Development of an FES neuroprosthesis for rehabilitation following SCI

Project: Research project

Project Details

Description

I and my Northwestern University colleagues Matthew Tresch (Depts. of Biomedical Engineering and Physical Medicine and Rehabilitation) and Vicki Tysseling (Dept. of Physical Therapy and Human Movement Sciences) propose to draw on our combined experience on the forefront of the fields of the neural engineering, neuromuscular physiology, and spinal cord injury (SCI), to launch a new research project created to benefit people living with SCI. We have structured our research agenda as a sequence of interrelated goals whose first objective is to restore voluntary hindlimb movement following SCI. This new research significantly extends our recent experiments demonstrating the potential of cortically-controlled FES to restore motor function of monkey’s forelimb muscles paralyzed by nerve block, thereby restoring the animals’ voluntary grasp. By using cortical signals normally involved in voluntary movements, this approach has the potential to restore a wide range of motor behaviors in people following SCI in a flexible and natural manner. However, a major limitation of that work is that nerve block replicates only the paralysis, not the many additional consequences of chronic SCI. However, as we plan the next stages of developing this promising approach, continuing to use primate models is unappealing in light of numerous practical and ethical considerations. Fortunately, we have identified an excellent alternative system to primates in the rat model frequently used in other types of SCI research. The first goal of our proposed project is to use a rat model to evaluate the potential for cortically-controlled FES to restore locomotion following SCI, enabling rats (and ultimately humans) paralyzed by SCI to walk again.
In addition to its objective of demonstrating a breakthrough reanimation of limbs paralyzed by SCI, the SCIRTS project we propose will evaluate critical design aspects of the system that will pave the way for its clinical translation. To this end, our second objective is to determine how invasive a cortically-controlled FES system must be in order to restore significant motor function. To make this determination, we will evaluate two types of neural interfaces, intracortical electrodes that are highly invasive but, as shown in on our primate experiments, carry adequate information to predict patterns of EMG, and epidural grid electrodes that are much less invasive but yield substantially less information about muscle activity. Our second research goal is to test epidural electrodes and a novel indirect approach to predicting EMG that may allow cortically-controlled FES to be achieved less invasively, thereby dramatically lowering the barrier to clinical implementation in people.
Finally, beyond the immediate restoration of the voluntary control of muscles, we will examine the potentially critical role of cortically-controlled FES to act as a novel rehabilitation strategy, improving motor function even after use of such a neuroprosthesis is discontinued. By tightly coupling the hindlimb movements produced by FES to the rat’s own effort to move, we hypothesize that activity dependent plasticity will drive adaptive changes in cortical and spinal systems, leading to accelerated recovery of voluntary function and a reduction in maladaptive spastic reflexes. Demonstrating this sustained general improvement in motor function would provide important information not only for the clinical translation of cortically-controlled FES, but also for any rehabilitation strategy following SCI, emphasizing the importance of coupling rehabilita
StatusFinished
Effective start/end date9/30/153/31/19

Funding

  • Craig H. Neilsen Foundation (340943)

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