报告人：Jocelyne Bloch & Grégoire Courtine
Over the past decade, we have developed synergistic neurotechnologies that restored leg motor control in animal models of spinal cord injury (SCI) and Parkinson’s disease. These neurotechnologies combine spatiotemporal electrical spinal cord stimulation, brain-machine interfaces and smart body weight support systems. Here, we report the ability of these neurotechnologies to enable or improve leg motor control in humans with chronic SCI. Seven non-ambulatory individuals with incomplete or motor complete SCI were surgically implanted with a spinal cord stimulation system equipped with real-time triggering capabilities. Personalized computational models of the spinal cord and intraoperative electrophysiological assessments guided the placement of an electrode paddle array targeting the posterior roots of the lumbosacral spinal cord. After recovery from surgery, we configured spatiotemporal stimulation protocols that aimed to facilitate leg movements during the execution of basic motor tasks. Concretely, the location, timing and parameters of electrical stimulation bursts were adjusted in order to modulate the regions of the spinal cord containing the motor neuron pools associated with the ongoing or desired movement. Application of these personalized spatiotemporal neuromodulation strategies boosted the residual commands from the brain, enabling single-joint movements, standing, walking and biking in individuals who were not able to perform these tasks without stimulation. Moreover, rehabilitative training enabled by these stimulation protocols led to improvement of motor functions even in the absence of stimulation. These results establish realistic avenues for the conception of a treatment that accelerates and improves motor recovery after SCI.
Jocelyne Bloch is a neurosurgeon at Lausanne University Hospital. She specialized in stereotactic and functional neurosurgery, and acquired an extensive experience and expertise in deep brain stimulation (DBS) and neuromodulation for movement disorders, pain and epilepsy. She is in charge of the functional neurosurgical unit at the CHUV. Very active in research and translational neuroscience, professor Jocelyne Bloch is seeking to develop new indications for DBS, as well as to participate in the development of new advanced technologies and therapeutic strategies.
Grégoire Courtine is an Associate Professor at the Center for Neuroprosthetics and the Brain Mind Institute at the Swiss Federal Institute of Technology Lausanne (EPFL). He and his team have conducted extensive research in the field of neural interfaces, neurorehabilitation and spinal cord injury. The research of his group is internationally recognized and has led to numerous publications in the world most renowned science journals, such as Nature, Science, Cell, Nature Medicine and Science Translational Medicine.