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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
Edited from Frontiers in Neuroscience

Targeted transcutaneous stimulation of the cervical spinal cord using custom-designed configurable electrode array results in upper extremity functional recovery in individuals with cervical spinal cord injury.

Neuromodulation of the lumbar spinal cord using epidurally placed electrodes has recently shown great promise in facilitating voluntary movements of the lower limb during stimulation after SCI, in rats, non-human primates and humans. Additionally, when paired with intense motor training, lumbar epidural stimulation has demonstrated recovery of voluntary motor control even in the absence of stimulation. However, such benefits are generally restricted to muscles that have at least some preserved motor function.

Experiment setup. (A) Schematic showing the location of a 1 × 3 activated electrode configuration superimposed over the human spinal cord showing the dorsal column and roots. (B) The custom electronically configurable electrode array placed over the cervical spinal cord of a study participant with a 1 × 3 configuration of activated electrodes (green LEDs). (C) Setup for measuring triceps force. The ulnar protrusion of the wrist is placed over the 25 lb. load cell during the task (red dashed square).

Epidural stimulation has been shown to primarily engage the large-to-medium size sensory afferent fibers present in the roots and dorsal column of the spinal cord. Local spinal circuits constitute of these afferent fibers forming synaptic connections with spinal interneurons and motoneurons. Pharmacological and computational experiments suggest that activation of the dorsal fibers increases the excitability of the local spinal circuitry including the efferent fibers. Expanding this idea further, recent studies have demonstrated that epidural stimulation targeting cervical spinal cord could activate and restore upper limb movement. Though extremely promising, the invasive nature of epidural stimulation presents a hurdle for clinical translation and persistent rehabilitation.

This study is in collaboration with Neural Bypass and Brain Computer Interface Laboratory, Feinstein Institutes for Medical Research, New York.

This article was authored by:

  • Santosh Chandrasekaran
  • Nikunj A. Bhagat
  • Richard Ramdeo
  • Sadegh Ebrahim
  • Pawan D. Sharma
  • Dough G. Griffin
  • Adam Stein
  • Susan J. Harkema
  • Chad E. Bouton

Read the entire Published Article in Frontiers in Neuroscience

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