STIMO

Motivation

‍The goal of this project is to develop and clinically validate procedures to achieve the most effective and clinically applicable therapy by:

1. Personalizing the selection of the most effective lead out of four available,
2. Personalizing the placement of the selected lead in the most effective location,
3. Personalizing the EES protocols to enable the most effective lower-limb motor activities.

We will design these procedures to be used by treating physicians through a web-based portal with less involvement of experts and with a limited amount of data. Our goal is to enhance usability and automation to facilitate broader adoption of the STIMO therapy.

Proposed Approach / Solution

‍The structure and framework of the spinal circuitry that governs the firing of motor neurons in response to complex EES protocols is largely unknown. We will therefore model the response of each motor neuron pool using either a “black box” neural network, more abstract state space models suited to model the dynamics of neural circuitry response or hybrids of the two. These spinal circuity models will exploit the general relationship between EES parameters and muscle responses. We will calibrate personalized spinal circuitry models, as well as a “general” spinal circuitry model from previously recorded data of patients in which the personalized bioelectrical spinal model and proprioceptive maps have been generated. The project overview is presented in Fig. 2.

Impact

‍The success of this project will considerably enhance the STIMO therapy and open a clear path towards its widespread use. As a commercial partner in the consortium, ONWARD Medical will directly pursue the next steps towards regulatory approval and worldwide distribution of the personalized STIMO therapy, thereby ensuring that our work transforms the lives of many people paralyzed by spinal cord injury and decreases the overwhelming societal and economic burden of paraplegia.