Epidural stimulation of the cervical spinal cord for post-stroke upper limb paresis

Nat Med, 2023 · DOI: 10.1038/s41591-022-02202-6 · Published: March 1, 2023

Simple Explanation

This study explores a new approach to help people regain arm and hand movement after a stroke. Strokes can damage the brain's connections to the spinal cord, leading to lasting weakness or paralysis. However, the spinal cord itself often remains intact. The researchers used electrical stimulation applied to the cervical spinal cord (the part in the neck) to boost the signals from the brain to the arm and hand muscles. This stimulation helped the participants to move their arms and hands better. The early results suggest that this spinal cord stimulation could be a promising way to assist and restore upper limb movement after a stroke, although more research is needed to confirm these findings.

Study Duration

29 days

Participants

Two participants with chronic post-stroke hemiparesis

Evidence Level

Pilot study

Key Findings

1
Continuous stimulation through selected contacts improved strength (e.g. grip force +40% SCS01; +108% SCS02), kinematics (e.g. +30% to +40% speed), and functional movements.
2
Participants were able to perform movements that they could not perform without SCS.
3
Both participants retained some of these improvements even without stimulation and no serious adverse events were reported.

Research Summary

This study reports preliminary evidence from two participants showing that continuous SCS targeting cervical dorsal roots could immediately improve upper limb strength, motor control, and function in two humans with moderate to severe post-stroke hemiparesis. This assistive effect is lost when SCS is turned off. However, both participants showed some lasting improvements in motor function by the fourth and final week of the study that were retained even without stimulation. While we cannot conclude on safety and efficacy from two participants, here we discuss the first results obtained in humans on the effects of SCS on post-stroke upper limb hemiparesis.

Practical Implications

Assistive Technology

SCS can serve as an assistive technology, immediately improving motor control and enabling movements that were previously impossible.

Restorative Potential

SCS may have a restorative effect when combined with rehabilitation, potentially leading to lasting improvements in motor function even after stimulation is turned off.

Personalized Therapy

The study demonstrates the importance of personalized stimulation protocols, targeting specific dorsal roots to maximize benefits for individual patients based on their specific impairments.

Epidural stimulation of the cervical spinal cord for post-stroke upper limb paresis

Simple Explanation

Key Findings

Research Summary

Practical Implications

Assistive Technology

Restorative Potential

Personalized Therapy

Study Limitations

Your Feedback

Was this summary helpful?

Epidural stimulation of the cervical spinal cord for post-stroke upper limb paresis

Simple Explanation

Key Findings

Research Summary

Practical Implications

Assistive Technology

Restorative Potential

Personalized Therapy

Study Limitations

Your Feedback

Was this summary helpful?