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Case Study: Persistent Recovery of Hand Movement and Tactile Sensation in Peripheral Nerve Injury Using Targeted Transcutaneous Spinal Cord Stimulation

Frontiers in Neuroscience
Edited from Frontiers in Neuroscience

Peripheral nerve injury (PNI) can lead to uncomfortable sensations such as tingling, paresthesia, and chronic pain. 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. 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). Traditionally, physical therapy has been recommended to aid recovery in cases of PNI-induced paralysis. However, the benefits can often be limited in terms of recovered range of motions and/or strength (Maugeri et al., 2021). Thus, there is a major need to develop novel techniques for restoring lost motor and sensory capacities as a result of PNI.

We hypothesized that activating the local spinal circuitry through tSCS could help decrease the effects of peripheral nerve injury. In this pilot study, we performed targeted transcutaneous stimulation of the cervical spinal cord paired with specific activity-based training in one individual with a peripheral nerve injury. We used a custom electronically-configurable electrode array to target specific cervical levels. This enabled us to choose the precise location of stimulation to achieve maximal recruitment of the muscle group of interest. Even though the participant received stimulation and motor training only once per week, we observed a rapid increase in both volitionally controlled muscle activity, effective force and increase in somatosensation within a period of 5–6 weeks.

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).

Taken together, this study demonstrates the advantages of targeted tSCS paired with activity-based training in restoring volitional control of upper-limb movement and improvements in tactile sensitivity in case of peripheral injury.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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