Oct. 24, 2017
Safety and feasibility of low-level epidural electrical stimulation for individuals with SCI
A recent study replicating work conducted by the University of Louisville confirmed that motor function in patients after spinal cord injury (SCI) can be improved by electrical epidural stimulation (EES). Through this study, investigators seek to assess the safety and impact of long-duration, low-intensity EES on quality of life, autonomic functions, and volitional motor ability in subjects previously implanted with an EES system.
The researchers hypothesize that EES applied at low (below eEmc) voltage intensities will improve overall quality of life factors when compared with no stimulation during activities of daily living. They further hypothesize that low-intensity, long-duration stimulation will not inhibit volitional motor functionality enabled by EES.
Results from this work will have a high impact on subsequent clinical trials by providing information on the safety of low-intensity EES during extended durations, while reporting any changes in quality of life, autonomic function and control of volitional function enabled via EES.
Modulating the spinal cord microenvironment and sublesional circuitry using epidural stimulation with electrically conductive hydrogel scaffolds seeded with Schwann cells
In this project, researchers propose to regenerate neural tissue through the lesion site, as well as enhance signals that travel through by stimulating either across or distal to the lesion in combination with locomotor training. For this, they will combine epidural electrical stimulation (EES) with an electrically conductive hydrogel scaffold seeded with Schwann cells (SCs) to enhance regeneration into the site of a complete thoracic spinal cord transection in rodents.
The researchers hypothesize that modulating spinal circuitry through and below the injury using EES will facilitate functional and anatomical reconnection through the scaffold and improve neurologic function. Results from this research will have a high impact on application of spinal cord neuromodulation strategies.
- Igor A. Lavrov, M.D., Ph.D., Mayo Clinic Neural Engineering Laboratory
- Anthony J. Windebank, M.D., neurologist and director of Mayo Clinic's Regenerative Neurobiology Laboratory
Metabolic risk factors as targets to improve rehabilitation outcomes after spinal cord injury
The researchers' hypothesis is that features of systemic metabolic dysfunction, including insulin resistance and a pro-inflammatory state, are mirrored in the adult spinal cord where they exacerbate injury, impede spontaneous recovery and limit responses to rehabilitation.
The researchers further hypothesize that a well-studied insulin sensitizing agent, Metformin, can be administered to overcome these effects and metabolically condition the spinal cord to improve responses to treadmill training in the acute and more chronic periods after spinal cord injury (SCI).
This study will investigate:
- Whether administration of an insulin sensitizer can improve spontaneous recovery
- Whether outcomes in mice that develop metabolic dysfunction more chronically after SCI can also benefit from metabolic conditioning applied alone or in the context of treadmill training
- The relevance of findings to individuals with SCI by determining the impact of metabolic risk factors on recovery of functional independence measures
This project will advance a new paradigm of metabolic targeting to enhance outcomes and the efficacy of rehabilitation after SCI.