Epidural Spinal Electrogram Provides Direct Spinal Recordings in Awake Human Participants.

John F Burke,Prasad Shirvalkar,George Pasvankas,Lawrence Poree,Nikhita Kunwar,Kenneth H Louie,Paul Su,Doris D Wang,Lines Jacques,Melanie Henry,Maria S Yaroshinsky

doi:10.3389/fnhum.2021.721076

John F Burke, Prasad Shirvalkar + Show 9 more

Open Access

https://doi.org/10.3389/fnhum.2021.721076

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Abstract

Little is known about the electrophysiological activity of the spinal cord during voluntary movement control in humans. We present a novel method for recording electrophysiological activity from the human spinal cord using implanted epidural electrodes during naturalistic movements including overground walking. Spinal electrograms (SEGs) were recorded from epidural electrodes implanted as part of a test trial for patients with chronic pain undergoing evaluation for spinal cord stimulation. Externalized ends of the epidural leads were connected to an external amplifier to capture SEGs. Electromyographic and accelerometry data from the upper and lower extremities were collected using wireless sensors and synchronized to the SEG data. Patients were instructed to perform various arm and leg movements while SEG and kinematic data were collected. This study proves the safety and feasibility of performing epidural spinal recordings from human subjects performing movement tasks.

Highlights

The spinal cord is more than a passive conduit of sensorimotor information between the musculature and the brain; it contains complex neural circuitry capable of integrating top-down cortical control of movement with bottom up sensory and biomechanical information from the periphery
We developed a novel method to study neurophysiological activity of the spinal cord during volitional motor and sensory tasks in humans by recording from externalized spinal epidural electrodes in patients undergoing spinal cord stimulation (SCS) evaluation to treat chronic pain
We present our protocol for recording human spinal electrogram (SEG) (Shimoji et al, 1971) to advance our understanding of spinal neurophysiology

Summary

Introduction

The spinal cord is more than a passive conduit of sensorimotor information between the musculature and the brain; it contains complex neural circuitry capable of integrating top-down cortical control of movement with bottom up sensory and biomechanical information from the periphery. An example of such an intrinsic spinal neural circuit is the lumbosacral “central pattern generator” (CPG) (Grillner and Wallen, 1985; MacKay-Lyons, 2002), which is a theoretical circuit in the caudal aspect of the spinal cord capable of autonomously generating stereotyped movements involved with locomotion (Dimitrijevic et al, 1998). We present our protocol for recording human spinal electrogram (SEG) (Shimoji et al, 1971) to advance our understanding of spinal neurophysiology

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