Targeted transcutaneous spinal cord stimulation promotes persistent recovery of upper limb strength and tactile sensation in spinal cord injury: a pilot study
Long-term recovery of limb function is a significant unmet need in people with paralysis. Neuromodulation of the spinal cord through epidural stimulation, when paired with intense activity-based training, has shown promising results toward restoring volitional limb control in people with spinal cord...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1210328/full |
| _version_ | 1797785413267488768 |
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| author | Santosh Chandrasekaran Nikunj A. Bhagat Nikunj A. Bhagat Richard Ramdeo Sadegh Ebrahimi Pawan D. Sharma Doug G. Griffin Adam Stein Susan J. Harkema Susan J. Harkema Susan J. Harkema Susan J. Harkema Chad E. Bouton Chad E. Bouton |
| author_facet | Santosh Chandrasekaran Nikunj A. Bhagat Nikunj A. Bhagat Richard Ramdeo Sadegh Ebrahimi Pawan D. Sharma Doug G. Griffin Adam Stein Susan J. Harkema Susan J. Harkema Susan J. Harkema Susan J. Harkema Chad E. Bouton Chad E. Bouton |
| author_sort | Santosh Chandrasekaran |
| collection | DOAJ |
| description | Long-term recovery of limb function is a significant unmet need in people with paralysis. Neuromodulation of the spinal cord through epidural stimulation, when paired with intense activity-based training, has shown promising results toward restoring volitional limb control in people with spinal cord injury. Non-invasive neuromodulation of the cervical spinal cord using transcutaneous spinal cord stimulation (tSCS) has shown similar improvements in upper-limb motor control rehabilitation. However, the motor and sensory rehabilitative effects of activating specific cervical spinal segments using tSCS have largely remained unexplored. We show in two individuals with motor-complete SCI that targeted stimulation of the cervical spinal cord resulted in up to a 1,136% increase in exerted force, with weekly activity-based training. Furthermore, this is the first study to document up to a 2-point improvement in clinical assessment of tactile sensation in SCI after receiving tSCS. Lastly, participant gains persisted after a one-month period void of stimulation, suggesting that targeted tSCS may lead to persistent recovery of motor and sensory function. |
| first_indexed | 2024-03-13T00:53:45Z |
| format | Article |
| id | doaj.art-f65ae2cfb24a444e9d9ba720878f32db |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-13T00:53:45Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-f65ae2cfb24a444e9d9ba720878f32db2023-07-07T08:38:08ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-07-011710.3389/fnins.2023.12103281210328Targeted transcutaneous spinal cord stimulation promotes persistent recovery of upper limb strength and tactile sensation in spinal cord injury: a pilot studySantosh Chandrasekaran0Nikunj A. Bhagat1Nikunj A. Bhagat2Richard Ramdeo3Sadegh Ebrahimi4Pawan D. Sharma5Doug G. Griffin6Adam Stein7Susan J. Harkema8Susan J. Harkema9Susan J. Harkema10Susan J. Harkema11Chad E. Bouton12Chad E. Bouton13Neural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United StatesNeural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United StatesDepartment of Physical Medicine and Rehabilitation, University of Texas Health Science Center, Houston, TX, United StatesNeural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United StatesNeural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United StatesKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United StatesNorthwell Health STARS Rehabilitation, East Meadow, NY, United StatesDepartment of Physical Medicine and Rehabilitation, Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Manhasset, NY, United StatesKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United StatesDepartment of Bioengineering, University of Louisville, Louisville, KY, United StatesFrazier Rehabilitation Institute, University of Louisville Health, Louisville, KY, United StatesDepartment of Neurological Surgery, University of Louisville, Louisville, KY, United StatesNeural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United StatesDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, United StatesLong-term recovery of limb function is a significant unmet need in people with paralysis. Neuromodulation of the spinal cord through epidural stimulation, when paired with intense activity-based training, has shown promising results toward restoring volitional limb control in people with spinal cord injury. Non-invasive neuromodulation of the cervical spinal cord using transcutaneous spinal cord stimulation (tSCS) has shown similar improvements in upper-limb motor control rehabilitation. However, the motor and sensory rehabilitative effects of activating specific cervical spinal segments using tSCS have largely remained unexplored. We show in two individuals with motor-complete SCI that targeted stimulation of the cervical spinal cord resulted in up to a 1,136% increase in exerted force, with weekly activity-based training. Furthermore, this is the first study to document up to a 2-point improvement in clinical assessment of tactile sensation in SCI after receiving tSCS. Lastly, participant gains persisted after a one-month period void of stimulation, suggesting that targeted tSCS may lead to persistent recovery of motor and sensory function.https://www.frontiersin.org/articles/10.3389/fnins.2023.1210328/fullspinal cord injuryspinal cord stimulationbrain computer interfaceselective stimulationneuromodulationneurostimulation devices |
| spellingShingle | Santosh Chandrasekaran Nikunj A. Bhagat Nikunj A. Bhagat Richard Ramdeo Sadegh Ebrahimi Pawan D. Sharma Doug G. Griffin Adam Stein Susan J. Harkema Susan J. Harkema Susan J. Harkema Susan J. Harkema Chad E. Bouton Chad E. Bouton Targeted transcutaneous spinal cord stimulation promotes persistent recovery of upper limb strength and tactile sensation in spinal cord injury: a pilot study Frontiers in Neuroscience spinal cord injury spinal cord stimulation brain computer interface selective stimulation neuromodulation neurostimulation devices |
| title | Targeted transcutaneous spinal cord stimulation promotes persistent recovery of upper limb strength and tactile sensation in spinal cord injury: a pilot study |
| title_full | Targeted transcutaneous spinal cord stimulation promotes persistent recovery of upper limb strength and tactile sensation in spinal cord injury: a pilot study |
| title_fullStr | Targeted transcutaneous spinal cord stimulation promotes persistent recovery of upper limb strength and tactile sensation in spinal cord injury: a pilot study |
| title_full_unstemmed | Targeted transcutaneous spinal cord stimulation promotes persistent recovery of upper limb strength and tactile sensation in spinal cord injury: a pilot study |
| title_short | Targeted transcutaneous spinal cord stimulation promotes persistent recovery of upper limb strength and tactile sensation in spinal cord injury: a pilot study |
| title_sort | targeted transcutaneous spinal cord stimulation promotes persistent recovery of upper limb strength and tactile sensation in spinal cord injury a pilot study |
| topic | spinal cord injury spinal cord stimulation brain computer interface selective stimulation neuromodulation neurostimulation devices |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1210328/full |
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