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research article

A brain-spine interface alleviating gait deficits after spinal cord injury in primates

Capogrosso, Marco  
•
Milekovic, Tomislav  
•
Borton, David
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2016
Nature

Spinal cord injury disrupts the communication between the brain and the spinal circuits that orchestrate movement. To bypass the lesion, brain-computer interfaces(1-3) have directly linked cortical activity to electrical stimulation of muscles, and have thus restored grasping abilities after hand paralysis(1,4). Theoretically, this strategy could also restore control over leg muscle activity for walking(5). However, replicating the complex sequence of individual muscle activation patterns underlying natural and adaptive locomotor movements poses formidable conceptual and technological challenges(6,7). Recently, it was shown in rats that epidural electrical stimulation of the lumbar spinal cord can reproduce the natural activation of synergistic muscle groups producing locomotion(8-10). Here we interface leg motor cortex activity with epidural electrical stimulation protocols to establish a brain-spine interface that alleviated gait deficits after a spinal cord injury in non-human primates. Rhesus monkeys (Macaca mulatta) were implanted with an intracortical microelectrode array in the leg area of the motor cortex and with a spinal cord stimulation system composed of a spatially selective epidural implant and a pulse generator with realtime triggering capabilities. We designed and implemented wireless control systems that linked online neural decoding of extension and flexion motor states with stimulation protocols promoting these movements. These systems allowed the monkeys to behave freely without any restrictions or constraining tethered electronics. After validation of the brain-spine interface in intact (uninjured) monkeys, we performed a unilateral corticospinal tract lesion at the thoracic level. As early as six days post-injury and without prior training of the monkeys, the brain-spine interface restored weight-bearing locomotion of the paralysed leg on a treadmill and overground. The implantable components integrated in the brain-spine interface have all been approved for investigational applications in similar human research, suggesting a practical translational pathway for proof-of-concept studies in people with spinal cord injury.

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Type
research article
DOI
10.1038/nature20118
Web of Science ID

WOS:000387318500044

Author(s)
Capogrosso, Marco  
Milekovic, Tomislav  
Borton, David
Wagner, Fabien
Moraud, Eduardo
Mignardot, Jean-Baptiste
Buse, Nicolas
Gandar, Jerome
Barraud, Quentin  
Xing, David
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Date Issued

2016

Publisher

Nature Publishing Group

Published in
Nature
Volume

539

Issue

7628

Start page

284

End page

288

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
UPCOURTINE  
TNE  
Available on Infoscience
January 24, 2017
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/133646
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