Priming with High-Frequency Trans-spinal Stimulation to Augment Locomotor Training Benefits in Spinal Cord Injury
通过高频经脊柱刺激增强脊髓损伤的运动训练效果
基本信息
- 批准号:10643807
- 负责人:
- 金额:$ 54.69万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-06-09 至 2025-04-30
- 项目状态:未结题
- 来源:
- 关键词:AccelerationActivities of Daily LivingAffectBody WeightBrainChronicClinicalClinical TrialsComplexElectromyographyEquilibriumForce of GravityFrequenciesGoalsH-ReflexHumanHyperreflexiaImpairmentIndividualInterventionKnowledgeLegLimb structureLocomotor trainingMental DepressionMotorMotor Evoked PotentialsMotor NeuronsMuscleNeuronal PlasticityNeuronsParticipantPatternPersonsPhysiologicalPostureRandomizedRecoveryReflex actionRehabilitation therapySoleus MuscleSpinalSpinal CordSpinal cord injuryStep trainingSupinationSupine PositionSynapsesTestingTherapeutic InterventionTrainingTreatment ProtocolsUnited States National Institutes of HealthVertebral columnWalkingWorkclinical practiceeffective interventionfunctional gainimprovedinjuredmotor recoveryneuralneuronal circuitryneurophysiologyneuroregulationsensory inputspinal reflexstandard of care
项目摘要
PROJECT SUMMARY
Spinal cord injury (SCI) greatly impairs standing and walking ability, which severely compromises daily living
activities. While these deficits are partially improved by locomotor training, even after multiple training
sessions, abnormal muscle activity and coordination still persist. Thus, locomotor training alone cannot fully
optimize the neuronal plasticity required to strengthen the synapses connecting the brain, spinal cord, and
local circuits. As such, treatment interventions that effectively promote neuromodulation of spinal locomotor
networks and strengthen neural connectivity of the injured human spinal cord are greatly needed.
Transcutaneous spinal cord (transspinal) stimulation alters motoneuron excitability over multiple segments by
bringing motoneurons closer to threshold, a pre-requisite for functioning descending and local inputs.
Importantly, whether concurrent treatment with transspinal stimulation and locomotor training maximizes motor
recovery after SCI is unknown. The goal of this clinical trial is to use high frequency (30 Hz) transspinal
stimulation to prime locomotor training and ultimately improve standing and walking ability in individuals with
chronic incomplete SCI (iSCI). Forty-five individuals with iSCI will undergo 40 sessions of body weight-
supported step training primed with high-frequency transspinal stimulation. Participants will be randomized to
receive transspinal stimulation during standing (real or sham) or while supine (real). Aim 1 evaluates how
priming locomotor training with high-frequency transspinal stimulation in iSCI alters corticomotoneuronal
connectivity strength, as indicated by motor evoked potentials recorded from the legs. Aim 2 evaluates how
priming locomotor training with high-frequency transspinal stimulation in iSCI affects reorganization and
appropriate engagement of spinal neuronal circuits. Finally, Aim 3 evaluates improvement in intralimb
coordination and the ability to stand and walk. These results will support the notion that tonic high-frequency
transspinal stimulation strengthens corticomotoneuronal connectivity through posture-dependent corticospinal
neuroplasticity. Additionally, these results will indicate appropriate neuromodulation and facilitation of spinal
locomotor neuronal networks. We anticipate that the information gained from this mechanistic clinical trial will
greatly impact clinical practice. This is because in real-world clinical settings, noninvasive transspinal
stimulation can be more easily and widely implemented than invasive epidural stimulation. Additionally, by
applying multiple interventions to accelerate motor recovery, we are employing a treatment regimen that
represents a true clinical approach. Indeed, this multi-faceted approach meets the priorities of the National
Institutes of Health for rehabilitation.
项目概要
脊髓损伤 (SCI) 严重损害站立和行走能力,严重影响日常生活
活动。虽然这些缺陷可以通过运动训练得到部分改善,即使经过多次训练
训练期间,异常的肌肉活动和协调性仍然存在。因此,单靠运动训练并不能完全
优化加强连接大脑、脊髓和神经的突触所需的神经元可塑性
本地电路。因此,有效促进脊髓运动神经调节的治疗干预
网络和加强受伤的人类脊髓的神经连接是非常需要的。
经皮脊髓(经脊柱)刺激通过以下方式改变多个节段的运动神经元兴奋性
使运动神经元更接近阈值,这是发挥下行和局部输入功能的先决条件。
重要的是,同时进行经脊柱刺激和运动训练治疗是否可以最大限度地提高运动能力
SCI 后的恢复情况未知。该临床试验的目标是使用高频(30 Hz)经脊柱
刺激以促进运动训练并最终提高患有此病的个体的站立和行走能力
慢性不完全性脊髓损伤 (iSCI)。 45 名 iSCI 患者将接受 40 次体重测量
支持以高频经脊柱刺激为基础的步进训练。参与者将被随机分配到
在站立(真实或假)或仰卧(真实)时接受经脊柱刺激。目标 1 评估如何
在 iSCI 中用高频经脊柱刺激启动运动训练会改变皮质运动神经元
连接强度,如从腿部记录的运动诱发电位所示。目标 2 评估如何
在 iSCI 中用高频经脊柱刺激启动运动训练会影响重组和
脊髓神经元回路的适当参与。最后,目标 3 评估肢体内的改善
协调性以及站立和行走的能力。这些结果将支持高频补品的观点
经脊柱刺激通过姿势依赖性皮质脊髓增强皮质运动神经元连接
神经可塑性。此外,这些结果将表明适当的神经调节和促进脊柱
运动神经元网络。我们预计从这一机械临床试验中获得的信息将
极大地影响临床实践。这是因为在现实世界的临床环境中,无创经脊柱
与侵入性硬膜外刺激相比,刺激可以更容易、更广泛地实施。此外,通过
通过采用多种干预措施来加速运动恢复,我们正在采用一种治疗方案
代表了真正的临床方法。事实上,这种多方面的方法符合国家的优先事项
健康康复研究所。
项目成果
期刊论文数量(12)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Priming locomotor training with transspinal stimulation in people with spinal cord injury: study protocol of a randomized clinical trial.
对脊髓损伤患者进行经脊柱刺激启动运动训练:随机临床试验的研究方案。
- DOI:10.21203/rs.3.rs-2527617/v1
- 发表时间:2023
- 期刊:
- 影响因子:0
- 作者:Skiadopoulos,Andreas;Famodimu,GraceO;Solomon,ShammahK;Agrawal,Parul;Harel,NoamY;Knikou,Maria
- 通讯作者:Knikou,Maria
Adapting Human-Based Transcutaneous Spinal Cord Stimulation to Develop a Clinically Relevant Animal Model.
- DOI:10.3390/jcm11072023
- 发表时间:2022-04-05
- 期刊:
- 影响因子:3.9
- 作者:Malloy DC;Knikou M;Côté MP
- 通讯作者:Côté MP
Brain and spinal cord paired stimulation coupled with locomotor training facilitates motor output in human spinal cord injury.
- DOI:10.3389/fneur.2022.1000940
- 发表时间:2022
- 期刊:
- 影响因子:3.4
- 作者:
- 通讯作者:
Tapping Into the Human Spinal Locomotor Centres With Transspinal Stimulation.
通过跨脊柱刺激挖掘人类脊柱运动中心。
- DOI:10.21203/rs.3.rs-3818499/v1
- 发表时间:2024
- 期刊:
- 影响因子:0
- 作者:Skiadopoulos,Andreas;Knikou,Maria
- 通讯作者:Knikou,Maria
Neurophysiological Changes After Paired Brain and Spinal Cord Stimulation Coupled With Locomotor Training in Human Spinal Cord Injury.
- DOI:10.3389/fneur.2021.627975
- 发表时间:2021
- 期刊:
- 影响因子:3.4
- 作者:Pulverenti TS;Zaaya M;Grabowski M;Grabowski E;Islam MA;Li J;Murray LM;Knikou M
- 通讯作者:Knikou M
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NOAM Y. HAREL其他文献
NOAM Y. HAREL的其他文献
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{{ truncateString('NOAM Y. HAREL', 18)}}的其他基金
Identification of New Biomarkers for Determining Risk of Lower Extremity Fracture during Exoskeleton-assisted Ambulation: Developing a Personal Rehabilitation Approach to Optimize Function after SCI
鉴定用于确定外骨骼辅助行走期间下肢骨折风险的新生物标志物:开发个人康复方法以优化 SCI 后的功能
- 批准号:
10314390 - 财政年份:2021
- 资助金额:
$ 54.69万 - 项目类别:
Identification of New Biomarkers for Determining Risk of Lower Extremity Fracture during Exoskeleton-assisted Ambulation: Developing a Personal Rehabilitation Approach to Optimize Function after SCI
鉴定用于确定外骨骼辅助行走期间下肢骨折风险的新生物标志物:开发个人康复方法以优化 SCI 后的功能
- 批准号:
10734065 - 财政年份:2021
- 资助金额:
$ 54.69万 - 项目类别:
Identification of New Biomarkers for Determining Risk of Lower Extremity Fracture during Exoskeleton-assisted Ambulation: Developing a Personal Rehabilitation Approach to Optimize Function after SCI
鉴定用于确定外骨骼辅助行走期间下肢骨折风险的新生物标志物:开发个人康复方法以优化 SCI 后的功能
- 批准号:
10507770 - 财政年份:2021
- 资助金额:
$ 54.69万 - 项目类别:
Cognitive-based Rehabilitation Platform of Hand Grasp after Spinal Cord Injury using Virtual Reality and Instrumented Wearables
使用虚拟现实和仪器化可穿戴设备的脊髓损伤后手部抓握认知康复平台
- 批准号:
10326389 - 财政年份:2020
- 资助金额:
$ 54.69万 - 项目类别:
Priming with High-Frequency Trans-spinal Stimulation to Augment Locomotor Training Benefits in Spinal Cord Injury
通过高频经脊柱刺激增强脊髓损伤的运动训练效果
- 批准号:
10394311 - 财政年份:2020
- 资助金额:
$ 54.69万 - 项目类别:
Priming with High-Frequency Trans-spinal Stimulation to Augment Locomotor Training Benefits in Spinal Cord Injury
通过高频经脊柱刺激增强脊髓损伤的运动训练效果
- 批准号:
10187619 - 财政年份:2020
- 资助金额:
$ 54.69万 - 项目类别:
Cognitive-based Rehabilitation Platform of Hand Grasp after Spinal Cord Injury using Virtual Reality and Instrumented Wearables
使用虚拟现实和仪器化可穿戴设备的脊髓损伤后手部抓握认知康复平台
- 批准号:
10733413 - 财政年份:2020
- 资助金额:
$ 54.69万 - 项目类别:
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