Neuromodulation Of Spinal Networks To Regain Sensorimotor Function After Paralysis

Dimitry Sayenko, M.D., Ph.D.
Via Zoom
The mammalian spinal cord can generate rhythmic or tonic motor output even in the absence
of input from the brain. This evidence led to the hypothesis that if similar spinal circuits exist
in humans, then electrically stimulating the lumbosacral spinal cord in combination with
motor activity could facilitate motor function and mobility in patients with spinal cord injury
(SCI). Adults with chronic motor complete paraplegia underwent epidural spinal stimulation
therapy, could maintain minimally assisted standing, and revealed significant levels of
voluntary control of the lower limbs during stimulation. Similar functional outcomes can be
obtained using transcutaneous spinal stimulation. Activation of sub-functional longitudinal
fibers across the lesion, and emerging responsiveness of spinal networks below the lesion to
descending commands and proprioception is considered the main mechanism for both
invasive and non-invasive spinal stimulation to restore function after paralysis.