Engaging cervical spinal cord networks to re-enable volitional control of hand function in tetraplegic patients

This study investigates whether stimulating the cervical spinal cord can improve hand function in people with tetraplegia (paralysis of all four limbs). The research explores a neuromodulatory approach, similar to how stimulating the lower spinal cord can improve leg function. Two individuals with chronic cervical spinal cord injuries were implanted with an electrode array to deliver epidural stimulation (ES). The researchers then assessed hand strength and control before, during, and after the application of ES. The study found that cervical ES improved hand strength and volitional hand control in both subjects. The findings suggest that this type of stimulation could be a valuable clinical intervention for people with tetraplegia.

• 1
  Both subjects demonstrated improved hand strength (approximately three-fold) and volitional hand control in the presence of epidural stimulation.
• 2
  Repeated test sessions resulted in sustained long-term improvements akin to a training phenomenon.
• 3
  The evoked potentials generated by ES during a voluntary effort were not synchronized solely to each evoked stimulation pulse, suggesting that the ES effects were largely mediated via interneuronal networks rather than direct stimulation of motor neurons.