We hypothesized that activating the local spinal circuitry through tSCS could help decrease the effects of peripheral nerve injury. Pairing transcutaneous spinal cord stimulation (tSCS) at the cervical levels with intense motor training can result in sustained improvements in hand and arm function ( Benavides et al., 2020 Zhang et al., 2020 Inanici et al., 2021). Pharmacological and computational work ( Capogrosso et al., 2013) suggest that activation of the dorsal fibers via spinal cord stimulation increases the excitability of the local spinal circuitry including the efferent fibers. Spinal cord stimulation has shown great promise in restoring voluntary control of muscles of the upper-limb in spinal cord injury ( Freyvert et al., 2018 Gad et al., 2018 Inanici et al., 2021) and stroke ( Powell et al., 2023). Thus, there is a major need to develop novel techniques for restoring lost motor and sensory capacities as a result of PNI. However, the benefits can often be limited in terms of recovered range of motions and/or strength ( Maugeri et al., 2021). Traditionally, physical therapy has been recommended to aid recovery in cases of PNI-induced paralysis. Neuromodulation targeted at the spinal cord through electrical stimulation has been routinely used in the clinic to mitigate chronic pain, including that arising from PNIs ( Gupta et al., 2020). Depending on the severity of the injury, PNI can also result in loss of somatosensation, fine motor control and dexterity, and even paralysis, thereby drastically impacting quality of life. Peripheral nerve injury (PNI) can lead to uncomfortable sensations such as tingling, paresthesia, and chronic pain. Non-invasive spinal cord stimulation shows tremendous promise as a safe and effective therapeutic approach with broad applications in functional recovery after debilitating injuries. Lastly, the motor and sensory gains persisted for several months after stimulation was received, suggesting tSCS may lead to long-lasting benefits, even in PNI. Furthermore, this is the first study to document a persisting 3-point improvement during clinical assessment of tactile sensation in peripheral injury after receiving 6 weeks of tSCS. We show, for the first time, the effectiveness of targeted tSCS in restoring strength (407% increase from 1.79 ± 1.24 N to up to 7.3 ± 0.93 N) and significantly increasing hand dexterity in an individual with paralysis due to a peripheral nerve injury (PNI). Neuromodulation of the spinal cord through transcutaneous spinal cord stimulation (tSCS), when paired with activity-based training, has shown promising results towards restoring volitional limb control in people with spinal cord injury. Spinal cord stimulation has been used in the clinic to provide pain relief arising from peripheral nerve injuries, however, its ability to restore function after peripheral nerve injury have not been explored. Peripheral nerve injury can lead to chronic pain, paralysis, and loss of sensation, severely affecting quality of life. 9Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, United States.8Department of Neurological Surgery, University of Louisville, Louisville, KY, United States.7Frazier Rehabilitation Institute, University of Louisville Health, Louisville, KY, United States.6Department of Bioengineering, University of Louisville, Louisville, KY, United States.5Department of Physical Medicine and Rehabilitation, Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Manhasset, NY, United States. 4Northwell Health STARS Rehabilitation, East Meadow, NY, United States.3Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United States.2Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center, Houston, TX, United States.1Neural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States.Bhagat 1,2 Richard Ramdeo 1 Sadegh Ebrahimi 1 Pawan D.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |