Neuroprosthetic technology for individuals with spinal cord injury

Abstract

Context

Spinal cord injury (SCI) results in a loss of function and sensation below the level of the lesion. Neuroprosthetic technology has been developed to help restore motor and autonomic functions as well as to provide sensory feedback.

Findings

This paper provides an overview of neuroprosthetic technology that aims to address the priorities for functional restoration as defined by individuals with SCI. We describe neuroprostheses that are in various stages of preclinical development, clinical testing, and commercialization including functional electrical stimulators, epidural and intraspinal microstimulation, bladder neuroprosthesis, and cortical stimulation for restoring sensation. We also discuss neural recording technologies that may provide command or feedback signals for neuroprosthetic devices.

Conclusion/clinical relevance

Neuroprostheses have begun to address the priorities of individuals with SCI, although there remains room for improvement. In addition to continued technological improvements, closing the loop between the technology and the user may help provide intuitive device control with high levels of performance.

Keywords:

• Spinal cord injuries, Assistive technology, Neural interface, Neuroprosthesis, Brain–computer interface, Electrical stimulation, Epidural stimulation, Central pattern generators, Neurogenic bladder, Paraplegia, Tetraplegia, Rehabilitation

Acknowledgements

This material is based on work supported by the Office of Research and Development, Rehabilitation Research & Development Service, Department of Veterans Affairs (Grants #B6789C, B7143R, and RX720), the Defense Advanced Research Projects Agency (DARPA) Revolutionizing Prosthetics program contract number N66001-10-C-4056, the National Institutes of Health, National Institute of Neurological Disorders and Stroke Grant #F32NS074565, and the UPMC Rehabilitation Institute. The views expressed herein are those of the authors and do not reflect the official policy or position of the Department of Veterans Affairs, Department of Defense, National Institutes of Health, National Institute of Neurological Disorders and Stroke, or the United States government.