Spinal Cord Imaging Markers and Recovery of Volitional Leg Movement With Spinal Cord Epidural Stimulation in Individuals With Clinically Motor Complete Spinal Cord Injury
Previous studies have shown that epidural stimulation of the lumbosacral spinal cord (scES) can re-enable lower limb volitional motor control in individuals with chronic, clinically motor complete spinal cord injury (SCI). This observation entails that residual supraspinal connectivity to the lumbos...
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Frontiers Media S.A.
2020-10-01
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Series: | Frontiers in Systems Neuroscience |
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Online Access: | https://www.frontiersin.org/articles/10.3389/fnsys.2020.559313/full |
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doaj-d1262d81f35e4c67a00ff2fdfe936924 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Enrico Rejc Enrico Rejc Andrew C. Smith Kenneth A. Weber Beatrice Ugiliweneza Beatrice Ugiliweneza Robert J. Bert Mohammadjavad Negahdar Maxwell Boakye Maxwell Boakye Susan J. Harkema Susan J. Harkema Susan J. Harkema Susan J. Harkema Claudia A. Angeli Claudia A. Angeli Claudia A. Angeli |
spellingShingle |
Enrico Rejc Enrico Rejc Andrew C. Smith Kenneth A. Weber Beatrice Ugiliweneza Beatrice Ugiliweneza Robert J. Bert Mohammadjavad Negahdar Maxwell Boakye Maxwell Boakye Susan J. Harkema Susan J. Harkema Susan J. Harkema Susan J. Harkema Claudia A. Angeli Claudia A. Angeli Claudia A. Angeli Spinal Cord Imaging Markers and Recovery of Volitional Leg Movement With Spinal Cord Epidural Stimulation in Individuals With Clinically Motor Complete Spinal Cord Injury Frontiers in Systems Neuroscience epidural stimulation spinal cord injury voluntary movement spinal cord MRI spinal cord lesion spinal tracts |
author_facet |
Enrico Rejc Enrico Rejc Andrew C. Smith Kenneth A. Weber Beatrice Ugiliweneza Beatrice Ugiliweneza Robert J. Bert Mohammadjavad Negahdar Maxwell Boakye Maxwell Boakye Susan J. Harkema Susan J. Harkema Susan J. Harkema Susan J. Harkema Claudia A. Angeli Claudia A. Angeli Claudia A. Angeli |
author_sort |
Enrico Rejc |
title |
Spinal Cord Imaging Markers and Recovery of Volitional Leg Movement With Spinal Cord Epidural Stimulation in Individuals With Clinically Motor Complete Spinal Cord Injury |
title_short |
Spinal Cord Imaging Markers and Recovery of Volitional Leg Movement With Spinal Cord Epidural Stimulation in Individuals With Clinically Motor Complete Spinal Cord Injury |
title_full |
Spinal Cord Imaging Markers and Recovery of Volitional Leg Movement With Spinal Cord Epidural Stimulation in Individuals With Clinically Motor Complete Spinal Cord Injury |
title_fullStr |
Spinal Cord Imaging Markers and Recovery of Volitional Leg Movement With Spinal Cord Epidural Stimulation in Individuals With Clinically Motor Complete Spinal Cord Injury |
title_full_unstemmed |
Spinal Cord Imaging Markers and Recovery of Volitional Leg Movement With Spinal Cord Epidural Stimulation in Individuals With Clinically Motor Complete Spinal Cord Injury |
title_sort |
spinal cord imaging markers and recovery of volitional leg movement with spinal cord epidural stimulation in individuals with clinically motor complete spinal cord injury |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Systems Neuroscience |
issn |
1662-5137 |
publishDate |
2020-10-01 |
description |
Previous studies have shown that epidural stimulation of the lumbosacral spinal cord (scES) can re-enable lower limb volitional motor control in individuals with chronic, clinically motor complete spinal cord injury (SCI). This observation entails that residual supraspinal connectivity to the lumbosacral spinal circuitry still persisted after SCI, although it was non-detectable when scES was not provided. In the present study, we aimed at exploring further the mechanisms underlying scES-promoted recovery of volitional lower limb motor control by investigating neuroimaging markers at the spinal cord lesion site via magnetic resonance imaging (MRI). Spinal cord MRI was collected prior to epidural stimulator implantation in 13 individuals with chronic, clinically motor complete SCI, and the spared tissue of specific regions of the spinal cord (anterior, posterior, right, left, and total cord) was assessed. After epidural stimulator implantation, and prior to any training, volitional motor control was evaluated during left and right lower limb flexion and ankle dorsiflexion attempts. The ability to generate force exertion and movement was not correlated to any neuroimaging marker. On the other hand, spared tissue of specific cord regions significantly and importantly correlated with some aspects of motor control that include activation amplitude of antagonist (negative correlation) muscles during left ankle dorsiflexion, and electromyographic coordination patterns during right lower limb flexion. The fact that amount and location of spared spinal cord tissue at the lesion site were not related to the ability to generate volitional lower limb movements may suggest that supraspinal inputs through spared spinal cord regions that differ across individuals can result in the generation of lower limb volitional motor output prior to any training when epidural stimulation is provided. |
topic |
epidural stimulation spinal cord injury voluntary movement spinal cord MRI spinal cord lesion spinal tracts |
url |
https://www.frontiersin.org/articles/10.3389/fnsys.2020.559313/full |
work_keys_str_mv |
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doaj-d1262d81f35e4c67a00ff2fdfe9369242020-11-25T03:44:30ZengFrontiers Media S.A.Frontiers in Systems Neuroscience1662-51372020-10-011410.3389/fnsys.2020.559313559313Spinal Cord Imaging Markers and Recovery of Volitional Leg Movement With Spinal Cord Epidural Stimulation in Individuals With Clinically Motor Complete Spinal Cord InjuryEnrico Rejc0Enrico Rejc1Andrew C. Smith2Kenneth A. Weber3Beatrice Ugiliweneza4Beatrice Ugiliweneza5Robert J. Bert6Mohammadjavad Negahdar7Maxwell Boakye8Maxwell Boakye9Susan J. Harkema10Susan J. Harkema11Susan J. Harkema12Susan J. Harkema13Claudia A. Angeli14Claudia A. Angeli15Claudia A. Angeli16Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United StatesDepartment of Neurological Surgery, University of Louisville, Louisville, KY, United StatesUniversity of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Physical Therapy Program, Aurora, CO, United StatesDepartment of Anethesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United StatesKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United StatesDepartment of Neurological Surgery, University of Louisville, Louisville, KY, United StatesDepartment of Radiology, University of Louisville, Louisville, KY, United StatesDepartment of Radiology, University of Louisville, Louisville, KY, United StatesKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United StatesDepartment of Neurological Surgery, University of Louisville, Louisville, KY, United StatesKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United StatesDepartment of Neurological Surgery, University of Louisville, Louisville, KY, United StatesFrazier Rehabilitation Institute, University of Louisville Health, Louisville, KY, United StatesDepartment of Bioengineering, University of Louisville, Louisville, KY, United StatesKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United StatesFrazier Rehabilitation Institute, University of Louisville Health, Louisville, KY, United StatesDepartment of Bioengineering, University of Louisville, Louisville, KY, United StatesPrevious studies have shown that epidural stimulation of the lumbosacral spinal cord (scES) can re-enable lower limb volitional motor control in individuals with chronic, clinically motor complete spinal cord injury (SCI). This observation entails that residual supraspinal connectivity to the lumbosacral spinal circuitry still persisted after SCI, although it was non-detectable when scES was not provided. In the present study, we aimed at exploring further the mechanisms underlying scES-promoted recovery of volitional lower limb motor control by investigating neuroimaging markers at the spinal cord lesion site via magnetic resonance imaging (MRI). Spinal cord MRI was collected prior to epidural stimulator implantation in 13 individuals with chronic, clinically motor complete SCI, and the spared tissue of specific regions of the spinal cord (anterior, posterior, right, left, and total cord) was assessed. After epidural stimulator implantation, and prior to any training, volitional motor control was evaluated during left and right lower limb flexion and ankle dorsiflexion attempts. The ability to generate force exertion and movement was not correlated to any neuroimaging marker. On the other hand, spared tissue of specific cord regions significantly and importantly correlated with some aspects of motor control that include activation amplitude of antagonist (negative correlation) muscles during left ankle dorsiflexion, and electromyographic coordination patterns during right lower limb flexion. The fact that amount and location of spared spinal cord tissue at the lesion site were not related to the ability to generate volitional lower limb movements may suggest that supraspinal inputs through spared spinal cord regions that differ across individuals can result in the generation of lower limb volitional motor output prior to any training when epidural stimulation is provided.https://www.frontiersin.org/articles/10.3389/fnsys.2020.559313/fullepidural stimulationspinal cord injuryvoluntary movementspinal cord MRIspinal cord lesionspinal tracts |