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  1. Article ; Online: Spinal automaticity of movement control and its role in recovering function after spinal injury.

    Edgerton, V Reggie / Gad, Parag

    Expert review of neurotherapeutics

    2022  Volume 22, Issue 8, Page(s) 655–667

    Abstract: Introduction: The significance of the spinal cord in controlling postural and locomotor functions largely reemerged in the mid-1970s under the leadership of Sten Grillner, demonstrating key phenomena of 'central pattern generation' and 'fictive ... ...

    Abstract Introduction: The significance of the spinal cord in controlling postural and locomotor functions largely reemerged in the mid-1970s under the leadership of Sten Grillner, demonstrating key phenomena of 'central pattern generation' and 'fictive locomotion' with an evolutionary perspective. These concepts raised the question of how much function can be recovered after paralysis, given the intrinsic automaticity of spinal networks in injured and uninjured states in adults.
    Areas covered: This review explores biological mechanisms governing spinal control of movements such as posture and locomotion. We focus on concepts that have evolved from experiments performed over the past decade. Rather than a comprehensive review of the vast literature on the neural control of posture and locomotion, we focus on the various mechanisms underlying functional automaticity, and their clinical relevance.
    Expert opinion: We propose that multiple combinations of sensory mechanoreceptors linked to proprioception that generate an infinite number of different sensory ensembles, having species-specific meaning and extensive influence in controlling posture and locomotion. These sensory ensembles are translated as a probabilistic phenomenon into highly specific but indeterminate actions. Therefore, we opine that spinal translation of these ensembles in real-time plays a central role in the automaticity of motor control in individuals with and without severe neuromotor dysfunction.
    MeSH term(s) Humans ; Locomotion/physiology ; Spinal Cord ; Spinal Injuries
    Language English
    Publishing date 2022-08-27
    Publishing country England
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2112534-X
    ISSN 1744-8360 ; 1473-7175
    ISSN (online) 1744-8360
    ISSN 1473-7175
    DOI 10.1080/14737175.2022.2115359
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  2. Book ; Conference proceedings: Proceedings of the 24th Annual International Gravitational Physiology Meeting

    Edgerton, V. Reggie

    4 - 9 May, 2003, Santa Monica, CA

    (Journal of gravitational physiology ; 10,1)

    2003  

    Event/congress International Gravitational Physiology Meeting (24, 2003, SantaMonicaCalif.)
    Author's details organizing committee V. Reggie Edgerton
    Series title Journal of gravitational physiology ; 10,1
    Collection
    Language English
    Size P118 S. : Ill., graph. Darst.
    Publisher Galileo Foundation
    Publishing place Davis, CA
    Publishing country United States
    Document type Book ; Conference proceedings
    HBZ-ID HT015006779
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    Zs A 6244 -10- verfügbar in Königswinter Königswinter

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  3. Article ; Online: Reply by Authors.

    Kreydin, Evgeniy I / Abedi, Aidin / Montero, Veronica Stefania / Morales, Luis / Jen, Rita / Perez, Laura / La Riva, Anibal / Kohli, Priya / Liu, Charles Y / Ginsberg, David A / Gad, Parag / Edgerton, V Reggie / Jann, Kay

    The Journal of urology

    2024  Volume 211, Issue 2, Page(s) 304

    Language English
    Publishing date 2024-02-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1097/JU.0000000000003776.03
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  4. Article ; Online: Combining spinal neuromodulation and activity based neurorehabilitation therapy improves sensorimotor function in cerebral palsy.

    Sachdeva, Rahul / Girshin, Kristin / Shirkhani, Yousef / Gad, Parag / Edgerton, V Reggie

    Frontiers in rehabilitation sciences

    2023  Volume 4, Page(s) 1216281

    Abstract: Motor dysfunction in individuals with cerebral palsy (CP) such as the inability to initiate voluntary movements, walking with compensatory movement patterns, and debilitating spasticity is due to the aberrant neural connectivity between the brain and ... ...

    Abstract Motor dysfunction in individuals with cerebral palsy (CP) such as the inability to initiate voluntary movements, walking with compensatory movement patterns, and debilitating spasticity is due to the aberrant neural connectivity between the brain and spinal cord. We tested the efficacy of noninvasive spinal cord neuromodulation (SCiP™, SpineX Inc.) with activity-based neurorehabilitation therapy (ABNT) in improving the sensorimotor function in six children with CP. Children received 8 weeks of either SCiP™ or sham therapy with ABNT (
    Language English
    Publishing date 2023-07-26
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2673-6861
    ISSN (online) 2673-6861
    DOI 10.3389/fresc.2023.1216281
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  5. Article: sPinal cOrd neUromodulatioN to treat Cerebral palsy in pEdiatrics: POUNCE Multisite Randomized Clinical Trial.

    Girshin, Kristin / Sachdeva, Rahul / Cohn, Richard / Gad, Parag / Krassioukov, Andrei V / Edgerton, V Reggie

    Frontiers in neuroscience

    2023  Volume 17, Page(s) 1221809

    Abstract: ... Function Classification Scale Levels I-V will be recruited and divided equally into two groups (G1 and G2 ...

    Abstract Introduction: Cerebral palsy (CP) affects up to 4 children in 1,000 live births, making it the most common motor disorder in children. It impairs the child's ability to move voluntarily and maintain balance and posture, and results in a wide range of other functional disorders during early development impairments in various sensory modalities, e.g., vision, hearing ability and proprioception. Current standard of care therapy focuses on symptom management and does not mitigate the progression of many of these underlying neurological impairments. The goal of this trial is to conduct a prospective multicenter, double-blinded, sham-controlled, crossover, randomized control trial to demonstrate the safety and efficacy of noninvasive spinal cord neuromodulation (SCiP™, SpineX Inc.) in conjunction with activity-based neurorehabilitation therapy (ABNT) to improve voluntary sensorimotor function in children with cerebral palsy.
    Methods and analysis: Sixty participants (aged 2-13 years) diagnosed with CP classified as Gross Motor Function Classification Scale Levels I-V will be recruited and divided equally into two groups (G1 and G2). Both groups will receive identical ABNT 2 days/wk. G1 will initially receive sham stimulation, whereas G2 will receive therapeutic SCiP™ therapy for 8 weeks. After 8 weeks, G1 will cross over and receive therapeutic SCiP™ therapy for 8 weeks, whereas G2 will continue to receive SCiP™ therapy for another 8 weeks, for a total of 16 weeks. Primary and secondary outcome measures will include Gross Motor Function Measure-88 and Modified Ashworth Scale, respectively. Frequency and severity of adverse events will be established by safety analyses.
    Ethics and dissemination: The trial is registered on clinicaltrials.gov (NCT05720208). The results from this trial will be reported on clinicaltrials.gov, published in peer-reviewed journals and presented at scientific and clinical conferences.
    Language English
    Publishing date 2023-07-26
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2411902-7
    ISSN 1662-453X ; 1662-4548
    ISSN (online) 1662-453X
    ISSN 1662-4548
    DOI 10.3389/fnins.2023.1221809
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  6. Article ; Online: Home-Based SCONE

    Gad, Parag / Zhong, Hui / Edgerton, V Reggie / Kreydin, Evgeniy

    Neurotrauma reports

    2021  Volume 2, Issue 1, Page(s) 165–168

    Abstract: A wide range of dysfunction can occur after a stroke including symptoms such as urinary urgency, frequency, and urge incontinence. The Spinal Cord Neuromodulator ( ... ...

    Abstract A wide range of dysfunction can occur after a stroke including symptoms such as urinary urgency, frequency, and urge incontinence. The Spinal Cord Neuromodulator (SCONE
    Language English
    Publishing date 2021-03-18
    Document type Journal Article
    ISSN 2689-288X
    ISSN (online) 2689-288X
    DOI 10.1089/neur.2020.0061
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  7. Article: Engaging Spinal Networks to Mitigate Supraspinal Dysfunction After CP.

    Edgerton, V Reggie / Hastings, Susan / Gad, Parag N

    Frontiers in neuroscience

    2021  Volume 15, Page(s) 643463

    Abstract: Although children with cerebral palsy seem to have the neural networks necessary to generate most movements, they are markedly dysfunctional, largely attributable to abnormal patterns of muscle activation, often characterized as spasticity, largely ... ...

    Abstract Although children with cerebral palsy seem to have the neural networks necessary to generate most movements, they are markedly dysfunctional, largely attributable to abnormal patterns of muscle activation, often characterized as spasticity, largely reflecting a functionally abnormal spinal-supraspinal connectivity. While it is generally assumed that the etiologies of the disruptive functions associated with cerebral palsy can be attributed primarily to supraspinal networks, we propose that the more normal connectivity that persists between peripheral proprioception-cutaneous input to the spinal networks can be used to guide the reorganization of a more normal spinal-supraspinal connectivity. The level of plasticity necessary to achieve the required reorganization within and among different neural networks can be achieved with a combination of spinal neuromodulation and specific activity-dependent mechanisms. By engaging these two concepts, we hypothesize that bidirectional reorganization of proprioception-spinal cord-brain connectivity to higher levels of functionality can be achieved without invasive surgery.
    Language English
    Publishing date 2021-04-12
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2411902-7
    ISSN 1662-453X ; 1662-4548
    ISSN (online) 1662-453X
    ISSN 1662-4548
    DOI 10.3389/fnins.2021.643463
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  8. Article ; Online: Stochastic spinal neuromodulation tunes the intrinsic logic of spinal neural networks.

    Taccola, Giuliano / Ichiyama, Ronaldo M / Edgerton, V Reggie / Gad, Parag

    Experimental neurology

    2022  Volume 355, Page(s) 114138

    Abstract: The present review focuses on the physiological states of spinal networks, which are stochastically modulated by continuously changing ensembles of proprioceptive and supraspinal input resulting in highly redundant neural networks. Spinal epidural ... ...

    Abstract The present review focuses on the physiological states of spinal networks, which are stochastically modulated by continuously changing ensembles of proprioceptive and supraspinal input resulting in highly redundant neural networks. Spinal epidural interfaces provide a platform for probing spinal network dynamics and connectivity among multiple motor pool-specific spinal networks post-injury under in vivo experimental conditions. Continuous epidural low-frequency pulses at low intensity can evoke motor responses of stochastically changing amplitudes and with an oscillatory pattern of modulation. The physiological significance of this oscillatory pattern, intrinsic to "resting" spinal networks and observed in both uninjured and injured locomotor circuits, is unclear. This neural variability among spinal networks appears to be a fundamental mechanism of the network's design and not a "noise" interfering with movement control. Data to date also suggest that the greater the level of stimulation above motor threshold, the greater the loss of modulation over the motor output that is physiologically provided by interneuronal networks, which integrate naturally occurring proprioceptive and cutaneous input generated during movement. Sub-motor threshold spinal electrical stimulation experiments demonstrate a range of functional improvements of multiple physiological systems when used in concert with sensorimotor training after spinal cord injury. Although our understanding of the systemic, cellular and molecular modulatory mechanisms that trigger these activity-dependent adaptive processes remain incomplete, some basic physiological principles have evolved, at least at the systemic and neural network levels and to some degree at the cellular level.
    MeSH term(s) Humans ; Logic ; Movement ; Neural Networks, Computer ; Spinal Cord ; Spinal Cord Injuries/therapy
    Language English
    Publishing date 2022-06-05
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 207148-4
    ISSN 1090-2430 ; 0014-4886
    ISSN (online) 1090-2430
    ISSN 0014-4886
    DOI 10.1016/j.expneurol.2022.114138
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  9. Article ; Online: Combining spinal neuromodulation and activity based neurorehabilitation therapy improves sensorimotor function in cerebral palsy

    Rahul Sachdeva / Kristin Girshin / Yousef Shirkhani / Parag Gad / V. Reggie Edgerton

    Frontiers in Rehabilitation Sciences, Vol

    2023  Volume 4

    Abstract: Motor dysfunction in individuals with cerebral palsy (CP) such as the inability to initiate voluntary movements, walking with compensatory movement patterns, and debilitating spasticity is due to the aberrant neural connectivity between the brain and ... ...

    Abstract Motor dysfunction in individuals with cerebral palsy (CP) such as the inability to initiate voluntary movements, walking with compensatory movement patterns, and debilitating spasticity is due to the aberrant neural connectivity between the brain and spinal cord. We tested the efficacy of noninvasive spinal cord neuromodulation (SCiP™, SpineX Inc.) with activity-based neurorehabilitation therapy (ABNT) in improving the sensorimotor function in six children with CP. Children received 8 weeks of either SCiP™ or sham therapy with ABNT (n = 3 per group). At the end of 8 weeks, all participants received 8 weeks of SCiP™ therapy with ABNT. Follow up assessments were done at week 26 (10 weeks after the last therapy session). Sensorimotor function was measured by the Gross Motor Function Measure 88 (GMFM88) test. We observed minimal change in sham group (mean 6% improvement), however, eight weeks of SCiP™ therapy with ABNT resulted in statistically and clinically relevant improvement in GMFM88 scores (mean 23% increase from baseline). We also observed reduced scores on the modified Ashworth scale only with SCiP™ therapy (−11% vs. +5.53% with sham). Similar improvements were observed in sham group but only after the cross over to SCiP™ therapy group at the end of the first eight weeks. Finally, sixteen weeks of SCiP™ therapy with ABNT resulted in further improvement of GMFM88 score. The improvement in GMFM88 scores were maintained at week 26 (10 weeks after the end of therapy), suggesting a sustained effect of SCiP™ therapy.
    Keywords spinal cord neuromodulation ; noninvasive stimulation ; cerebral palsy ; sensorimotor function ; spasticity ; Other systems of medicine ; RZ201-999 ; Medical technology ; R855-855.5
    Subject code 796 ; 610
    Language English
    Publishing date 2023-07-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Is the vagus nerve our neural connectome?

    Edgerton, V Reggie / Gad, Parag

    eLife

    2018  Volume 7

    Abstract: What are the implications of the vagus nerve being able to mediate the time-dependent plasticity of an array of sensorimotor networks? ...

    Abstract What are the implications of the vagus nerve being able to mediate the time-dependent plasticity of an array of sensorimotor networks?
    MeSH term(s) Connectome ; Humans ; Spinal Cord Injuries ; Vagus Nerve
    Language English
    Publishing date 2018-03-16
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 2687154-3
    ISSN 2050-084X ; 2050-084X
    ISSN (online) 2050-084X
    ISSN 2050-084X
    DOI 10.7554/eLife.35592
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