Enabling Task-Specific Volitional Motor Functions via Spinal Cord Neuromodulation in a Human With Paraplegia

Peter J Grahn; Igor A Lavrov; Dimitry G Sayenko; Meegan G Van Straaten; Megan L Gill; Jeffrey A Strommen; Jonathan S Calvert; Dina I Drubach; Lisa A Beck; Margaux B Linde; Andrew R Thoreson; Cesar Lopez; Aldo A Mendez; Parag N Gad; Yury P Gerasimenko; V Reggie Edgerton; Kristin D Zhao; Kendall H Lee

doi:10.1016/j.mayocp.2017.02.014

Enabling Task-Specific Volitional Motor Functions via Spinal Cord Neuromodulation in a Human With Paraplegia

Mayo Clin Proc. 2017 Apr;92(4):544-554. doi: 10.1016/j.mayocp.2017.02.014.

Authors

Peter J Grahn¹, Igor A Lavrov¹, Dimitry G Sayenko², Meegan G Van Straaten³, Megan L Gill³, Jeffrey A Strommen³, Jonathan S Calvert⁴, Dina I Drubach¹, Lisa A Beck³, Margaux B Linde³, Andrew R Thoreson³, Cesar Lopez³, Aldo A Mendez¹, Parag N Gad², Yury P Gerasimenko⁵, V Reggie Edgerton², Kristin D Zhao⁶, Kendall H Lee⁷

Affiliations

¹ Department of Neurologic Surgery, Mayo Clinic, Rochester, MN.
² Department of Integrative Biology and Physiology, University of California Los Angeles.
³ Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.
⁴ Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN.
⁵ Department of Integrative Biology and Physiology, University of California Los Angeles; Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia.
⁶ Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN. Electronic address: zhao.kristin@mayo.edu.
⁷ Department of Neurologic Surgery, Mayo Clinic, Rochester, MN; Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN. Electronic address: lee.kendall@mayo.edu.

PMID: 28385196
DOI: 10.1016/j.mayocp.2017.02.014

Abstract

We report a case of chronic traumatic paraplegia in which epidural electrical stimulation (EES) of the lumbosacral spinal cord enabled (1) volitional control of task-specific muscle activity, (2) volitional control of rhythmic muscle activity to produce steplike movements while side-lying, (3) independent standing, and (4) while in a vertical position with body weight partially supported, voluntary control of steplike movements and rhythmic muscle activity. This is the first time that the application of EES enabled all of these tasks in the same patient within the first 2 weeks (8 stimulation sessions total) of EES therapy.

Publication types

Case Reports

MeSH terms

Adult
Electric Stimulation Therapy / methods*
Electromyography / methods
Humans
Male
Muscle, Skeletal / physiopathology*
Paraplegia* / diagnosis
Paraplegia* / etiology
Paraplegia* / physiopathology
Posture / physiology
Spinal Cord / physiopathology*
Spinal Cord Injuries* / complications
Spinal Cord Injuries* / physiopathology
Spinal Cord Injuries* / therapy
Task Performance and Analysis
Treatment Outcome
Walking / physiology