Functional ultrasound imaging of the human spinal cord

K A Agyeman; D J Lee; J Russin; E I Kreydin; W Choi; A Abedi; Y T Lo; J Cavaleri; K Wu; V R Edgerton; C Liu; V N Christopoulos

doi:10.1016/j.neuron.2024.02.012

Functional ultrasound imaging of the human spinal cord

Neuron. 2024 May 15;112(10):1710-1722.e3. doi: 10.1016/j.neuron.2024.02.012. Epub 2024 Mar 7.

Authors

K A Agyeman¹, D J Lee², J Russin², E I Kreydin³, W Choi⁴, A Abedi⁴, Y T Lo⁵, J Cavaleri⁶, K Wu⁴, V R Edgerton⁷, C Liu⁸, V N Christopoulos⁹

Affiliations

¹ Department of Bioengineering, University of California Riverside, Riverside, CA, USA.
² Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA; Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.
³ Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA; Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁴ Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁵ Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore.
⁶ Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁷ Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA. Electronic address: redgerton@gmail.com.
⁸ Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA; Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA. Electronic address: cliu@usc.edu.
⁹ Department of Bioengineering, University of California Riverside, Riverside, CA, USA; Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Neuroscience Graduate Program, University of California Riverside, Riverside, CA, USA. Electronic address: vchristo@engr.ucr.edu.

PMID: 38458198
DOI: 10.1016/j.neuron.2024.02.012

Abstract

Utilizing the first in-human functional ultrasound imaging (fUSI) of the spinal cord, we demonstrate the integration of spinal functional responses to electrical stimulation. We record and characterize the hemodynamic responses of the spinal cord to a neuromodulatory intervention commonly used for treating pain and increasingly used for the restoration of sensorimotor and autonomic function. We found that the hemodynamic response to stimulation reflects a spatiotemporal modulation of the spinal cord circuitry not previously recognized. Our analytical capability offers a mechanism to assess blood flow changes with a new level of spatial and temporal precision in vivo and demonstrates that fUSI can decode the functional state of spinal networks in a single trial, which is of fundamental importance for developing real-time closed-loop neuromodulation systems. This work is a critical step toward developing a vital technique to study spinal cord function and effects of clinical neuromodulation.

Keywords: epidural spinal cord stimulation; fUSI; functional neuroimaging; functional ultrasound imaging; neuromodulation; spinal cord.

MeSH terms

Adult
Electric Stimulation* / methods
Female
Hemodynamics / physiology
Humans
Male
Spinal Cord* / diagnostic imaging
Spinal Cord* / physiology
Ultrasonography* / methods