Research ArticleNEUROTECHNOLOGY

Closed-loop neuromodulation of spinal sensorimotor circuits controls refined locomotion after complete spinal cord injury

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Science Translational Medicine  24 Sep 2014:
Vol. 6, Issue 255, pp. 255ra133
DOI: 10.1126/scitranslmed.3008325

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Closing the Loop on Neuroprosthetic Control

Patients with spinal cord injury (SCI) and paralysis may soon be outfitted with so-called neuromodulation devices, which electrically stimulate the brain or spinal cord, causing movement in the legs. Currently, tuning such modulation requires constant observation and patient-specific adjustments, which are not ideal for fluid movement or for broad translation of these technologies to injured patients. In response, Wenger et al. have created a closed-loop system that will essentially “auto-tune” the device, allowing the paralyzed patient—or, in their study, the paralyzed rat—to move freely, without worrying about adjusting electrical pulse width, amplitude, or frequency. The authors gave rats complete SCI epidural electrical stimulation and then mapped their leg movements and sensorimotor responses while in a body support system, walking upright (bipedal) on a treadmill, or climbing stairs. From this information, they devised a computational system that integrated feedback and feed-forward models for closed-loop, continuous control of leg movement and, in turn, a more natural locomotion. Closed-loop neuromodulation of spinal circuits could impart fluid motor control and prevent fatigue when rehabilitating patients with SCI.

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