The Effect of Intraspinal Micro Stimulation With Variable Stimulating Pattern in Adult Rat With Induction of Spinal Cord Injury in the Treatment of Spinal Cord Injuries

Background: Spinal cord injury is one of the diseases that, no specific treatment has yet found despite the variety of works that have done in this field. Different approaches to treat such injuries have investigated today. One of them is invasive intra-spinal interventions such as electrical stimulation. Therefore, in this study, the effect of the protocol for intra-spinal variable and fixed electrical stimulation has been investigated in order to recover from spinal cord injury. Methods: In the study, 18 Wistar male rats randomly divided into Three groups, including intra-spinal electrical stimulation (IES), IES with variable pattern of stimulation (VP IES) and a sham group. Animals initially subjected to induced spinal cord injury. After one week, the animal movement was recorded on the treadmill during practice using a camera and angles of the ankle joint were measured using the Tracker software. Then, the obtained data were analyzed by nonlinear evaluations in the phase space. Results: The motion analyses and kinematic analyses were carried out on all groups. According to the achieved results, the gait dynamics of the VP IES group has the most conformity to the gait dynamics of the healthy group. Also, the best quality of the balance preservation observed in the VP IES group. Conclusion: It can be concluded that the IES with variable pattern of stimulation along with exercise therapy has significant gait restorative effects and increases the range of motion in rats with induced spinal cord injury

Multilevel Analysis of Locomotion in Immature Preparations Suggests Innovative Strategies to Reactivate Stepping after Spinal Cord Injury

Locomotion is one of the most complex motor behaviors. Locomotor patterns change during early life, reflecting development of numerous peripheral and hierarchically organized central structures. Among them, the spinal cord is of particular interest since it houses the central pattern generator (CPG) for locomotion. This main command center is capable of eliciting and coordinating complex series of rhythmic neural signals sent to motoneurons and to corresponding target-muscles for basic locomotor activity. For a long-time, the CPG has been considered a black box. In recent years, complementary insights from in vitro and in vivo animal models have contributed significantly to a better understanding of its constituents, properties and ways to recover locomotion after a spinal cord injury (SCI). This review discusses key findings made by comparing the results of in vitro isolated spinal cord preparations and spinal-transected in vivo models from neonatal animals. Pharmacological, electrical, and sensory stimulation approaches largely used to further understand CPG function may also soon become therapeutic tools for potent CPG reactivation and locomotor movement induction in persons with SCI or developmental neuromuscular disorder

Human dental pulp stem cells transplantation combined with treadmill training in rats after traumatic spinal cord injury

Spinal cord injury (SCI) is a disabling condition resulting in deficits of sensory and motor functions, and has no effective treatment. Considering that protocols with stem cell transplantation and treadmill training have shown promising results, the present study evaluated the effectiveness of stem cells from human exfoliated deciduous teeth (SHEDs) transplantation combined with treadmill training in rats with experimental spinal cord injury. Fifty-four Wistar rats were spinalized using NYU impactor. The rats were randomly distributed into 5 groups: Sham (laminectomy with no SCI, n=10); SCI (laminectomy followed by SCI, n=12); SHEDs (SCI treated with SHEDs, n=11); TT (SCI treated with treadmill training, n=11); SHEDs+TT (SCI treated with SHEDs and treadmill training; n=10). Treatment with SHEDs alone or in combination with treadmill training promoted functional recovery, reaching scores of 15 and 14, respectively, in the BBB scale, being different from the SCI group, which reached 11. SHEDs treatment was able to reduce the cystic cavity area and glial scar, increase neurofilament. Treadmill training alone had no functional effectiveness or tissue effects. In a second experiment, the SHEDs transplantation reduced the TNF-a levels in the cord tissue measured 6 h after the injury. Contrary to our hypothesis, treadmill training either alone or in combination, caused no functional improvement. However, SHEDs showed to be neuroprotective, by the reduction of TNF-a levels, the cystic cavity and the glial scar associated with the improvement of motor function after SCI. These results provide evidence that grafted SHEDs might be an effective therapy to spinal cord lesions, with possible anti-inflammatory action

Robot-driven epidural spinal cord stimulation compared with conventional stimulation in adult spinalized rats

Epidural stimulation to trigger locomotion is a promising treatment after spinal cord injury (SCI). Continuous stimulation during locomotion is the conventional method. To improve recovery, we designed and tested an innovative robot-driven epidural stimulation method, coupled with a trunk-based neurorobotic system. The system was tested in rats, and the results were compared with the results of the neurorobotic therapy combined with the conventional epidural stimulation method, and with robotic rehabilitation alone. The rats had better recovery after treatment with the robot-driven epidural stimulation than conventional stimulation or controls in our neurorobotic rehabilitation system.Ph.D., Biomedical Engineering -- Drexel University, 201

Effects of Therapeutic Interventions on the Organization of the Rat Sensorimotor Cortex

A spinal cord injury (SCI) not only impacts the spinal circuitry, but also affects the cortical sensory and motor representations in the brain. After injury, these representational maps of body parts on the surface of the brain can reorganize, which is defined as an extension of cortical representations of intact body areas into the cortical regions normally devoted to the deafferented body areas. In fact, cortical reorganization within these sensory and motor representations can play a major role in recovery after SCI. Therefore, it has been suggested that therapeutic interventions should act at, and therefore potentially promote, plasticity at all levels of the sensorimotor system. Unfortunately, the impact of rehabilitative strategies on cortical reorganization remains largely unknown. Both serotonergic (5-HT) pharmacotherapy and exercise therapy can act above and below the level of a SCI, and are each involved in the promotion of plasticity. Importantly, these interventions have been shown to improve locomotor recovery after SCI. However, their effects on cortical organization after SCI are unknown. In this thesis work, we have utilized 5-HT pharmacotherapy and passive bicycling exercise to promote recovery in the adult rat completely transected as an adult at spinal level T8/9. We hypothesized that these two therapeutic interventions used in combination would promote significant sensorimotor cortical reorganization, the magnitude of which would be correlated to locomotor recovery. To assess this hypothesis, we have utilized high resolution electrophysiological mapping techniques to investigate the somatosensory (single neuron mappings) and motor (intracortical microstimulation) representations in cortex after injury and therapy. These quantifications of sensory and motor cortical reorganization are then compared to locomotor recovery measures across therapy groups. Our results show that a combination of chronically administered 5-HT pharmacotherapy and passive bicycling exercise promotes significant reorganization of functionally relevant representations in the somatosensory and motor cortices, the magnitude of which is correlated to locomotor recovery. Interestingly, lesioning these new cortical circuits significantly reduced the achieved locomotor recovery seen in these animals. Therefore, the cortical reorganization induced by this combination therapy may play a major role in locomotor recovery, equating to new supraspinal control strategies and eventually weight-supported stepping.Ph.D., Biomedical Engineering -- Drexel University, 201

Spinal locomotion in cats following spinal cord injury : a prospective study

Research Areas: Agriculture ; Veterinary SciencesThis article aimed to evaluate the safety and efficacy of intensive neurorehabilitation in paraplegic cats, with no deep pain perception (grade 0 on the modified Frankel scale), with more than three months of injury. Nine cats, admitted to the Arrábida Veterinary Hospital/Arrábida Animal Rehabilitation Center (CRAA), were subjected to a 12-week intensive functional neurorehabilitation protocol, based on ground and underwater treadmill locomotor training, electrostimulation, and kinesiotherapy exercises, aiming to obtain a faster recovery to ambulation and a modulated locomotor pattern of flexion/extension. Of the nine cats that were admitted in this study, 56% (n = 5) recovered from ambulation, 44% of which (4/9) did so through functional spinal locomotion by reflexes, while one achieved this through the recovery of deep pain perception. These results suggest that intensive neurorehabilitation can play an important role in ambulation recovery, allowing for a better quality of life and well-being, which may lead to a reduction in the number of euthanasia procedures performed on paraplegic animals.info:eu-repo/semantics/publishedVersio

The Role of Supraspinal Structures for Recovery after SCI: From Motor Dysfunction to Mental Health

Neural circuitry controlling limbed locomotion is located in the spinal cord, known as Central Pattern Generators (CPGs). After a traumatic Spinal Cord Injury (SCI), ascending and descending tracts are damaged, interrupting the communication between CPGs and supraspinal structures that are fundamental to initiate, control and adapt movement to the environment. Although low vertebrates and some mammals regain some physiological functions after a spinal insult, the capacity to recover in hominids is rather limited. The consequences after SCI include physiological (sensory, autonomic and motor) and mental dysfunctions, which causes a profound impact in social and economic aspects of patients and their relatives Despite the recent progress in the development of therapeutic strategies for SCI, there is no satisfactory agreement for choosing the best treatment that restores the affected functions of people suffering the devastating consequences after SCI. Studies have described that patients with chronic SCI can achieve some degree of neurorestoration with strategies that include physical rehabilitation, neuroprosthesis, electrical stimulation or cell therapies. Particularly in the human, the contribution of supraspinal structures to the clinical manifestations of gait deficits in people with SCI and its potential role as therapeutic targets is not well known. Additionally, mental health is considered fundamental as it represents the first step to overcome daily adversities and to face progression of this unfortunate condition. This chapter focuses on the consequences of spinal cord disconnection from supraspinal structures, from motor dysfunction to mental health. Recent advancements on the study of supraspinal structures and combination of different approaches to promote recovery after SCI are discussed. Promising strategies are used alone or in combination and include drugs, physical exercise, robotic devices, and electrical stimulation

Gain and loss of functional locomotor recovery following contusive spinal cord injury in the adult rat.

Activity-based rehabilitation in the form of overground or body weight-supported treadmill (BWST) locomotor step training has become the most widely accepted therapy translated from preclinical animal research to spinal cord injury (SCI) patients. However, locomotor training does not provide the level of functional locomotor recovery that animal models are interpreted to promise because preclinical studies have used complete spinal cord transections that do not sufficiently mimic the clinical presentation. Furthermore, animal models do not include the same standard of care, immobilization with stretch/range-ofmotion manual therapies, SCI patients receive. Therefore, we have developed an experimental animal model that includes aspects of acute patient care, immobilization and manual therapy interventions, applied daily throughout the 8 weeks following incomplete low thoracic contusion SCI in adult rats. We hypothesize that laboratory animals with clinically relevant incomplete contusion SCI achieve maximal locomotor recovery while moving about in their cages, auto-training, within the first few weeks post-injury. Our results show that when immobilization and/or manual therapy interventions are applied the animals suffer severe short-term loss of locomotor function that significantly limits potential for long-term recovery even weeks after the interventions end. Our studies suggest that immobilization and widely practiced manual therapies may be maladaptive for functional locomotor recovery after clinically relevant incomplete SCI