Spinal cord injury (SCI) often results in irreversible sensorimotor and autonomic dysfunction, severely limiting independence and quality of life. Individuals with clinically complete SCI (AIS A) have traditionally been considered beyond functional recovery. This pilot study aimed to evaluate the therapeutic potential and broader impact of epidural spinal cord stimulation (eSCS) on this population. Three participants with chronic, sensorimotor complete thoracic SCI received implantation of a 32-contact epidural stimulator targeting the lumbosacral spinal cord. Personalized stimulation protocols were developed to support lower limb activation and upright posture. Motor, autonomic, and quality of life outcomes were assessed over a 12-month follow-up. All participants achieved independent standing through eSCS-enabled muscle activation, despite the absence of voluntary movement. The intervention led to improvements in postural control and trunk stability, as well as clinically meaningful gains in autonomic functions, including bladder, bowel, and sexual health, alongside reductions in spasticity and neuropathic pain. Importantly, participants reported sustained and substantial improvements in their perceived quality of life. This study provides evidence that eSCS can restore key functional capacities and significantly enhance the quality of life for individuals with sensorimotor complete SCI.

• Klíčová slova
• autonomic dysfunction, epidural spinal cord stimulation, functional improvement, spinal cord injury, weight-bearing standing,
• Publikační typ
• časopisecké články MeSH

Chemogenetics is a newly developed set of tools that allow for selective manipulation of cell activity. They consist of a receptor mutated irresponsive to endogenous ligands and a synthetic ligand that does not interact with the wild-type receptors. Many different types of these receptors and their respective ligands for inhibiting or excitating neuronal subpopulations were designed in the past few decades. It has been mainly the G-protein coupled receptors (GPCRs) selectively responding to clozapine-N-oxide (CNO), namely Designer Receptors Exclusively Activated by Designer Drugs (DREADDs), that have been employed in research. Chemogenetics offers great possibilities since the activity of the receptors is reversible, inducible on demand by the ligand, and non-invasive. Also, specific groups or types of neurons can be selectively manipulated thanks to the delivery by viral vectors. The effect of the chemogenetic receptors on neurons lasts longer, and even chronic activation can be achieved. That can be useful for behavioral testing. The great advantage of chemogenetic tools is especially apparent in research on brain diseases since they can manipulate whole neuronal circuits and connections between different brain areas. Many psychiatric or other brain diseases revolve around the dysfunction of specific brain networks. Therefore, chemogenetics presents a powerful tool for investigating the underlying mechanisms causing the disease and revealing the link between the circuit dysfunction and the behavioral or cognitive symptoms observed in patients. It could also contribute to the development of more effective treatments.

• MeSH
• duševní poruchy * genetika   metabolismus   MeSH
• klozapin analogy a deriváty   farmakologie   terapeutické užití   MeSH
• lidé MeSH
• neurony metabolismus   účinky léků   MeSH
• nové syntetické drogy farmakologie   MeSH
• receptory spřažené s G-proteiny metabolismus   genetika   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• klozapin MeSH
• nové syntetické drogy MeSH
• receptory spřažené s G-proteiny MeSH