High density epidural stimulation for facilitation of locomotion, posture, voluntary movement, and recovery of autonomic, sexual, vasomotor, and cognitive function after neurological injury

A system for enabling or improving, in a patient having a neurologically derived paralysis, control autonomic functions including at least one of a cardiovascular autonomic function or a vasomotor autonomic function, the system comprising:

• an electrode array electrically coupled to a portion of a spinal cord of the patient;
• and
• a processor communicatively coupled to the electrode array, the processor configured to:
• receive data related to the one or more autonomic functions in the patient during postural training using a training device, the training device configured to induce postural proprioceptive signals in the patient,
• detect the one or more autonomic functions in the patient during the postural training based on the received data,
• select electrical stimulation parameters among a plurality of electrical stimulation parameters based on the detected one or more autonomic functions, and
• cause the electrode array to apply electrical stimulation using the selected stimulation parameters to the portion of the spinal cord of the patient,
• wherein at least one of the electrical stimulation or the postural training is configured to modulate electrophysiological properties of a spinal circuit in the patient so the spinal circuit is activated by the postural proprioceptive signals that are derived from a region of the patient where the one or more autonomic functions are enabled or improved.

A method of enabling or improving, in a patient having a nervous system disorder, one or more autonomic function selected from the group consisting of cardiovascular function, body temperature, metabolic processes, sexual function, bladder function, vasomotor function, or cognitive function, the method comprising:

• inducing, with a stimulator including a processor connected to at least one electrode, spinal interneuronal excitability to a sub-threshold level within at least one spinal circuit by:
• applying, via at least one of the at least one electrode, an electrical stimulation according to selected electrical stimulation parameters to excite neurons in dorsal roots of the patient to the sub-threshold level,
• wherein the electrical stimulation activates in real time dorsal root afferent fibers in the patient to stimulate a neural circuit regulating the one or more autonomic function, and
• wherein the at least one autonomic function is enabled or improved.

A system for enabling or improving, in a patient having a nervous system disorder, at least one autonomic function selected from a group consisting of cardiovascular function, body temperature, metabolic processes, bladder function, sexual function, vasomotor function, or cognitive function, the system comprising:

• at least one electrode;
• and
• a stimulator including a processor communicatively coupled to the at least one electrode, the stimulator comprising at least one processor and a memory, the stimulator configured to:
• select electrical stimulation parameters from a memory to induce, with the stimulator connected to the at least one electrode, spinal interneuronal excitability to a sub-threshold level within at least one spinal circuit, and
• cause the at least one electrode to apply electrical stimulation according to the selected stimulation parameters to excite neurons in dorsal roots of the patient to the sub-threshold level,
• wherein parameters of the electrical stimulation are configured to activate in real time dorsal root afferent fibers in the patient to stimulate a neural circuit regulating the at least one autonomic function,
• wherein the one or more autonomic function is enabled or improved.