Epidural Electrical Stimulation: A Review of Plasticity Mechanisms That Are Hypothesized to Underlie Enhanced Recovery From Spinal Cord Injury With Stimulation
Spinal cord injury (SCI) often results in life-long sensorimotor impairment. Spontaneous recovery from SCI is limited, as supraspinal fibers cannot spontaneously regenerate to form functional networks below the level of injury. Despite this, animal models and humans exhibit many motor behaviors indi...
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doaj-64a63d0a32c84279aa7c5269e1152f702020-11-25T03:26:09ZengFrontiers Media S.A.Frontiers in Molecular Neuroscience1662-50992020-09-011310.3389/fnmol.2020.00163531619Epidural Electrical Stimulation: A Review of Plasticity Mechanisms That Are Hypothesized to Underlie Enhanced Recovery From Spinal Cord Injury With StimulationJaclyn T. Eisdorfer0Rupert D. Smit1Kathleen M. Keefe2Michel A. Lemay3George M. Smith4Andrew J. Spence5Department of Bioengineering, College of Engineering, Temple University, Philadelphia, PA, United StatesDepartment of Neuroscience, Shriners Hospitals Pediatric Research Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United StatesDepartment of Bioengineering, College of Engineering, Temple University, Philadelphia, PA, United StatesDepartment of Bioengineering, College of Engineering, Temple University, Philadelphia, PA, United StatesDepartment of Neuroscience, Shriners Hospitals Pediatric Research Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United StatesDepartment of Bioengineering, College of Engineering, Temple University, Philadelphia, PA, United StatesSpinal cord injury (SCI) often results in life-long sensorimotor impairment. Spontaneous recovery from SCI is limited, as supraspinal fibers cannot spontaneously regenerate to form functional networks below the level of injury. Despite this, animal models and humans exhibit many motor behaviors indicative of recovery when electrical stimulation is applied epidurally to the dorsal aspect of the lumbar spinal cord. In 1976, epidural stimulation was introduced to alleviate spasticity in Multiple Sclerosis. Since then, epidural electrical stimulation (EES) has been demonstrated to improve voluntary mobility across the knee and/or ankle in several SCI patients, highlighting its utility in enhancing motor activation. The mechanisms that EES induces to drive these improvements in sensorimotor function remain largely unknown. In this review, we discuss several sensorimotor plasticity mechanisms that we hypothesize may enable epidural stimulation to promote recovery, including changes in local lumbar circuitry, propriospinal interneurons, and the internal model. Finally, we discuss genetic tools for afferent modulation as an emerging method to facilitate the search for the mechanisms of action.https://www.frontiersin.org/article/10.3389/fnmol.2020.00163/fullplasticityelectrical epidural stimulationpropriospinal detoursmonosynaptic connectionsinternal motor copyefferent motor copy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jaclyn T. Eisdorfer Rupert D. Smit Kathleen M. Keefe Michel A. Lemay George M. Smith Andrew J. Spence |
spellingShingle |
Jaclyn T. Eisdorfer Rupert D. Smit Kathleen M. Keefe Michel A. Lemay George M. Smith Andrew J. Spence Epidural Electrical Stimulation: A Review of Plasticity Mechanisms That Are Hypothesized to Underlie Enhanced Recovery From Spinal Cord Injury With Stimulation Frontiers in Molecular Neuroscience plasticity electrical epidural stimulation propriospinal detours monosynaptic connections internal motor copy efferent motor copy |
author_facet |
Jaclyn T. Eisdorfer Rupert D. Smit Kathleen M. Keefe Michel A. Lemay George M. Smith Andrew J. Spence |
author_sort |
Jaclyn T. Eisdorfer |
title |
Epidural Electrical Stimulation: A Review of Plasticity Mechanisms That Are Hypothesized to Underlie Enhanced Recovery From Spinal Cord Injury With Stimulation |
title_short |
Epidural Electrical Stimulation: A Review of Plasticity Mechanisms That Are Hypothesized to Underlie Enhanced Recovery From Spinal Cord Injury With Stimulation |
title_full |
Epidural Electrical Stimulation: A Review of Plasticity Mechanisms That Are Hypothesized to Underlie Enhanced Recovery From Spinal Cord Injury With Stimulation |
title_fullStr |
Epidural Electrical Stimulation: A Review of Plasticity Mechanisms That Are Hypothesized to Underlie Enhanced Recovery From Spinal Cord Injury With Stimulation |
title_full_unstemmed |
Epidural Electrical Stimulation: A Review of Plasticity Mechanisms That Are Hypothesized to Underlie Enhanced Recovery From Spinal Cord Injury With Stimulation |
title_sort |
epidural electrical stimulation: a review of plasticity mechanisms that are hypothesized to underlie enhanced recovery from spinal cord injury with stimulation |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Molecular Neuroscience |
issn |
1662-5099 |
publishDate |
2020-09-01 |
description |
Spinal cord injury (SCI) often results in life-long sensorimotor impairment. Spontaneous recovery from SCI is limited, as supraspinal fibers cannot spontaneously regenerate to form functional networks below the level of injury. Despite this, animal models and humans exhibit many motor behaviors indicative of recovery when electrical stimulation is applied epidurally to the dorsal aspect of the lumbar spinal cord. In 1976, epidural stimulation was introduced to alleviate spasticity in Multiple Sclerosis. Since then, epidural electrical stimulation (EES) has been demonstrated to improve voluntary mobility across the knee and/or ankle in several SCI patients, highlighting its utility in enhancing motor activation. The mechanisms that EES induces to drive these improvements in sensorimotor function remain largely unknown. In this review, we discuss several sensorimotor plasticity mechanisms that we hypothesize may enable epidural stimulation to promote recovery, including changes in local lumbar circuitry, propriospinal interneurons, and the internal model. Finally, we discuss genetic tools for afferent modulation as an emerging method to facilitate the search for the mechanisms of action. |
topic |
plasticity electrical epidural stimulation propriospinal detours monosynaptic connections internal motor copy efferent motor copy |
url |
https://www.frontiersin.org/article/10.3389/fnmol.2020.00163/full |
work_keys_str_mv |
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