Decoding and training spared motor neuron activity in children with paralyzed hands

ongoing

We have recently identified single motor neuron activity in humans with spinal cord injury and stroke resulting in complete loss of hand function. We have then demonstrated that these individuals can control with high levels of precision the spared motor neurons ensemble in real-time, up to four degrees of freedom of the hand. We have now collected pilot data in children (<4 years old) with a completely paralyzed hand and we also found spared electromyographic activity when the children were playing with an instrumented toy. We developed a new stretchable wireless high-density EMG bracelet tailored forearm of children <3 years old, and also developed a new soft-neuroorthosis to control the small hand of the children. In this proof-of-concept project, we aim to develop a minimally invasive neuromotoric interface for children with paralyzed hands after pediatric stroke and or hemispherotomy. We will develop a system to decode the motor intention of the paralyzed children during gaming activities and associate the spared motor neuron discharge times to a wearable neuroorthosis. We have already demonstrated that our innovative neural controlled orthosis can comfortably move the hand of two paralyzed children. By leveraging the spared motor neuron output and the connection with the proposed neurorthosis, we aim to develop a new neurorehabilitation system for children, that is synchrony with the actual intended movement that are still spared after the neural lesions. This bidirectional neural interface will engage and monitor the remaining neural pathways at the cellular level, with the goal of enhancing and transforming the activity of spared motor neurons into highly functional motor capacities. By leveraging these advanced technologies, we aim to open new research and commercial avenues in paediatric neurorehabilitation and also to answer fundamental questions in movement neuroscience related to pediatric stroke or hemispherotomy.