Journal article
Neurocontrol of Movement in Humans With Spinal Cord Injury
Artificial organs, v 39(10), pp 823-833
01 Oct 2015
PMID: 26471132
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
In this review of neurocontrol of movement after spinal cord injury, we discuss neurophysiological evidences of conducting and processing mechanisms of the spinal cord. We illustrate that external afferent inputs to the spinal cord below the level of the lesion can modify, initiate, and maintain execution of movement in absence or partial presence of brain motor control after chronic spinal cord injury. We review significant differences between spinal reflex activity elicited by single and repetitive stimulation. The spinal cord can respond with sensitization, habituation, and dis-habituation to regular repetitive stimulation. Therefore, repetitive spinal cord reflex activity can contribute to the functional configuration of the spinal network. Moreover, testing spinal reflex activity in individuals with motor complete spinal cord injury provided evidences for subclinical residual brain influence, suggesting the existence of axons traversing the injury site and influencing the activities below the level of lesion. Thus, there are two motor control models of chronic spinal cord injury in humans: discomplete and reduced and altered volitional motor control. We outline accomplishments in modification and initiation of altered neurocontrol in chronic spinal cord injury people with epidural and functional electrical stimulation. By nonpatterned electrical stimulation of lumbar posterior roots, it is possible to evoke bilateral extension as well as rhythmic motor outputs. Epidural stimulation during treadmill stepping shows increased and/or modified motor activity. Finally, volitional efforts can alter epidurally induced rhythmic activities in incomplete spinal cord injury. Overall, we highlight that upper motor neuron paralysis does not entail complete absence of connectivity between cortex, brain stem, and spinal motor cells, but there can be altered anatomy and corresponding neurophysiological characteristics. With specific input to the spinal cord below the level of the lesion, the clinical status of upper motor neuron paralysis without structural modification can be modified, and movements can be initiated. Thus, external afferent input can partially replace brain control.
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Details
- Title
- Neurocontrol of Movement in Humans With Spinal Cord Injury
- Creators
- Milan R. Dimitrijevic - Baylor College of MedicineSimon M. Danner - Medical University of ViennaWinfried Mayr - Medical University of Vienna
- Publication Details
- Artificial organs, v 39(10), pp 823-833
- Publisher
- Wiley
- Number of pages
- 11
- Grant note
- Foundation of Movement Recovery, Oslo, Norway WFL-AT-007/11 / Wings for Life Spinal Cord Research Foundation (WfL) LS11-057 / Vienna Science and Technology Fund (WWTF)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurobiology and Anatomy; College of Medicine; Drexel University
- Web of Science ID
- WOS:000363330200006
- Scopus ID
- 2-s2.0-84944445533
- Other Identifier
- 991020099716404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Engineering, Biomedical
- Transplantation