Using EMG to deliver lumbar dynamic electrical stimulation to facilitate cortico-spinal excitability.

Taccola, G; Gad, P; Culaclii, S; Ichiyama, RM; Liu, W; Edgerton, VR

Using EMG to deliver lumbar dynamic electrical stimulation to facilitate cortico-spinal excitability.

Taccola, G Gad, P Culaclii, S Ichiyama, RM Liu, W Edgerton, VR

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Brain Stimulation, 2020, 13, (1), pp. 20-34
Issue Date:: 2020-01

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Field	Value	Language
dc.contributor.author	Taccola, G
dc.contributor.author	Gad, P
dc.contributor.author	Culaclii, S
dc.contributor.author	Ichiyama, RM
dc.contributor.author	Liu, W
dc.contributor.author	Edgerton, VR
dc.date.accessioned	2020-10-16T04:40:53Z
dc.date.available	2019-09-24
dc.date.available	2020-10-16T04:40:53Z
dc.date.issued	2020-01
dc.identifier.citation	Brain Stimulation, 2020, 13, (1), pp. 20-34
dc.identifier.issn	1876-4754
dc.identifier.issn	1876-4754
dc.identifier.uri	http://hdl.handle.net/10453/143299
dc.description.abstract	BACKGROUND:Potentiation of synaptic activity in spinal networks is reflected in the magnitude of modulation of motor responses evoked by spinal and cortical input. After spinal cord injury, motor evoked responses can be facilitated by pairing cortical and peripheral nerve stimuli. OBJECTIVE:To facilitate synaptic potentiation of cortico-spinal input with epidural electrical stimulation, we designed a novel neuromodulation method called dynamic stimulation (DS), using patterns derived from hind limb EMG signal during stepping. METHODS:DS was applied dorsally to the lumbar enlargement through a high-density epidural array composed of independent platinum-based micro-electrodes. RESULTS:In fully anesthetized intact adult rats, at the interface array/spinal cord, the temporal and spatial features of DS neuromodulation affected the entire lumbosacral network, particularly the most rostral and caudal segments covered by the array. DS induced a transient (at least 1 min) increase in spinal cord excitability and, compared to tonic stimulation, generated a more robust potentiation of the motor output evoked by single pulses applied to the spinal cord. When sub-threshold pulses were selectively applied to a cortical motor area, EMG responses from the contralateral leg were facilitated by the delivery of DS to the lumbosacral cord. Finally, based on motor-evoked responses, DS was linked to a greater amplitude of motor output shortly after a calibrated spinal cord contusion. CONCLUSION:Compared to traditional tonic waveforms, DS amplifies both spinal and cortico-spinal input aimed at spinal networks, thus significantly increasing the potential and accelerating the rate of functional recovery after a severe spinal lesion.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Brain Stimulation
dc.relation.isbasedon	10.1016/j.brs.2019.09.013
dc.rights	Elsevier required licence: © 2020 . This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/. The definitive publisher version is available online at https://doi.org/10.1016/j.brs.2019.09.013	en_US
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Neurology & Neurosurgery
dc.subject.mesh	Lumbar Vertebrae
dc.subject.mesh	Motor Cortex
dc.subject.mesh	Spinal Cord
dc.subject.mesh	Animals
dc.subject.mesh	Rats
dc.subject.mesh	Rats, Sprague-Dawley
dc.subject.mesh	Rats, Wistar
dc.subject.mesh	Electromyography
dc.subject.mesh	Recovery of Function
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Spinal Cord Stimulation
dc.subject.mesh	Animals
dc.subject.mesh	Electromyography
dc.subject.mesh	Female
dc.subject.mesh	Lumbar Vertebrae
dc.subject.mesh	Male
dc.subject.mesh	Motor Cortex
dc.subject.mesh	Rats
dc.subject.mesh	Rats, Sprague-Dawley
dc.subject.mesh	Rats, Wistar
dc.subject.mesh	Recovery of Function
dc.subject.mesh	Spinal Cord
dc.subject.mesh	Spinal Cord Stimulation
dc.title	Using EMG to deliver lumbar dynamic electrical stimulation to facilitate cortico-spinal excitability.
dc.type	Journal Article
utslib.citation.volume	13
utslib.location.activity	United States
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	open_access	*
pubs.consider-herdc	true
dc.date.updated	2020-10-16T04:40:37Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	13
utslib.citation.issue	1

Abstract:

BACKGROUND:Potentiation of synaptic activity in spinal networks is reflected in the magnitude of modulation of motor responses evoked by spinal and cortical input. After spinal cord injury, motor evoked responses can be facilitated by pairing cortical and peripheral nerve stimuli. OBJECTIVE:To facilitate synaptic potentiation of cortico-spinal input with epidural electrical stimulation, we designed a novel neuromodulation method called dynamic stimulation (DS), using patterns derived from hind limb EMG signal during stepping. METHODS:DS was applied dorsally to the lumbar enlargement through a high-density epidural array composed of independent platinum-based micro-electrodes. RESULTS:In fully anesthetized intact adult rats, at the interface array/spinal cord, the temporal and spatial features of DS neuromodulation affected the entire lumbosacral network, particularly the most rostral and caudal segments covered by the array. DS induced a transient (at least 1 min) increase in spinal cord excitability and, compared to tonic stimulation, generated a more robust potentiation of the motor output evoked by single pulses applied to the spinal cord. When sub-threshold pulses were selectively applied to a cortical motor area, EMG responses from the contralateral leg were facilitated by the delivery of DS to the lumbosacral cord. Finally, based on motor-evoked responses, DS was linked to a greater amplitude of motor output shortly after a calibrated spinal cord contusion. CONCLUSION:Compared to traditional tonic waveforms, DS amplifies both spinal and cortico-spinal input aimed at spinal networks, thus significantly increasing the potential and accelerating the rate of functional recovery after a severe spinal lesion.

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http://hdl.handle.net/10453/143299