Case study: persistent recovery of hand movement and tactile sensation in peripheral nerve injury using targeted transcutaneous spinal cord stimulation

Frontiers in Neuroscience, 2023 · DOI: 10.3389/fnins.2023.1210544 · Published: July 17, 2023

Simple Explanation

Peripheral nerve injuries can cause chronic pain, paralysis, and loss of sensation. This study explores using spinal cord stimulation to help restore function after such injuries. The study shows that stimulating the spinal cord through the skin (transcutaneous spinal cord stimulation or tSCS), combined with exercise, can improve limb control in people with spinal cord injuries. The research indicates that tSCS could lead to lasting improvements in strength and sensation, even after the stimulation is stopped, suggesting a new potential therapy for peripheral nerve injuries.

Study Duration

35 weeks

Participants

One 48-year-old woman with partial paralysis of the left hand due to peripheral nerve injury

Evidence Level

Level 4; Case Study

Key Findings

1
Targeted tSCS increased hand strength by 407% in an individual with paralysis due to a peripheral nerve injury.
2
The study documented a persisting 3-point improvement in clinical assessment of tactile sensation after 6 weeks of tSCS.
3
Motor and sensory gains persisted for several months after stimulation was received, suggesting long-lasting benefits.

Research Summary

This case study investigates the effectiveness of targeted transcutaneous spinal cord stimulation (tSCS) in restoring hand function and tactile sensation in an individual with peripheral nerve injury (PNI). The results showed a substantial increase in muscle activity and strength in specific upper-limb muscles, along with significant improvements in tactile sensation following tSCS administration. The motor and sensory improvements persisted for up to 2 months after stimulation was withdrawn, suggesting that targeted tSCS may have broader applications beyond spinal cord or central nervous system injuries.

Practical Implications

Therapeutic Potential

tSCS may be a safe and effective therapeutic approach for functional recovery after debilitating injuries, including peripheral nerve injuries.

Improved Dexterity

Activity-based training paired with tSCS can improve the volitional control of a group of muscles, enabling an increase in dexterity and grasp strength.

Combination Therapy

Combining tSCS with brain-computer interface approaches may lead to even better outcomes in traumatic injuries by providing continual feedback and modulating stimulation patterns.

Study Limitations

1
The study is limited by being a case study with only one participant.
2
The possibility of spontaneous recovery cannot be entirely ruled out.
3
The importance of activity-based training and the required dosage is an unknown question.

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