCI). The objectives of this study were to (1) determine whether individuals with chronic paralysis can stand with the aid of non-invasive electrical spinal stimulation with their knees and hips extended without trainer assistance, and (2) investigate whether postural control can be further improved following repeated sessions of stand training. Using a double-blind, balanced, within-subject crossover, and sham-controlled study design, 15 individuals with SCI of various severity received transcutaneous electrical spinal stimulation to regain self-assisted standing. The primary outcomes included qualitative comparison of need of external assistance for knee and hip extension provided by trainers during standing without and in the presence of stimulation in the same participants, as well as quantitative measures, such as the level of knee assistance and amount of time spent standing without trainer assistance. None of the participants could stand unassisted without stimulation or in the presence of sham stimulation. With stimulation all participants could maintain upright standing with minimum and some (n = 7) without external assistance applied to the knees or hips, using their hands for upper body balance as needed. Quality of balance control was practice-dependent, and improved with subsequent training. During self-initiated bodyweight displacements in standing enabled by spinal stimulation, high levels of leg muscle activity emerged, and depended on the amount of muscle loading. Our findings indicate that the lumbosacral spinal networks can be modulated transcutaneously using electrical spinal stimulation to facilitate self-assisted standing after chronic motor and sensory complete paralysis.

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“…Although this has been a classical staple for lower limb rehabilitation, we recently witnessed a paradigm shift to therapies designed to reinforce voluntary supraspinal effort (13,22,23). The user is required to attempt engaging residual descending projections, while neurostimulation specifically targets the lumbar pattern-generating networks (12,24,25). These new therapies have shown outstanding potential to promote beneficial activity-dependent plasticity and thus foster recovery of voluntary movements (3,12,23,24).…”

Section: Introductionmentioning

confidence: 99%

An intracortical neuroprosthesis immediately alleviates walking deficits and improves recovery of leg control after spinal cord injury

Bonizzato

Martinez

2021

Sci. Transl. Med.

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Most rehabilitation interventions after spinal cord injury (SCI) only target the sublesional spinal networks, peripheral nerves, and muscles. However, mammalian locomotion is not a mere act of rhythmic pattern generation. Recovery of cortical control is essential for voluntary movement and modulation of gait. We developed an intracortical neuroprosthetic intervention to SCI, with the goal to condition cortical locomotor control. Neurostimulation delivered in phase coherence with ongoing locomotion immediately alleviated primary SCI deficits, such as leg dragging, in rats with incomplete SCI. Cortical neurostimulation achieved high fidelity and markedly proportional online control of leg trajectories in both healthy and SCI rats. Long-term neuroprosthetic training lastingly improved cortical control of locomotion, whereas short training held transient improvements. We performed longitudinal awake cortical motor mapping, unveiling that recovery of cortico-spinal transmission tightly parallels return of locomotor function in rats. These results advocate directly targeting the motor cortex in clinical neuroprosthetic approaches.

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Publisher Correction: Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia

Abstract: This affiliation has been added for the author, and the rest of the affiliations have been renumbered accordingly. The error has been corrected in the HTML and PDF versions of this article.

Cited by 16 publications

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Transcutaneous Electrical Spinal Cord Neuromodulator (TESCoN) Improves Symptoms of Overactive Bladder

Transcutaneous Electrical Spinal Cord Neuromodulator (TESCoN) Improves Symptoms of Overactive Bladder

Self-Assisted Standing Enabled by Non-Invasive Spinal Stimulation after Spinal Cord Injury

An intracortical neuroprosthesis immediately alleviates walking deficits and improves recovery of leg control after spinal cord injury

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