Disruption of Proprioceptive Information During Electrical Stimulation of the Cutaneous Afferents

Restoration of proprioception with neurotechnology is critical to improve effectiveness of robotic neuro-prostheses. Unfortunately, after initial enthusiasm clinical results showed that unlike touch, proprioception could not be reliably induced. Here we show that concurrent activation of multiple sensory modalities may trigger unwanted sensory regulation mechanisms that disrupt proprioception. We recorded intra-spinal neural activity induced by stimulation of proprioceptive afferents from the radial nerve in three monkeys. Then, we superimposed stimulation of the radial nerve cutaneous branch and quantified its impact on spinal neural activity via population analysis. Proprioceptive pulses produced robust neural trajectories in the neural manifold that were disrupted by concurrent stimulation of cutaneous afferents. This disruption correlated with a reduction of afferent volleys and multi-unit activity both in the spinal cord and somatosensory cortex. Our results suggest that limited specificity not only impacts localization of artificial percepts, but also their nature to an extent that was never considered.

Disruption Of Proprioceptive Information During Electrical Stimulation Of The Cutaneous Afferents

Restoration of proprioception with neurotechnology is critical to improve effectiveness of robotic neuro-prostheses. Unfortunately, after initial enthusiasm clinical results showed that unlike touch, proprioception could not be reliably induced. Here we show that concurrent activation of multiple sensory modalities may trigger unwanted sensory regulation mechanisms that disrupt proprioception. We recorded intra-spinal neural activity induced by stimulation of proprioceptive afferents from the radial nerve in three monkeys. Then, we superimposed stimulation of the radial nerve cutaneous branch and quantified its impact on spinal neural activity via population analysis. Proprioceptive pulses produced robust neural trajectories in the neural manifold that were disrupted by concurrent stimulation of cutaneous afferents. This disruption correlated with a reduction of afferent volleys and multi-unit activity both in the spinal cord and somatosensory cortex. Our results suggest that limited specificity not only impacts localization of artificial percepts, but also their nature to an extent that was never considered.

Sensitization of Cutaneous Primary Afferents in Bone Cancer Revealed by In Vivo Calcium Imaging

Cancer-induced bone pain (CIBP) is a complex condition, comprising components of inflammatory and neuropathic processes, but changes in the physiological response profiles of bone-innervating and cutaneous afferents remain poorly understood. We used a combination of retrograde labelling and in vivo calcium imaging of bone marrow-innervating dorsal root ganglia (DRG) neurons to determine the contribution of these cells in the maintenance of CIBP. We found a majority of femoral bone afferent cell bodies in L3 dorsal root ganglia (DRG) that also express the sodium channel subtype Nav1.8—a marker of nociceptive neurons—and lack expression of parvalbumin—a marker for proprioceptive primary afferents. Surprisingly, the response properties of bone marrow afferents to both increased intraosseous pressure and acid were unchanged by the presence of cancer. On the other hand, we found increased excitability and polymodality of cutaneous afferents innervating the ipsilateral paw in cancer bearing animals, as well as a behavioural phenotype that suggests changes at the level of the DRG contribute to secondary hypersensitivity. This study demonstrates that cutaneous afferents at distant sites from the tumour bearing tissue contribute to mechanical hypersensitivity, highlighting these cells as targets for analgesia.

Repeated and patterned stimulation of cutaneous reflex pathways amplifies spinal cord excitability

Priming via patterned stimulation of the nervous system induces neuroplasticity. Yet, accessing previously known cutaneous reflex pathways to alter muscle reflex excitability has not yet been examined. Here, we show that sensory stimulation of the cutaneous afferents that innervate the foot sole can amplify spinal cord excitability, which, in this case, is attributed to reductions in presynaptic inhibition.

Exploiting evolutionarily conserved pathways to promote plasticity of human spinal circuits

Humans evolved from species that walked on all 4 limbs, which means that experiments in quadrupeds can guide and support experiments in humans. This is particularly helpful for neural rehabilitation because the central nervous system is plastic in nature, meaning that activities promoting central nervous system activity can alter subsequent output properties. This is known as neuroplasticity and can be measured as changes in spinal cord excitability through reflexes as a proxy. By targeting evolutionarily conserved pathways that act on similar interneurons within the spinal cord to either increase or decrease excitability, it may be possible to preferentially modulate spinal cord excitability based on a desirable outcome. For example, rhythmic movement reduces spinal cord excitability whereas brief sensory input to cutaneous afferents increases spinal cord excitability. Alterations in spinal cord excitability have been shown to outlast the activity duration, suggesting that neuroplasticity is not transient. This evidence suggests that both rhythmic movement and sensory input can induce acute neuroplasticity of spinal cord excitability. The overall purpose of this dissertation was 2-fold: (i) to provide reviews of how evolutionarily conserved pathways are studied in humans and how they contribute to human rhythmic movement; and (ii) experimentally examine how these conserved pathways, which converge onto similar interneuron circuitry, can be exploited to cause bidirectional changes in spinal cord excitability. Reviews indicate that humans have retained characteristics of quadrupedal locomotion and, in particular, activity of the arms affects the excitability of the legs, and vice versa. Cutaneous input is integrated throughout the body during locomotion, such that cutaneous sensations elicit neuromechanical responses that are nerve-specific and modulated according to the phase of movement. In experiment 1, there was increased spinal cord excitability following patterned stimulation of cutaneous afferents innervating the bottom of the foot. In experiment 2, stimulation to cutaneous afferents innervating both the top and bottom of the foot amplified voluntary plantar- and dorsiflexion. In experiment 3, cervicolumbar connections were exploited to amplify plasticity in spinal cord excitability induced by rhythmic movement. Finally, in experiment 4, there were interactions of rhythmic movement and fatigue, which both reduce spinal cord excitability, with cutaneous stimulation, which increases spinal cord excitability, such that reductions in spinal cord excitability associated with fatigue were mitigated by cutaneous stimulation. Taken together, these experiments suggest that cutaneous stimulation can increase spinal cord excitability, whereas quadrupedal locomotor activity can decrease spinal cord excitability. These conserved pathways can be exploited to intentionally modify spinal cord excitability in a bidirectional fashion, which provides fruitful information for the exploration of rehabilitation and sport performance practices.

Central Plasticity of Cutaneous Afferents Is Associated with Nociceptive Hyperreflexia after Spinal Cord Injury in Rats

Electrical stimulations of dorsal cutaneous nerves (DCNs) at each lumbothoracic spinal level produce the bilateral cutaneus trunci muscle (CTM) reflex responses which consist of two temporal components: an early and late responses purportedly mediated by Aδ and C fibers, respectively. We have previously reported central projections of DCN A and C fibers and demonstrated that different projection patterns of those afferent types contributed to the somatotopic organization of CTM reflex responses. Unilateral hemisection spinal cord injury (SCI) was made at T10 spinal segments to investigate the plasticity of early and late CTM responses 6 weeks after injury. Both early and late responses were drastically increased in response to both ipsi- and contralateral DCN stimulations both above (T6 and T8) and below (T12 and L1) the levels of injury demonstrating that nociceptive hyperreflexia developed at 6 weeks following hemisection SCI. We also found that DCN A and C fibers centrally sprouted, expanded their projection areas, and increased synaptic terminations in both T7 and T13, which correlated with the size of hemisection injury. These data demonstrate that central sprouting of cutaneous afferents away from the site of injury is closely associated with enhanced responses of intraspinal signal processing potentially contributing to nociceptive hyperreflexia following SCI.

Presynaptic inhibition of cutaneous afferents prevents self-generated itch

SummaryChronic itch represents an incapacitating burden on patients suffering a wide spectrum of diseases. Despite recent advances in our understanding of the cells and circuits implicated in the processing of itch information, chronic itch often presents itself without apparent cause. Here, we identify a spinal subpopulation of inhibitory neurons defined by the expression of Ptf1a involved in gating mechanosensory information self-generated during movement. These neurons receive tactile and motor input and establish presynaptic inhibitory contacts on mechanosensory afferents. Loss of Ptf1a neurons leads to increased hairy skin sensitivity and chronic itch, at least partially mediated through the classic itch pathway involving gastrin releasing peptide receptor (GRPR) spinal neurons. Conversely, chemogenetic activation of GRPR neurons elicits itch which is suppressed by concomitant activation of Ptf1a neurons. These findings shed new light on the circuit mechanisms implicated in chronic itch and open novel targets for therapy developments.Highlights*Ptf1a specifies adult spinal presynaptic neurons contacting cutaneous afferents*Loss of spinal Ptf1a+ neurons leads to self-generated itch and excessive grooming*Absence of Ptf1a+ neurons increases hairy skin sensitivity which triggers scratching*GRPR+ neurons act downstream of Ptf1a+ neurons in spontaneous itch