Neuroprosthetic baroreflex controls haemodynamics after spinal cord injury
Squair JW, Gautier M, Mahe L, Soriano JE, Rowald A, Bichat A, Cho N, Anderson MA, James ND, Gandar J, Incognito AV, Schiavone G, Sarafis ZK, Laskaratos A, Bartholdi K, Demesmaeker R, Komi S, Moerman C, Vaseghi B, Scott B, Rosentreter R, Kathe C, Ravier J, McCracken L, Kang X, Vachicouras N, Fallegger F, Jelescu I, Cheng YL, Li Q, Buschman R, Buse N, Denison T, Dukelow S, Charbonneau R, Rigby I, Boyd SK, Millar PJ, Moraud EM, Capogrosso M, Wagner FB, Barraud Q, Bezard E, Lacour SP, Bloch J, Courtine G, Phillips AA (2021)
Publication Type: Journal article
Publication year: 2021
Journal
Book Volume: 590
Pages Range: 308-314
Journal Issue: 7845
DOI: 10.1038/s41586-020-03180-w
Abstract
Spinal cord injury (SCI) induces haemodynamic instability that threatens survival1–3, impairs neurological recovery4,5, increases the risk of cardiovascular disease6,7, and reduces quality of life8,9. Haemodynamic instability in this context is due to the interruption of supraspinal efferent commands to sympathetic circuits located in the spinal cord10, which prevents the natural baroreflex from controlling these circuits to adjust peripheral vascular resistance. Epidural electrical stimulation (EES) of the spinal cord has been shown to compensate for interrupted supraspinal commands to motor circuits below the injury11, and restored walking after paralysis12. Here, we leveraged these concepts to develop EES protocols that restored haemodynamic stability after SCI. We established a preclinical model that enabled us to dissect the topology and dynamics of the sympathetic circuits, and to understand how EES can engage these circuits. We incorporated these spatial and temporal features into stimulation protocols to conceive a clinical-grade biomimetic haemodynamic regulator that operates in a closed loop. This ‘neuroprosthetic baroreflex’ controlled haemodynamics for extended periods of time in rodents, non-human primates and humans, after both acute and chronic SCI. We will now conduct clinical trials to turn the neuroprosthetic baroreflex into a commonly available therapy for people with SCI.
Involved external institutions
École Polytechnique Fédérale de Lausanne (EPFL)
Switzerland (CH)
University of Calgary
Canada (CA)
Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV)
Switzerland (CH)
Motac Neuroscience
United Kingdom (GB)
Medtronic
United States (USA) (US)
University of Oxford
United Kingdom (GB)
McCaig Institute for Bone and Joint Health
Canada (CA)
University of Guelph (U of G)
Canada (CA)
University of Fribourg / Universitè de Fribourg
Switzerland (CH)
Switzerland (CH)
University of Calgary
Canada (CA)
Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV)
Switzerland (CH)
Motac Neuroscience
United Kingdom (GB)
Medtronic
United States (USA) (US)
University of Oxford
United Kingdom (GB)
McCaig Institute for Bone and Joint Health
Canada (CA)
University of Guelph (U of G)
Canada (CA)
University of Fribourg / Universitè de Fribourg
Switzerland (CH)
How to cite
APA:
Squair, J.W., Gautier, M., Mahe, L., Soriano, J.E., Rowald, A., Bichat, A.,... Phillips, A.A. (2021). Neuroprosthetic baroreflex controls haemodynamics after spinal cord injury. Nature, 590(7845), 308-314. https://doi.org/10.1038/s41586-020-03180-w
MLA:
Squair, Jordan W., et al. "Neuroprosthetic baroreflex controls haemodynamics after spinal cord injury." Nature 590.7845 (2021): 308-314.
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