Effect of epidural stimulation of the lumbosacral spinal：腰骶部脊髓硬膜外刺激的影响.pptVIP

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2018-06-23 发布于浙江
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Effect of epidural stimulation of the lumbosacral spinal：腰骶部脊髓硬膜外刺激的影响.ppt

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Effect of epidural stimulation of the lumbosacral spinal：腰骶部脊髓硬膜外刺激的影响

Effect of epidural stimulation of the lumbosacral spinal cordon voluntary movement, standing, and assisted steppingafter motor complete paraplegia: a case study Presented by: Monzurul Alam 18th July 2011 Authors Susan Harkema, Ph.D.Professor, Department of Neurological Surgery Rehabilitation Research Director,Kentucky Spinal Cord Injury Research CenterOwsley B. Frazier Chair in Neurological Rehabilitation University of Louisville, KY, USA V. Reggie Edgerton, Ph.D.Professor, Department of Neurobilogy Vice Chair, Integrative Biology and Physiology University of California, Los Angeles, CA, USA. Story A 23-year-old man who had paraplegia from a C7–T1 subluxation as a result of a motor vehicle accident in July 2006, He was presented with complete loss of clinically detectable voluntary motor function and partial preservation of sensation below the T1 cord segment. After 170 locomotor training sessions over 26 months, a 16-electrode array was surgically placed on the dura (L1–S1 cord segments) in December 2009, to allow for chronic electrical stimulation. Spinal cord stimulation was done during sessions that lasted up to 250 min. 29 experiments and several stimulation combinations and parameters were carried out with the aim of the patient achieving standing and stepping. Findings Epidural stimulation enabled the man to achieve full weight-bearing standing with assistance provided only for balance for 4·25 min. The patient achieved this standing during stimulation using parameters identified as specific for standing while providing bilateral load-bearing proprioceptive input. We also noted locomotor-like patterns when stimulation parameters were optimised for stepping. Additionally, 7 months after implantation, the patient recovered supraspinal control of some leg movements, but only during epidural stimulation. Video evidence Hypothesis Repeated stimulation of the spinal cord and training increased the ability to control movement in animal model