小柯机器人

瑞士联邦理工学院Grégoire Courtine和Jocelyne Bloch研究小组合作宣布，他们发现活动依赖性脊髓神经调节可在完全瘫痪后迅速恢复躯干和腿部运动功能。这一研究成果发表在2022年2月7日出版的国际学术期刊《自然-医学》杂志上。

在本研究中，研究人员猜想针对参与腿部和躯干运动的背根集合电极布置可产生显著的功效，在严重脊髓损伤(SCI)后恢复多样化的运动能力。为了验证这一假设，研究人员建立了一个计算模型，该模型为新桨电极上电极的最佳布置提供信息，并指导其神经外科定位。研究人员还研发了支持快速配置活动特异性刺激程序的软件，该程序再现了每个活动背后运动神经元的自然激活。

作为正在进行的临床试验的一部分，研究人员在三个感觉运动完全麻痹的个体中测试了这一神经技术。在一天之内，针对特定活动的刺激计划使这三个人能够站立、行走、骑自行车、游泳和控制躯干运动。神经康复产生了明显的改善，恢复社区环境中的这些活动，这为支持SCI患者开展硬膜外电刺激(EES) 日常活动提供了一条可实现的道路。

据悉，针对腰骶段背根的EES可使SCI患者恢复行走。然而，EES使用时带有最初设计用于靶向脊髓背柱的多电极桨状导线。

附：英文原文

Title: Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis

Author: Rowald, Andreas, Komi, Salif, Demesmaeker, Robin, Baaklini, Edeny, Hernandez-Charpak, Sergio Daniel, Paoles, Edoardo, Montanaro, Hazael, Cassara, Antonino, Becce, Fabio, Lloyd, Bryn, Newton, Taylor, Ravier, Jimmy, Kinany, Nawal, DErcole, Marina, Paley, Aurlie, Hankov, Nicolas, Varescon, Camille, McCracken, Laura, Vat, Molywan, Caban, Miroslav, Watrin, Anne, Jacquet, Charlotte, Bole-Feysot, La, Harte, Cathal, Lorach, Henri, Galvez, Andrea, Tschopp, Manon, Herrmann, Natacha, Wacker, Mora, Geernaert, Lionel, Fodor, Isabelle, Radevich, Valentin, Van Den Keybus, Katrien, Eberle, Grgoire, Pralong, Etienne, Roulet, Maxime, Ledoux, Jean-Baptiste, Fornari, Eleonora, Mandija, Stefano, Mattera, Loan, Martuzzi, Roberto, Nazarian, Bruno, Benkler, Stefan, Callegari, Simone, Greiner, Nathan, Fuhrer, Benjamin, Froeling, Martijn, Buse, Nik, Denison, Tim, Buschman, Rik, Wende, Christian, Ganty, Damien, Bakker, Jurriaan, Delattre, Vincent, Lambert, Hendrik, Minassian, Karen

Issue&Volume: 2022-02-07

Abstract: Epidural electrical stimulation (EES) targeting the dorsal roots of lumbosacral segments restores walking in people with spinal cord injury (SCI). However, EES is delivered with multielectrode paddle leads that were originally designed to target the dorsal column of the spinal cord. Here, we hypothesized that an arrangement of electrodes targeting the ensemble of dorsal roots involved in leg and trunk movements would result in superior efficacy, restoring more diverse motor activities after the most severe SCI. To test this hypothesis, we established a computational framework that informed the optimal arrangement of electrodes on a new paddle lead and guided its neurosurgical positioning. We also developed software supporting the rapid configuration of activity-specific stimulation programs that reproduced the natural activation of motor neurons underlying each activity. We tested these neurotechnologies in three individuals with complete sensorimotor paralysis as part of an ongoing clinical trial ( www.clinicaltrials.gov identifier NCT02936453). Within a single day, activity-specific stimulation programs enabled these three individuals to stand, walk, cycle, swim and control trunk movements. Neurorehabilitation mediated sufficient improvement to restore these activities in community settings, opening a realistic path to support everyday mobility with EES in people with SCI. Implantation of a multielectrode paddle that allows personalized electrical stimulation to all regions of the spinal cord involved in leg and trunk movements rapidly restores motor function in patients with spinal cord injury with complete paralysis. Purposed-built technologies for spatiotemporal stimulation of the spinal cord restore standing, walking, cycling, swimming and trunk control in people with complete paralysis due to a spinal cord injury.

DOI: 10.1038/s41591-021-01663-5

Source: https://www.nature.com/articles/s41591-021-01663-5

Nature Medicine：《自然—医学》，创刊于1995年。隶属于施普林格·自然出版集团，最新IF：87.241
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