Potentiation of cortico-spinal output via targeted electrical stimulation of the motor thalamus

Autor: Jonathan C. Ho, Erinn M. Grigsby, Arianna Damiani, Lucy Liang, Josep-Maria Balaguer, Sridula Kallakuri, Lilly W. Tang, Jessica Barrios-Martinez, Vahagn Karapetyan, Daryl Fields, Peter C. Gerszten, T. Kevin Hitchens, Theodora Constantine, Gregory M. Adams, Donald J. Crammond, Marco Capogrosso, Jorge A. Gonzalez-Martinez, Elvira Pirondini
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Nature Communications, Vol 15, Iss 1, Pp 1-21 (2024)
Druh dokumentu: article
ISSN: 2041-1723
DOI: 10.1038/s41467-024-52477-1
Popis: Abstract Cerebral white matter lesions prevent cortico-spinal descending inputs from effectively activating spinal motoneurons, leading to loss of motor control. However, in most cases, the damage to cortico-spinal axons is incomplete offering a potential target for therapies aimed at improving volitional muscle activation. Here we hypothesize that, by engaging direct excitatory connections to cortico-spinal motoneurons, stimulation of the motor thalamus could facilitate activation of surviving cortico-spinal fibers thereby immediately potentiating motor output. To test this hypothesis, we identify optimal thalamic targets and stimulation parameters that enhance upper-limb motor-evoked potentials and grip forces in anesthetized monkeys. This potentiation persists after white matter lesions. We replicate these results in humans during intra-operative testing. We then design a stimulation protocol that immediately improves strength and force control in a patient with a chronic white matter lesion. Our results show that electrical stimulation targeting surviving neural pathways can improve motor control after white matter lesions.
Databáze: Directory of Open Access Journals