Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy

Spinal neuromodulation and activity-based rehabilitation triggers neural network reorganization and enhances sensory-motor performances involving the lower limbs, the trunk, and the upper limbs. This study reports the acute efects of Transcutaneous Electrical Spinal Cord Neuromodulation (SCONE™, Spi...

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Autores: Gad, Parag|||0000-0001-8352-7614, Hastings, Susan, Zhong, Hui, Seth, Gaurav, Kandhari, Sachin, Edgerton, Victor|||0000-0001-6534-1875
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:250438
Acceso en línea:https://ddd.uab.cat/record/250438
https://dx.doi.org/urn:doi:10.1007/s13311-021-01087-6
Access Level:acceso abierto
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spelling Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral PalsyGad, Parag|||0000-0001-8352-7614Hastings, SusanZhong, HuiSeth, GauravKandhari, SachinEdgerton, Victor|||0000-0001-6534-1875Spinal neuromodulation and activity-based rehabilitation triggers neural network reorganization and enhances sensory-motor performances involving the lower limbs, the trunk, and the upper limbs. This study reports the acute efects of Transcutaneous Electrical Spinal Cord Neuromodulation (SCONE™, SpineX Inc.) on 12 individuals (ages 2 to 50) diagnosed with cerebral palsy (CP) with Gross Motor Function Classifcation Scale (GMFCS) levels ranging from I to V. Acute spinal neuromodulation improved the postural and locomotor abilities in 11 out of the 12 patients including the ability to generate bilateral weight bearing stepping in a 2-year-old (GMFCS level IV) who was unable to step. In addition, we observed independent head-control and weight bearing standing with stimulation in a 10-year-old and a 4-year old (GMFCS level V) who were unable to hold their head up or stand without support in the absence of stimulation. All patients signifcantly improved in coordination of fexor and extensor motor pools and inter and intralimb joint angles while stepping on a treadmill. While it is assumed that the etiologies of the disruptive functions of CP are associated with an injury to the supraspinal networks, these data are consistent with the hypothesis that spinal neuromodulation and functionally focused activity-based therapies can form a functionally improved chronic state of reorganization of the spinal supraspinal connectivity. We further suggest that the level of reorganization of spinal-supraspinal connectivity with neuromodulation contributed to improved locomotion by improving the coordination patterns of fexor and extensor muscles by modulating the amplitude and fring patterns of EMG burst during stepping.Universitat Autònoma de Barcelona 22021-01-0120212021-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/250438https://dx.doi.org/urn:doi:10.1007/s13311-021-01087-6reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2504382026-06-06T12:50:31Z
dc.title.none.fl_str_mv Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy
title Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy
spellingShingle Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy
Gad, Parag|||0000-0001-8352-7614
title_short Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy
title_full Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy
title_fullStr Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy
title_full_unstemmed Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy
title_sort Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy
dc.creator.none.fl_str_mv Gad, Parag|||0000-0001-8352-7614
Hastings, Susan
Zhong, Hui
Seth, Gaurav
Kandhari, Sachin
Edgerton, Victor|||0000-0001-6534-1875
author Gad, Parag|||0000-0001-8352-7614
author_facet Gad, Parag|||0000-0001-8352-7614
Hastings, Susan
Zhong, Hui
Seth, Gaurav
Kandhari, Sachin
Edgerton, Victor|||0000-0001-6534-1875
author_role author
author2 Hastings, Susan
Zhong, Hui
Seth, Gaurav
Kandhari, Sachin
Edgerton, Victor|||0000-0001-6534-1875
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
description Spinal neuromodulation and activity-based rehabilitation triggers neural network reorganization and enhances sensory-motor performances involving the lower limbs, the trunk, and the upper limbs. This study reports the acute efects of Transcutaneous Electrical Spinal Cord Neuromodulation (SCONE™, SpineX Inc.) on 12 individuals (ages 2 to 50) diagnosed with cerebral palsy (CP) with Gross Motor Function Classifcation Scale (GMFCS) levels ranging from I to V. Acute spinal neuromodulation improved the postural and locomotor abilities in 11 out of the 12 patients including the ability to generate bilateral weight bearing stepping in a 2-year-old (GMFCS level IV) who was unable to step. In addition, we observed independent head-control and weight bearing standing with stimulation in a 10-year-old and a 4-year old (GMFCS level V) who were unable to hold their head up or stand without support in the absence of stimulation. All patients signifcantly improved in coordination of fexor and extensor motor pools and inter and intralimb joint angles while stepping on a treadmill. While it is assumed that the etiologies of the disruptive functions of CP are associated with an injury to the supraspinal networks, these data are consistent with the hypothesis that spinal neuromodulation and functionally focused activity-based therapies can form a functionally improved chronic state of reorganization of the spinal supraspinal connectivity. We further suggest that the level of reorganization of spinal-supraspinal connectivity with neuromodulation contributed to improved locomotion by improving the coordination patterns of fexor and extensor muscles by modulating the amplitude and fring patterns of EMG burst during stepping.
publishDate 2021
dc.date.none.fl_str_mv 2
2021-01-01
2021
2021-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
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dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/250438
https://dx.doi.org/urn:doi:10.1007/s13311-021-01087-6
url https://ddd.uab.cat/record/250438
https://dx.doi.org/urn:doi:10.1007/s13311-021-01087-6
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
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dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
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eu_rights_str_mv openAccess
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dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
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