ID: 219111 Guided Intraoperative Dorsal Root Entry Zone Stimulation Facilitates Cortical Motor Evoked Potentials in Humans

Abstract

Learning of skilled movement requires coincident activation of motor and sensory connections. In rats we have developed a spinal cord associative plasticity protocol which relies on synchronized stimulation of the brain and cervical spinal cord. Immediate facilitation of cortical motor evoked potentials occurs when spine and brain stimulation are timed to converge in the spinal cord. Repeated application of these synchronized pulses for 5-30 minutes induces lasting changes in spinal excitability and produces improvements in dexterity in rats [1-2]. We hypothesized that appropriately timed epidural stimulation targeting the dorsal root entry zones of the human cervical spinal cord would facilitate cortical motor evoked responses in people.