Download or read book Advances in Spinal Cord Epidural Stimulation for Motor and Autonomic Functions Recovery After Severe Spinal Cord Injury written by Enrico Rejc and published by Frontiers Media SA. This book was released on 2022-02-14 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Neuromodulation Through Spinal Cord Stimulation for Functional Restoration and Rehabilitation After Cervical Spinal Cord Injury written by Soshi Samejima and published by . This book was released on 2020 with total page 186 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spinal cord injury (SCI) results in permanent neurological deficits. The limited physical function impacts quality of life and socioeconomic engagement. Up to now, we have no effective interventions to restore impaired function. Activity-dependent plasticity holds great promise to promote recovery of motor and autonomic function. Neuromodulation via electrical stimulation of the spinal cord has shown growing evidence of promoting activity-dependent plasticity and functional gains following SCI. First, we review the background information about the burden and recovery process of SCI. We also summarize current advances of pharmacological, cellular, and neuromodulation approaches. Emerging evidence with stimulation technologies demonstrates potential to facilitate neuroplasticity bridging the lesion. In the second part, we demonstrated a cost- and time-efficient experimental tool to assess forelimb function in a rodent model with severe cervical SCI. This novel strategy for the behavior task may accelerate preclinical trials. By using the behavior tasks, in the third part, we present a clinically viable brain-computer spinal interface to reanimate paralyzed forelimb function in rodents with cervical SCI. We demonstrate a stable and computationally efficient local field potential decoder enabling graded forelimb movements via epidural stimulation. Consequently, the brain-controlled epidural stimulation led to functional improvements in freely moving rats with cervical SCI. The closed-loop algorithm was implemented in an implantable size circuit capable of onboard computing, providing a clinically viable strategy to accelerate the translation of brain-computer interfaces to human use. In the fourth part, we investigate the efficacy of transcutaneous spinal stimulation paired with intensive locomotor training in two individuals with cervical SCI. We present the additive effect of transcutaneous spinal stimulation for locomotor recovery with more coordinated movements. Furthermore, we demonstrate the first evidence of transcutaneous spinal stimulation for restoring bowel function. Lastly, we discuss the potential of these neurotechnology approaches. We address the current limitations of scientific understanding and technology to guide future research to restore sensorimotor and autonomic function following cervical SCI.

Download or read book Neuromodulation for Restoration of Spinal Autonomic Functions that Increase Exercise Capacity After Spinal Cord Injury written by Sarah Flett and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spinal cord injury results in varying degrees of motor and autonomic dysfunction. Cardiovascular and metabolic diseases are much more prevalent with an earlier onset in persons with spinal cord injury compared to the general population. Physical activity is widely accepted method for maintaining appropriate body weight, composition and overall health. Unfortunately, those living with a cervical or high thoracic spinal cord injury experience mild to severe dysautonomia, limiting their exercise performance and subsequent health benefits. Electrical spinal cord stimulation has been a therapeutic strategy investigated in recent years and has demonstrated beneficial effects on motor function as well as autonomic functions related to bladder, bowel and sexual function. Within the last 15 years, spinal stimulation studies aimed at improving motor function began to include anecdotal reports of improved autonomic functions, such cardiovascular control, metabolism, and exercise performance. This area of research is relatively new, and the neural mechanisms mediating these positive effects and the optimal parameters and stimulus locations have yet to be elucidated. We therefore performed a systematic scoping review to identify what has been reported about the effects of spinal cord stimulation on autonomic functions related to exercise outcomes to help identify knowledge gaps. A total of 1815 unique records were screened for eligibility following an electronic database search of Medline, EMBASE, Scopus, CINAHL and SportDiscus. Based on our inclusion criteria, 21 studies were included in this review. Of these 21 articles, 9 were transcutaneous stimulation studies and 12 were epidural stimulation studies. Improvements in blood pressure regulation, exercise output, thermoregulation, and body composition were reported in multiple studies. However, stimulation locations and parameters were highly variable and the number of participants relatively small. Therefore, further pre-clinical mechanism-based research and studies systematically testing different stimulus locations and parameters with larger numbers of participants are necessary to establish optimal stimulation interventions to improve exercise related autonomic functions.

Download or read book Facilitation of Motor and Bladder Function After Spinal Cord Injury Via Epidural Stimulation and Pharmacology written by Parag Gad and published by . This book was released on 2013 with total page 194 pages. Available in PDF, EPUB and Kindle. Book excerpt: A complete spinal cord transection results in loss of all supraspinal motor and bladder control below the level of the injury. The neural circuitry in the lumbosacral spinal cord, however, can generate locomotor patterns in the hindlimbs of rats and cats with the aid of motor training, epidural stimulation and/or administration of monoaminergic agonists. Gerasimenko et al., (2003) first reported the use of electrical stimulation to facilitate locomotion in chronic decerebrated cats. Ichiyama et al (2005) then demonstrated that epidural electrical stimulation of the spinal cord can induce rhythmic, alternating hindlimb locomotor activity in chronic spinal rats. Stimulation at the L2 spinal segment at frequencies between 30 and 50 Hz consistently produced successful bilateral stepping. Similar epidural stimulation at other spinal segments were less effective, e.g., epidural stimulation at the T13 or L1 evoked rhythmic activity in only one leg and stimulation at the L3, L4, or L5 produced mainly flexion movements. More recently, completely paralyzed (motor complete, sensory incomplete) human subjects were implanted with a commercially available spinal cord electrode array and stimulation package originally designed for pain suppression (Harkema et al., 2011). Stimulation of specific spinal segments (caudal electrodes, ~ S1 spinal level) in combination with the sensory information from the lower limbs and weeks of stand training was sufficient to generate full weight-bearing standing. These subjects also recovered some voluntary control of movements of the toe, ankle, and the entire lower limb, but only when epidural stimulation was present. Thus it appears that the epidural stimulation provided excitation of lumbosacral interneurons and motoneurons that, when combined with the weak excitatory activity of descending axons that were not otherwise detectable, achieved a level of excitation that was sufficient to activate the spinal motor circuits. These results demonstrate that some patients clinically diagnosed as having complete paralysis can use proprioceptive input combined with some synaptic input from descending motor signals, perhaps residual but functionally silent without epidural stimulation to the spinal motor circuits to generate and control a range of motor functions during epidural stimulation. The mechanisms of pharmacological and/or epidural electrical stimulation that enable motor control (eEmc) in the spinal circuitry for locomotion are still not clearly understood. During standing, a single bipolar epidural stimulus between L2 and S1 produces three types of evoked responses, i.e., early (ER, latency 1-3 ms), middle (MR, latency 4-6 ms), and late (LRs, latency >7 ms) in the hindlimb muscles in both intact (Gerasimenko et al., 2006) and spinal (Lavrov et al., 2006) rats. Similar responses were observed during rhythmic locomotor-like EMG activity in the hindlimb muscles of spinal rats while stepping on a motorized treadmill in the presence of epidural stimulation (40 Hz) between L2 and S1 (Lavrov et al., 2008). In addition, the time course of the re-emergence of the LRs was similar to that for the recovery of stepping after a complete spinal cord injury (SCI), indicating that LRs are a potential biomarker of functional recovery (Lavrov et al., 2006). The results demonstrate that spinal rats can stand and step when the spinal cord is stimulated (tonic 40 Hz stimulation) by electrodes located at specific sites on the spinal cord and at specific frequencies of stimulation. The quality of stepping and standing was dependent on the location of the electrodes on the spinal cord, the specific stimulation parameters, and the orientation of the cathode and anode. spinal cord stimulation triggered evoked potentials in flexor and extensors muscles form a 'foot print' of the physiological state of the spinal cord. Chronic subthreshold stimulation enabled greater activity in completely transected rats but only with stimulation. Spinal cord stimulation at specific frequencies resulted in partial bladder control.

Download or read book Locomotor Training written by Susan J. Harkema and published by . This book was released on 2011 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: Physical rehabilitation for walking recovery after spinal cord injury is undergoing a paradigm shift. Therapy historically has focused on compensation for sensorimotor deficits after SCI using wheelchairs and bracing to achieve mobility. With locomotor training, the aim is to promote recovery via activation of the neuromuscular system below the level of the lesion. What basic scientists have shown us as the potential of the nervous system for plasticity, to learn, even after injury is being translated into a rehabilitation strategy by taking advantage of the intrinsic biology of the central nervous system. While spinal cord injury from basic and clinical perspectives was the gateway for developing locomotor training, its application has been extended to other populations with neurologic dysfunction resulting in loss of walking or walking disability.

Download or read book Maximising Recovery of Function After Severe Spinal Cord Injury by Combining Electrical Epidural Stimulation Locomotor Training and Intraspinal Lentiviral mediated Chondroitinase ABC Delivery written by Yazi Dhahia Al'joboori and published by . This book was released on 2016 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Spinal Cord Stimulation written by Paul Kreis and published by Oxford University Press. This book was released on 2009-06-03 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spinal cord stimulators (SCS) are implantable medical devices used to treat chronic pain of neurologic origin, such as sciatica, intractable back pain, and diabetic. The device generates an electric pulse near the spinal cord's dorsal surface, providing a parasthesia sensation that alters the perception of pain by the patient, and is typically used in conjunction with conventional medical management. Spinal cord stimulators (SCS) are implantable medical devices used to treat chronic pain of neurologic origin, such as sciatica, intractable back pain, and diabetic. The device generates an electric pulse near the spinal cord's dorsal surface, providing a parasthesia sensation that alters the perception of pain by the patient, and is typically used in conjunction with conventional medical management.

Download or read book Electrical Stimulation and Recording of the Spinal Cord for Autonomic Neuromodulation written by Paymon Garakani Rezaii and published by . This book was released on 2016 with total page 101 pages. Available in PDF, EPUB and Kindle. Book excerpt: Electrical stimulation of the spinal cord has been demonstrated to facilitate recovery of motor functions. Here, the effects of spinal cord stimulation on autonomic functions is demonstrated via two series of experiments. The first series involved epidural stimulation of the dorsal cervical spinal cord in anesthetized patients for respiratory modulation. Application of epidural stimulation resulted in acute changes in respiratory rate and tidal volume, dependent on the location and frequency of stimulation. The second series involved transcutaneous electrical stimulation (tSCS) of the thoracolumbar spinal cord of spinal cord injury subjects to enable bladder function. Results demonstrate improvements in bladder function via repeated application of tSCS. Lastly, epidural thoracic potentials were analyzed to determine if the waveforms contained information regarding the onset of bladder sensations. Distinct differences in spectral characteristics of the waveforms were demonstrated; however, a larger sample size is needed to confirm whether the waveforms can decode urge onset.

Download or read book Epidural Spinal Stimulation is Associated with Changes in Surviving Axons and Associated Glial Cells After Spinal Cord Injury in Rodents written by Kyleigh Alexis DePetro and published by . This book was released on 2017 with total page 46 pages. Available in PDF, EPUB and Kindle. Book excerpt: We previously demonstrated that epidural spinal stimulation (ES) and transcutaneous stimulation combined with step training can restore voluntary motor control in humans with chronic, motor-complete spinal cord injuries in at least 24 hours. The purpose of this study was to determine the underlying pathways involved. We hypothesized that chronic ES can provide motor improvements that persist in the absence of stimulation and that both surviving axons and their associated glial cells play important roles in ES-facilitated recovery. Our kinematic data suggested that chronic ES is associated with persistent motor recovery when ES is off. Our histological analysis demonstrated that the node of Ranvier, oligodendrocytes, astrocytic process extension, and apoptosis play important roles in mediating axonal integrity associated with functional motor improvement with ES in rats.

Download or read book Utilizing Neuromodulation of the Spinal Cord to Assess and Modulate Aberrant Spinal Physiology Below the Lesion Following Severe Upper Motor Neuron Injury written by Lisa Moore and published by . This book was released on 2018 with total page 169 pages. Available in PDF, EPUB and Kindle. Book excerpt: Upper motor neuron injury damages the descending circuits connecting the brain to sensory and motor neurons responsible for sensing and interacting with the world. While spinal cord stimulation is showing extraordinary promise as a novel therapeutic to restore lost motor function following spinal cord injury, we have yet to fully characterize the mechanisms of its action or identify the limits of its therapeutic potential. Towards these ends I conducted a series of three studies which utilized spinal stimulation in novel subject populations to map the cervical spinal cord, identify and modulate aberrant spinal physiology, and enhance upper limb function. In the first study a group of SCI subjects with motor complete lesions, half of which had no measurable hand strength, received transcutaneous stimulation to the cervical spinal cord alone and in combination with the partial serotonergic agonist buspirone. Stimulation but not buspirone significantly improved hand function in subjects with measurable strength prior to the study and maintained hand strength for up to five months following treatment in more functional subjects. In the second study, two subjects who demonstrated improvement with transcutaneous stimulation but failed to maintain it 5 months after treatment, received epidural stimulators. The different properties and performance outcomes of the two forms of stimulation were compared in these severely impaired subjects. Finally in a cohort of rats, epidural stimulation was used to map the cervical spinal cord, track physiological changes in the spinal cord following a severe stroke injury to the motor cortex, and treat observed deficits in reaching success and muscle activity. While 20 Hz stimulation enhanced afferent derived spinal activity, only 1 Hz stimulation resulted in improved reaching success and muscle activity. Together these studies further our understanding, by identifying patient pools most receptive to spinal cord stimulation, characterizing the different properties and functional outcomes of transcutaneous versus epidural stimulation, and illustrating the potential to utilize spinal cord stimulation for other forms of upper motor neuron injury.

Download or read book Neuroprosthetics and Brain Computer Interfaces in Spinal Cord Injury written by Gernot Müller-Putz and published by Springer Nature. This book was released on 2021-04-26 with total page 377 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive overview of the current state of the art of practical applications of neuroprosthesis based on functional electrical stimulation for restoration of motor functions lost by spinal cord injury and discusses the use of brain-computer interfaces for their control. The book covers numerous topics starting with basics about spinal cord injury, electrical stimulation, electrical brain signals and brain-computer interfaces. It continues with an overview of neuroprosthetic solutions for different purposes and non-invasive and invasive brain-computer interface implementations and presents clinical use cases and practical applications of BCIs. Finally, the authors give an outlook on cutting edge research with a high potential for clinical translation in the near future. All authors committed themselves to use easy-to-understand language and to avoid very specific information, focusing instead on the essential aspects. This makes this book an ideal choice not only for researchers and clinicians at all stages of their education interested in the topic of brain-computer interface-controlled neuroprostheses, but also for end users and their caregivers who want to inform themselves about the current technological possibilities to improve paralyzed motor functions.

Download or read book The Neuroscience of Spinal Cord Injury written by Rajkumar Rajendram and published by Academic Press. This book was released on 2022-05-27 with total page 1186 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diagnosis and Treatment of Spinal Cord Injury will enhance readers’ understanding of the complexities of the diagnosis and management of spinal cord injuries. Featuring chapters on drug delivery, exercise, and rehabilitation, this volume discusses in detail the impact of the clinical features, diagnosis, management, and long-term prognosis of spinal cord injuries on the lives of those affected. The book has applicability for neuroscientists, neurologists, clinicians, and anyone working to better understand spinal cord injuries. Spinal injury affects about 10 million people annually worldwide, impacting on the family unit and causing lifelong disabilities, with varied symptoms including paresthesia, spasticity, loss of motor control, and often severe pain. Cellular, Molecular, Physiological, and Behavioral Aspects of Spinal Cord Injury will enhance readers’ understanding of the biological and psychological effects of spinal cord injury. Featuring chapters on gene expression, metabolic effects, and behavior, this volume discusses in detail the impact of spinal cord injury to better understand the underlying pathways and processes. The book has applicability for neuroscientists, neurologists, clinicians, and anyone working to better understand these injuries. Diagnosis and Treatment of Spinal Cord Injury: Covers both the diagnosis and treatment of spinal cord injury Contains chapter abstracts, key facts, dictionary, and summary points to aid in understanding Features chapters on epidemiology and pain Includes MRI usage, biomarkers, and stem cell and gene therapy for management of spinal cord injury Discusses pain reduction, drug delivery, and rehabilitation Cellular, Molecular, Physiological, and Behavioral Aspects of Spinal Cord Injury: Summarizes the neuroscience of spinal cord injury, including cellular and molecular biology Contains chapter abstracts, key facts, dictionary, and summary points to aid in understanding Features chapters on signaling and hormonal events Includes plasticity and gene expression Examines health and stress behaviors after spinal cord injury

Download or read book Diagnosis and Treatment of Spinal Cord Injury written by Rajkumar Rajendram and published by Academic Press. This book was released on 2022-05-10 with total page 628 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diagnosis and Treatment of Spinal Cord Injury will enhance readers’ understanding of the complexities of the diagnosis and management of spinal cord injuries. Featuring chapters on drug delivery, exercise, and rehabilitation, this volume discusses in detail the impact of the clinical features, diagnosis, management, and long-term prognosis of spinal cord injuries on the lives of those affected. The book has applicability for neuroscientists, neurologists, clinicians, and anyone working to better understand spinal cord injuries. Covers both the diagnosis and treatment of spinal cord injury Contains chapter abstracts, key facts, dictionary, and summary points to aid in understanding Features chapters on epidemiology and pain Includes MRI usage, biomarkers, and stem cell and gene therapy for management of spinal cord injury Discusses pain reduction, drug delivery, and rehabilitation

Download or read book Modern Approaches to Augmentation of Brain Function written by Ioan Opris and published by Springer Nature. This book was released on 2021-08-25 with total page 747 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book covers recent advances in neural technology that provide for enhancements for brain function. It addresses a broad range of neural phenomena occurring in the brain circuits involved in perception, cognition, emotion and action, that represent the building blocks of behavior and cognition. Augmentation of brain function can be achieved by using brain implants for recordings, stimulation, or drug delivery. Alternative methods include employing brain-machine interfaces, as well as noninvasive activation of certain brain areas. This volume evaluates existing methods of brain augmentation while discussing the brain circuitry and neuronal mechanisms that make augmentation possible. This volume offers novel insights into brain disorders, and explores new devices for brain repair while also addressing the philosophical and ethical implications of brain augmentation. The information in this book is relevant to researchers in the fields of neuroscience, engineering, and clinical practice. Advance Praise for Modern Approaches to Augmentation of Brain Function: “This impressive book by leading experts in neuroscience and neuroengineering lays out the future of brain augmentation, in which the human mind and machine merge, leading to a rapid exponential growth of the power of humanity.” Ray Kurzweil, best-selling author, inventor, entrepreneur and a recipient of the National Medal of Technology and Innovation (1999), and the Lemelson-MIT Prize (2001) "This book employs a holistic approach in covering the recent advances in the fields of neuroscience, neuroinformatics, neurotechnology and neuro-psycho-pharmacology. Each chapter of the book covers major aspects of modern brain research in connection with the human mind and behavior, and is authored by researchers with unique expertise in their field. " Ioan Dumitrache, Prof. Dr. Eng. Faculty of Computer Science, Polytechnic University of Bucharest, Bucharest, Romania “This book presents compelling perspectives on what interactive neuroscience will look like in the future, delving into the innovatory ideas of a diverse set of neuroscientists, and speculating on the different ways computer chips implanted in the brains of humans can effect intelligence and communication.” György Buzsáki, MD, PhD is the Biggs Professor of Neuroscience, NYU School of Medicine, New York, NY

Download or read book Functional Electrical Stimulation written by Alojz Kralj and published by Routledge. This book was released on 2022-01-27 with total page 208 pages. Available in PDF, EPUB and Kindle. Book excerpt: This reference text covers the fundamental knowledge and principles of functional electrical stimulation (FES) as applied to the spinal cord injured (SCI) patient. The principles of FES application and basic biomechanical issues related to FES in SCI are stressed. The fundamentals regarding patient selection criteria, indication, contraindications, and descriptions of procedures are clearly presented. Also included are the fundamentals and rationale of gait restoration with patient selection, control strategies, and the synthesis of gait sequences with trends in the field. Each chapter contains numerous references to the FES literature for the reader to easily evaluate and extend his knowledge in the area of interest. Biomedical and rehabilitation engineering professionals and researchers for medical doctors, physical therapists, and orthotists will find this publication invaluable.

Download or read book Cellular Molecular Physiological and Behavioral Aspects of Spinal Cord Injury written by Rajkumar Rajendram and published by Academic Press. This book was released on 2022-05-10 with total page 558 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spinal injury affects about 10 million people annually worldwide, impacting on the family unit and causing lifelong disabilities, with varied symptoms including paresthesia, spasticity, loss of motor control, and often severe pain. Cellular, Molecular, Physiological, and Behavioral Aspects of Spinal Cord Injury will enhance readers’ understanding of the biological and psychological effects of spinal cord injury. Featuring chapters on gene expression, metabolic effects, and behavior, this volume discusses in detail the impact of spinal cord injury to better understand the underlying pathways and processes. The book has applicability for neuroscientists, neurologists, clinicians, and anyone working to better understand these injuries. Summarizes the neuroscience of spinal cord injury, including cellular and molecular biology Contains chapter abstracts, key facts, dictionary, and summary points to aid in understanding Features chapters on signaling and hormonal events Includes plasticity and gene expression Examines health and stress behaviors after spinal cord injury

Download or read book Spinal Cord Injury SCI Repair Strategies written by Giuseppe Perale and published by Woodhead Publishing. This book was released on 2019-10-30 with total page 346 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spinal Cord Injury (SCI) Repair Strategies provides researchers the latest information on potential regenerative approaches to spinal cord injury, specifically focusing on therapeutic approaches that target regeneration, including cell therapies, controlled drug delivery systems, and biomaterials. Dr. Giuseppe Perale and Dr. Filippo Rossi lead a team of authoritative authors in academia and industry in this innovative reference on the field of regenerative medicine and tissue engineering. This book presents all the information readers need to understand the current and potential array of techniques, materials, applications and their benefits for spinal cord repair. Covers current and future repair strategies for spinal cord injury repair Focuses on key research trends, clinics, biology and engineering Provides fundamentals on regenerative engineering and tissue engineering