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Non-invasive activation of cervical spinal networks after severe paralysis

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dc.contributor.author Gad P.
dc.contributor.author Lee S.
dc.contributor.author Terrafranca N.
dc.contributor.author Zhong H.
dc.contributor.author Turner A.
dc.contributor.author Gerasimenko Y.
dc.contributor.author Edgerton V.
dc.date.accessioned 2019-01-22T20:38:02Z
dc.date.available 2019-01-22T20:38:02Z
dc.date.issued 2018
dc.identifier.issn 0897-7151
dc.identifier.uri https://dspace.kpfu.ru/xmlui/handle/net/148062
dc.description.abstract © Copyright 2018, Mary Ann Liebert, Inc. 2018. Paralysis of the upper extremities following cervical spinal cord injury (SCI) significantly impairs one's ability to live independently. While regaining hand function or grasping ability is considered one of the most desired functions in tetraplegics, limited therapeutic development in this direction has been demonstrated to date in humans with a high severe cervical injury. The underlying hypothesis is that after severe cervical SCI, nonfunctional sensory-motor networks within the cervical spinal cord can be transcutaneously neuromodulated to physiological states that enable and amplify voluntary control of the hand. Improved voluntary hand function occurred within a single session in every subject tested. After eight sessions of non-invasive transcutaneous stimulation, combined with training over 4 weeks, maximum voluntary hand grip forces increased by ∼325% (in the presence of stimulation) and ∼225% (when grip strength was tested without simultaneous stimulation) in chronic cervical SCI subjects (American Spinal Injury Association Impairment Scale [AIS] B, n = 3; AIS C, n = 5) 1-21 years post-injury). Maximum grip strength improved in both the left and right hands and the magnitude of increase was independent of hand dominance. We refer to the neuromodulatory method used as transcutaneous enabling motor control to emphasize that the stimulation parameters used are designed to avoid directly inducing muscular contractions, but to enable task performance according to the subject's voluntary intent. In some subjects, there were improvements in autonomic function, lower extremity motor function, and sensation below the level of the lesion. Although a neuromodulation-training effect was observed in every subject tested, further controlled and blinded studies are needed to determine the responsiveness of a larger and broader population of subjects varying in the type, severity, and years post-injury. It appears rather convincing, however, that a "central pattern generation" phenomenon as generally perceived in the lumbosacral networks in controlling stepping neuromodulator is not a critical element of spinal neuromodulation to regain function among spinal networks.
dc.relation.ispartofseries Journal of Neurotrauma
dc.subject cervical spinal cord injury
dc.subject non-invasive spinal cord stimulation
dc.subject tetraplegia
dc.subject upper extremity rehabilitation
dc.title Non-invasive activation of cervical spinal networks after severe paralysis
dc.type Article
dc.relation.ispartofseries-issue 18
dc.relation.ispartofseries-volume 35
dc.collection Публикации сотрудников КФУ
dc.relation.startpage 2145
dc.source.id SCOPUS08977151-2018-35-18-SID85048944946


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  • Публикации сотрудников КФУ Scopus [24551]
    Коллекция содержит публикации сотрудников Казанского федерального (до 2010 года Казанского государственного) университета, проиндексированные в БД Scopus, начиная с 1970г.

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