Neuroprosthetic technology for individuals with spinal cord injury

Abstract

Context: Spinal cord injury (SCI) results in a loss of function and sensation below the level of the lesion. Neuroprosthetic technology has been developed to help restore motor and autonomic functions as well as to provide sensory feedback. Findings: This paper provides an overview of neuroprosthetic technology that aims to address the priorities for functional restoration as defined by individuals with SCI. We describe neuroprostheses that are in various stages of preclinical development, clinical testing, and commercialization including functional electrical stimulators, epidural and intraspinal microstimulation, bladder neuroprosthesis, and cortical stimulation for restoring sensation. We also discuss neural recording technologies that may provide command or feedback signals for neuroprosthetic devices. Conclusion/clinical relevance: Neuroprostheses have begun to address the priorities of individuals with SCI, although there remains room for improvement. In addition to continued technological improvements, closing the loop between the technology and the user may help provide intuitive device control with high levels of performance.

Spinal cord injury: overview of experimental approaches used to restore locomotor activity

“…By bridging the gap between the motor intention encoded in cortical signals and the sublesion locomotor infrastructure, a neuroprosthetic device could theoretically reestablish the communication between supraspinal and spinal circuits ( Jackson and Zimmermann, 2012 ) ( Figure 2 ). Several types of electronic devices that interface with the spinal cord are currently being developed in the hope of facilitating the rehabilitation of patients with SCI ( Jackson and Zimmermann, 2012 ;Collinger et al, 2013 ). Neuroprostheses can either be external or implanted devices ( Prochazka et al, 2001 ;Popovic et al, 2002 ) and are used to stimulate the spinal cord and muscles following SCI ( Jackson and Zimmermann, 2012 ).…”

Decoding gripping force based on local field potentials recorded from subthalamic nucleus in humans

“…Knowledge of how gripping force is encoded in the brain would facilitate the design and control of brain machine interfaces (BMI) driving neuroprosthetics to help physically impaired patients. However, the results of studies aimed to decode force based on cortical neural activity are still far from consistent and satisfactory, and no BMI user has yet achieved manipulation of the force generated by a robotic hand (Velliste et al, 2008; Collinger et al, 2013), or the control of the simulated grasp force used for a virtual object (Bensmaia and Miller, 2014). …”

Review of Epidural Spinal Cord Stimulation for Augmenting Cough after Spinal Cord Injury

“…Respiratory complications are a leading cause of hospitalization for individuals with SCI after genitourinary disorders and skin conditions (Cardenas et al, 2004) and restoration of cough presents a critical challenge for SCI patients. Importantly, none of the currently clinically-available neuroprosthetic devices for respiratory restoration are designed for restoring expiratory muscle function for cough (Ragnarsson, 2008; Collinger et al, 2013). Successful development of a device for functional electrical stimulation (FES)-evoked cough depends first on understanding the neuromuscular mechanisms involved in generating physiological cough.…”