Dr. Carmel and the Movement Recovery Laboratory Publishes in the Journal of Neurophysiology
Intraoperative Electrical Stimulation of the Human Dorsal Spinal Cord Reveals a Map of Arm and Hand Muscle Responses
Spinal cord stimulation has emerged as a promising therapy to restore mobility and autonomic function after spinal cord injury. While some organization of the cervical spinal cord is known, we do not yet know how to target stimulation of the cervical spinal cord to activate the arm and hand muscles that people with spinal cord injury need to recover. To close this gap in understanding, we systematically mapped muscle responses to cervical spinal cord stimulation in people undergoing clinically indicated spine surgery. We found a surprisingly large difference between stimulation applied laterally over the incoming sensory fibers and stimulation applied at the midline of the spinal cord. We also found that muscle responses were more distributed across the cervical cord than expected, suggesting strong connections within the cervical cord and connections to distant segments involved in leg muscle activation. This work will direct efforts in our lab and in the field more broadly to apply epidural stimulation for recovery of arm and hand function.
This study, along with the Movement Recover Laboratory’s study on “Spinal cord associative plasticity improves forelimb sensorimotor function after cervical injury” are sponsored by grants from the NIH and the Travis Roy Foundation.
The two papers demonstrate our translational research approach of developing effective plasticity protocols in model systems (rats) and then translate them to humans. In the upcoming year, we will be testing the spinal cord associative plasticity protocol we developed in rats in people undergoing clinically indicated spine surgery.