Spinal Cord Stimulation Improves Motor Function And Spasticity In Chronic Post-Stroke Upper Limb Hemiparesis
de Freitas, R. M.; Bhatia, S.; Sorensen, E.; Verma, N.; Carranza, E.; Ensel, S.; Borda, L.; Boos, A.; Goldsmith, J.; Fisher, L. E.; Fields, D. P.; Powell, M. P.; Gordon, S.; Balzer, J.; Friedlander, R. M.; Wittenberg, G. F.; Gerszten, P.; Krakauer, J. W.; Pirondini, E.; Weber, D. J.; Capogrosso, M.
Show abstract
Here, we report the final outcomes of a pilot clinical trial testing preliminary efficacy and safety of cervical epidural spinal cord stimulation (SCS) for chronic post-stroke upper-limb hemiparesis (NCT04512690). We implanted seven participants with profound motor deficits (Fugl-Meyer Assessment [FMA] scores 15-35) using two leads implanted unilaterally in the cervical spinal cord for 4 weeks. Under SCS ON, motor function immediately improved regardless of impairment severity (average +32% strength and +5.6 FMA-points). Notably, 3/7 participants with residual corticospinal connectivity to finger muscles regained hand/finger function with SCS. Despite performing only 8.6hrs of motor activity (5.5hrs with SCS ON), participants improved by average +6.6 FMA-points at the end of the study compared to baseline and spasticity decreased in all participants. While all benefited, our preliminary analysis indicates that spared sensory function may be a determinant of responsiveness to SCS. No serious adverse events occurred.
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