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Project

Neural Pathways and Recovery of Motor Function with Epidural Stimulation

Funder: Craig H Neilsen Foundation

Funding period
USD 300 K
Funding amount
Abstract
Motor complete spinal cord injury (SCI) results in severe paralysis below the lesion as a result of marked interruption in descending inputs to the spinal cord. The spinal cord itself does demonstrate an innate plastic ability to recover after injury, however, it is likely that recovery of motor function also involves strengthening of descending inputs to the neuronal circuitry responsible for motor functions. Epidural electrical stimulation (ES) combined with rehabilitation remains one of the most promising interventions following a complete spinal cord injury. This intervention provides an environment within the injured spinal cord that enables sensory-motor circuits to recover by capitalizing on the inherent functional capacity of these spinal circuits. To date, we have observed twelve individuals with motor complete injury who demonstrate recovery of either i) independent overground walking, ii) treadmill stepping, iii) independent standing and iv) voluntary movement. To assess the mechanisms of this recovery and to understand why some individuals may have recovered differently, we will examine the integrity of the corticospinal, reticulospinal and vestibulopinal tracts, in addition to the long propriospinal pathways within the human spinal cord. These pathways all play a significant and unique role in the generation of movements, however, to date only the role of the corticospinal tract in motor recovery after incomplete SCI has been elucidated. We hypothesize that ES increases the central state of excitability below the lesion, thereby allowing otherwise 'non-functional' levels of descending input to effectively modulate spinal cord activity. We further hypothesize that the contributions of each type of input to the spinal cord below the lesion will vary between individuals and may be related to the type of motor recovery exhibited by each individual. We will utilize appropriate stimuli to test each pathway both in the presence and absence of the three different ES configurations (ESstep, ESstand and ESvol). For the first time, the role of extrapyramidal pathways in motor recovery after SCI will be assessed, and this work will assess the viability of ES and rehabilitation in restoring functional descending connectivity. By furthering our understanding in this area, we hope that we will shed light on novel targets for further functional improvement after human SCI. (CHN: SCIRTS chn:wdg)
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System

Categories
  • FOR (ANZSRC)

    1106 Human Movement and Sports Science

  • FOR (ANZSRC)

    1109 Neurosciences

  • RCDC

    Injury (total) Accidents/Adverse Effects

  • RCDC

    Injury - Trauma - (Head and Spine)

  • RCDC

    Regenerative Medicine

  • RCDC

    Neurosciences

  • RCDC

    Rehabilitation

  • RCDC

    Spinal Cord Injury

  • RCDC

    Clinical Research

  • RCDC

    Neurodegenerative

  • HRCS HC

    Neurological

  • HRCS RAC

    1.1 Normal biological development and functioning

  • HRCS RAC

    2.1 Biological and endogenous factors

  • Health Research Areas

    Biomedical

  • Broad Research Areas

    Basic Science