Stroke

Spinal cord stimulation restores limb mobility in stroke survivors

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Stroke survivor Heather Rendulic demonstrates the function restored to her left arm and hand
Tim Betler/UPMC and Pitt Health Sciences

Stroke survivor Heather Rendulic demonstrates the function restored to her left arm and hand
Tim Betler/UPMC and Pitt Health Sciences

The team on hand for Rendulic's implant surgery
Tim Betler/UPMC and Pitt Health Sciences

It had been more than nine years since Rendulic could use a utensil in her left hand
Tim Betler/UPMC and Pitt Health Sciences

When switched on, the devices helped improve movement and function
Tim Betler/UPMC and Pitt Health Sciences

Study co-author Marco Capogrosso (second from left) watches over the surgery

Tim Betler/UPMC and Pitt Health Sciences

University of Pittsburgh's Dr Peter Gerszten explains how the implants will be positioned
Tim Betler/UPMC and Pitt Health Sciences

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A promising trial of spinal electrical stimulation that instantly boosts movement and dexterity in the arms and hands of stroke survivors has the potential to greatly improve quality of life for those with chronic motor function loss.

Research indicates that up three quarters of people who suffer a stroke continue to have hand and arm motor function impairments, including hemiparesis, the weakening or partial paralysis of the limb, that makes day-to-day tasks difficult.

Now, scientists from the University of Pittsburgh and Carnegie Mellon University have found that stimulating the spinal cord with a pair of thin metal electrodes implanted at the neck and using electrical pulses along the arm to engage intact neural circuits can result in distinctly improved movement. Until this pilot study, there’s been little research into epidural stimulation of the cervical spinal cord for upper-limb treatment.

“We discovered that electrical stimulation of specific spinal cord regions enables patients to move their arm in ways that they are not able to do without the stimulation,” explained Marco Capogrosso, co-senior author of the study and assistant professor in the Department of Neurosurgery at Pitt. “Perhaps even more interesting, we found that after a few weeks of use, some of these improvements endure when the stimulation is switched off, indicating exciting avenues for the future of stroke therapies.”

University of Pittsburgh's Dr Peter Gerszten explains how the implants will be positioned
Tim Betler/UPMC and Pitt Health Sciences

Capogrosso and team implanted spinal cord stimulator (SCS) leads for 29 days in two patients (females, aged 31 and 47) living with chronic limb weakness after suffering strokes. The results showed both women benefited from the trial, with one able to open locks, draw and use a knife and fork with her left hand – something she’d been unable to do since her stroke more than nine years earlier. While the effects of the stimulation waned after SCS implant removal, improvement was still measured for up to four weeks.

“When the stimulation is on, I now feel like I have control of my arm and my hand again, that I haven’t had in over nine years,” explained Heather Rendulic, now 33, one of the two women who took part in the trial. “The stimulation feels kind of like a tickle, and it’s never painful.”

When switched on, the devices helped improve movement and function
Tim Betler/UPMC and Pitt Health Sciences

This is the latest in SCS treatments for mobility and motor function, and while it is a new approach, it's not the first looking into restoring abilities in stroke survivors. The researchers acknowledge a larger study is needed, however, the findings of this pilot trial are a step towards developing treatment for those with chronic stroke-related arm and hand impairments.

Capogrosso is optimistic about the neurotechnology’s practical potential, adding that the easy-to-use stimulation “could be easily translated to the hospital and quickly moved from the lab to the clinic.”

The results of the study was published in Nature Medicine, and the following video shows Rendulic's experience with the treatment.

Source: University of Pittsburgh

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