Extended Data Fig. 10: DBSLH in two incomplete SCI individuals leads to immediate and durable improvements in walking.

a, Clinical trial timeline. b, Diffusion tensor imaging (DTI)-based tractography exploring LH neuronal projections in the first participant. c, Intra-operative spiking activity of the first participant while descending a micro-electrode within the LH exposes basal activity of neurons throughout the rostrocaudal extent of the LH. d, Coronal and axial sections of the preoperative MRI of the first participant showing the projection of the DBS leads. e, Computer simulations of volume of activated tissues of the most-used stimulation program of the first participant. The distribution of the proportion of activated regions shows the LH as the main activated region. P1 stimulation program: left & right DBS contacts 0 + 1-2 + , amplitude 7 mA. f, As in b, for the second participant. g, As in c, for the second participant. h, As in d, for the second participant. i, As in e, for the second participant. P2 stimulation program: left & right DBS contacts 1 + 2-3 + , amplitude 7 mA. Pulse width and frequency are not taken into account when calculating the activation volume. j, Kinematic and muscle analysis of participants P1 and P2 walking on parallel bars with and without DBSLH during the same calibration session. Walking was quantified using principal component analysis applied to gait parameters calculated from kinematic and muscle recordings. For both participants, the first principal component (PC1) distinguished steps enhanced by DBSLH from steps without DBSLH. Gait scores were thus quantified as the scores on PC1 (n ≥ 7 gait cycles). Statistics are provided in Supplementary Data 3. k, Attempts of participants P1 and P2 to perform 3 voluntary hip flexions with and without DBSLH, during the same calibration session. Associated recording of electromyographic activity from flexor muscle and its quantification (n = 3). l, Chronophotography of walking recorded in the second participant with and without DBSLH, together with the associated recording of electromyographic activity from extensor and flexor muscles and their quantification (n = 11 gait cycles, dots represent individual trials). Statistics are provided in Supplementary Data 3. m, Quantification of the walking improvements following 3 months of rehabilitation enhanced with DBS, for P1 and P2. Goal achievement score throughout rehabilitation for P1 and P2 (scale: 1, not achieved/with significant help; 2, very partially achieved / with light to moderate help; 3, partially achieved / under supervision; 4, achieved / independent). Proportion of weight support (BWS) provided to P1 during sessions. Quantification of number of stairs climbed and related speed of P2 throughout the whole study (PI: pre-implantation; Rehab: during rehabilitation, DBSON; M3: post-rehabilitation, DBSON; M6: end of main study, DBSON). Quantification of step height and step length while standing and walking on parallel bars respectively for P1 and P2, pre-implantation (PI) and at the end of main study (M6), DBSOFF. Statistics are provided in Supplementary Data 3.