Walking naturally after spinal cord injury using a brain-spine interface.

A spinal cord injury interrupts the communication between the brain and the region of the spinal cord that produces walking, leading to paralysis1,2. Here, we restored this communication with a digital bridge between the brain and spinal cord that enabled an individual with chronic tetraplegia to stand and walk naturally in community settings. This brain-spine interface (BSI) consists of fully implanted recording and stimulation systems that establish a direct link between cortical signals3 and the analogue modulation of epidural electrical stimulation targeting the spinal cord regions involved in the production of walking4-6. A highly reliable BSI is calibrated within a few minutes. This reliability has remained stable over one year, including during independent use at home. The participant reports that the BSI enables natural control over the movements of his legs to stand, walk, climb stairs and even traverse complex terrains. Moreover, neurorehabilitation supported by the BSI improved neurological recovery. The participant regained the ability to walk with crutches overground even when the BSI was switched off. This digital bridge establishes a framework to restore natural control of movement after paralysis.

Brain oscillatory correlates of visuomotor adaptive learning.

Sensorimotor adaptation involves the recalibration of the mapping between motor command and sensory feedback in response to movement errors. Although adaptation operates within individual movements on a trial-to-trial basis, it can also undergo learning when adaptive responses improve over the course of many trials. Brain oscillatory activities related to these "adaptation" and "learning" processes remain unclear. The main reason for this is that previous studies principally focused on the beta band, which confined the outcome message to trial-to-trial adaptation. To provide a wider understanding of adaptive learning, we decoded visuomotor tasks with constant, random or no perturbation from EEG recordings in different bandwidths and brain regions using a multiple kernel learning approach. These different experimental tasks were intended to separate trial-to-trial adaptation from the formation of the new visuomotor mapping across trials. We found changes in EEG power in the post-movement period during the course of the visuomotor-constant rotation task, in particular an increased (i) theta power in prefrontal region, (ii) beta power in supplementary motor area, and (iii) gamma power in motor regions. Classifying the visuomotor task with constant rotation versus those with random or no rotation, we were able to relate power changes in beta band mainly to trial-to-trial adaptation to error while changes in theta band would relate rather to the learning of the new mapping. Altogether, this suggested that there is a tight relationship between modulation of the synchronization of low (theta) and higher (essentially beta) frequency oscillations in prefrontal and sensorimotor regions, respectively, and adaptive learning.

Effects of a lower limb muscular fatigue on posture-movement interaction during a lower limb pointing task.

PURPOSE: The aim of the present study was to investigate the effects of muscular fatigue on the interaction between posture and movement during a lower limb pointing task. METHODS: Participants (n = 16), aged 18-30 years, kicked a ball toward a target in four conditions of fatigue: No muscular fatigue (NF), fatigue in the kicking (FM) or postural limb (FP) alone, and fatigue in both limbs (FMP). The mean amplitude and speed of the centre of foot pressure (CoP) and centre of mass (CoM) displacements were estimated through a force platform and an optoelectronic system, respectively. In addition, surface electromyography (EMG) of the biceps femoris, rectus femoris, medial gastrocnemius, and peroneus longus was recorded to investigate the anticipatory postural adjustments (APAs). RESULTS: Muscular fatigue yielded a decreased kicking accuracy (p < 0.001) and an increased time to perform the movement (p < 0.001), mainly during the backswing motion. In addition, significant increases in the mean amplitude and speed of the CoP and CoM displacement were found in the anteroposterior (AP) and mediolateral (ML) axes (ps < 0.001), especially when both limbs were fatigued. The EMG analysis confirmed that fatigue modified the way APAs were generated. During fatigue, postural muscle activity increased, but was delayed with respect to movement onset (ps < 0.001). This pattern of response was more consistent when both limbs were fatigued (p < 0.001). CONCLUSION: The present results suggested an additive effect of fatigue and a functional adaptation and subsequent decrease in the overall variability of APAs, indicating that postural and motor processes are interdependent.

Influence of dual-task constraints on the interaction between posture and movement during a lower limb pointing task.

One of the challenges regarding human motor control is making the movement fluid and at a limited cognitive cost. The coordination between posture and movement is a necessary requirement to perform daily life tasks. The present experiment investigated this interaction in 20 adult men, aged 18-30 years. The cognitive costs associated to postural and movement control when kicking towards a target was estimated using a dual-task paradigm (secondary auditory task). Results showed that addition of the attentional demanding cognitive task yielded a decreased kicking accuracy and an increased timing to perform the movement, mainly during the backswing motion. In addition, significant differences between conditions were found for COP and COM displacement (increased amplitude, mean speed) on the anteroposterior axis. However, no significant differences between conditions were found on the mediolateral axis. Finally, EMG analysis showed that dual-task condition modified the way anticipatory postural adjustments (APAs) were generated. More specifically, we observed an increase of the peroneus longus activity, whereas the temporal EMG showed a decrease of its latency with respect to movement onset. These results suggested a functional adaptation resulting in an invariance of overall APAs, emphasizing that cognitive, postural, and motor processes worked dependently.

Comparison of Trunk Motion between Moderate AIS and Healthy Children.

Analysis of kinematic and postural data of adolescent idiopathic scoliosis (AIS) patients seems relevant for a better understanding of biomechanical aspects involved in AIS and its etiopathogenesis. The present project aimed at investigating kinematic differences and asymmetries in early AIS in a static task and in uniplanar trunk movements (rotations, lateral bending, and forward bending). Trunk kinematics and posture were assessed using a 3D motion analysis system and a force plate. A total of fifteen healthy girls, fifteen AIS girls with a left lumbar main curve, and seventeen AIS girls with a right thoracic main curve were compared. Statistical analyses were performed to investigate presumed differences between the three groups. This study showed kinematic and postural differences between mild AIS patients and controls such as static imbalance, a reduced range of motion in the frontal plane, and a different kinematic strategy in lateral bending. These differences mainly occurred in the same direction, whatever the type of scoliosis, and suggested that AIS patients behave similarly from a dynamic point of view.