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, 2023 · DOI: 10.3389/fnins.2023.1210328 · Published: July 7, 2023

Simple Explanation

This study explores a non-invasive method to improve arm and hand function in people with spinal cord injuries using transcutaneous spinal cord stimulation (tSCS). The approach involves applying electrical stimulation to the spinal cord through the skin using a custom electrode array. The stimulation is paired with activity-based training, where participants perform specific exercises to activate targeted muscles. This combined approach aims to enhance muscle strength and sensory function in the upper limbs. The results showed improvements in muscle strength and tactile sensation that persisted even after the stimulation was stopped for a period, suggesting the potential for lasting recovery.

Study Duration

35 weeks

Participants

Two individuals with motor-complete SCI

Evidence Level

Level 4; Brief Research Report/Pilot Study

Key Findings

1
Targeted tSCS, along with weekly activity-based training, significantly increased muscle activity and strength in specific upper-limb muscles in individuals with motor-complete cervical SCI.
2
Participants experienced up to a 1,136% increase in exerted force and a 2-point increase in somatosensation within 5–6 weeks.
3
The gains persisted after a one-month period without stimulation, suggesting that targeted tSCS may lead to persistent recovery of motor and sensory function.

Research Summary

This study investigates the impact of targeted transcutaneous spinal cord stimulation (tSCS) combined with activity-based training on upper limb function in individuals with motor-complete spinal cord injury (SCI). The findings demonstrate that targeted tSCS can effectively activate specific motoneuron pools in the cervical spinal cord, leading to significant and sustained improvements in muscle activity, strength, and tactile sensation. The study highlights the potential of tSCS as a rehabilitative tool for restoring volitional control of upper-limb movement and sensation in people with SCI, even with a less frequent, weekly training regimen.

Practical Implications

Rehabilitation Potential

tSCS can be a promising rehabilitative tool for people with SCI, especially when paired with activity-based training.

Customizable Therapy

The use of electronically configurable electrode arrays allows for targeted stimulation of specific cervical segments, optimizing the recruitment of upper-limb motor pools.

Home-Based Application

Future studies can explore combining tSCS with brain-computer interfaces to create automated, user-driven stimulation patterns for home use.

Study Limitations

1
The study involved only two participants, limiting the generalizability of the findings.
2
Lower motoneuron damage could not be ruled out as a factor precluding motor improvement in finger flexor muscles.
3
The GRASSP scores may not have been sensitive enough to capture the full extent of motor improvements.

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