SPINAL CORD STIMULATION IMPROVES MOTOR FUNCTION AND SPASTICITY IN CHRONIC POST-STROKE UPPER LIMB HEMIPARESIS.

Area of Science:

• Neuroscience and Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Chronic post-stroke upper-limb hemiparesis significantly impacts quality of life.
• Limited effective treatments exist for severe motor deficits following stroke.
• Spinal cord stimulation (SCS) is an emerging neuromodulation technique.

Purpose of the Study:

• To evaluate the preliminary efficacy and safety of cervical epidural spinal cord stimulation (SCS).
• To assess SCS impact on motor function and spasticity in chronic post-stroke hemiparesis.
• To identify potential predictors of response to SCS treatment.

Main Methods:

• Pilot clinical trial involving seven participants with chronic post-stroke upper-limb hemiparesis.
• Unilateral cervical epidural implantation of two SCS leads for 4 weeks.
• Assessment of motor function using Fugl-Meyer Assessment (FMA) scores and muscle strength.

Main Results:

• Immediate motor function improvement during SCS ON periods (average +32% strength, +5.6 FMA-points).
• Significant gains in FMA scores (+6.6 points) and decreased spasticity in all participants.
• Regained hand/finger function observed in 3/7 participants with residual corticospinal connectivity.

Conclusions:

• Cervical epidural SCS shows preliminary efficacy in improving motor function and reducing spasticity in chronic post-stroke hemiparesis.
• SCS may be a promising therapeutic option for upper-limb motor recovery after stroke.
• Preserved sensory function might predict better response to SCS treatment.