Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy
Gad, Parag (University of California. Department of Neurobiology)
Hastings, Susan (Susan Hastings Pediatric Physical Therapy (San Jose, Estats Units d'Amèrica))
Zhong, Hui (University of California. Department of Neurobiology)
Seth, Gaurav (Banaras Hindu University. Indian Institute of Technology)
Kandhari, Sachin (Institute of Brain and Spine (Nova Delhi, India))
Edgerton, Victor (Institut Germans Trias i Pujol. Institut Guttmann)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	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.
Drets:	Aquest 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.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Neurotherapeutics, Vol. 18 (july 2021) , p. 1953-1962, ISSN 1878-7479

DOI: 10.1007/s13311-021-01087-6
PMID: 34244928

10 p, 2.6 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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