Abstract Considered over the years since 1776, the progressive tightening of government control over the UK Parliament may be relaxing somewhat. Select committees in particular have led the way in the recovery of parliamentary authority. At the same time, courts, both domestic and European, are challenging the concept of parliamentary sovereignty. The principles of separation of powers and of federalism embodied in the US Constitution were initially reactions to British monarchical supremacy during the period of colonial rule. Consistent with that basic document, limitations imposed upon each of the branches of the Federal government, the retention of some power to the States or to the people, as well as internal separation of some House and Senate legislative and also quasi‐executive and quasi‐judicial functions have all evolved over 221 years. Internally, the diminution of procedural fairness, deliberative capacity, and transparency has been demonstrated in both Houses.
Following injury or disease, neural circuitry can be altered to varying degrees leading to highly individualized characteristics that may or may not resemble original function. In addition, lost or partially damaged circuits and the effects of biological recovery processes coupled with learned compensatory strategies create a new neuroanatomy with capabilities that are often not functional or may interfere with daily life. To date, the majority of approaches used to treat neurological dysfunction have focused on the replacement of lost or damaged function, usually through the suppression of su ... More
Epidural spinal cord stimulation has a long history of application for improving motor control in spinal cord injury. This review focuses on its resurgence following the progress made in understanding the underlying neurophysiological mechanisms and on recent reports of its augmentative effects upon otherwise subfunctional volitional motor control. Early work revealed that the spinal circuitry involved in lower-limb motor control can be accessed by stimulating through electrodes placed epidurally over the posterior aspect of the lumbar spinal cord below a paralyzing injury. Current understanding is that such stimulation activates large-to-medium-diameter sensory fibers within the posterior roots. Those fibers then trans-synaptically activate various spinal reflex circuits and plurisegmentally organized interneuronal networks that control more complex contraction and relaxation patterns involving multiple muscles. The induced change in responsiveness of this spinal motor circuitry to any residual supraspinal input via clinically silent translesional neural connections that have survived the injury may be a likely explanation for rudimentary volitional control enabled by epidural stimulation in otherwise paralyzed muscles. Technological developments that allow dynamic control of stimulation parameters and the potential for activity-dependent beneficial plasticity may further unveil the remarkable capacity of spinal motor processing that remains even after severe spinal cord injuries.
