Neurosurgery Department, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
Neuroplasticity and Repair Laboratory, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
Sci Rep. 2022 May 11;12(1):7733. doi: 10.1038/s41598-022-11306-5.
Spinal cord stimulation enhanced restoration of motor function following spinal cord injury (SCI) in unblinded studies. To determine whether training combined with transcutaneous electrical spinal cord stimulation (tSCS), with or without systemic serotonergic treatment with buspirone (busp), could improve hand function in individuals with severe hand paralysis following SCI, we assessed ten subjects in a double-blind, sham-controlled, crossover study. All treatments-busp, tSCS, and the busp plus tSCS-reduced muscle tone and spasm frequency. Buspirone did not have any discernible impact on grip force or manual dexterity when administered alone or in combination with tSCS. In contrast, grip force, sinusoidal force generation and grip-release rate improved significantly after 6 weeks of tSCS in 5 out of 10 subjects who had residual grip force within the range of 0.1-1.5 N at the baseline evaluation. Improved hand function was sustained in subjects with residual grip force 2-5 months after the tSCS and buspirone treatment. We conclude that tSCS combined with training improves hand strength and manual dexterity in subjects with SCI who have residual grip strength greater than 0.1 N. Buspirone did not significantly improve the hand function nor add to the effect of stimulation.
在非盲研究中，脊髓刺激增强了脊髓损伤（SCI）后的运动功能恢复。为了确定训练结合经皮脊髓电刺激（tSCS）是否可以改善 SCI 后手瘫痪严重的个体的手部功能，我们在一项双盲、假对照、交叉研究中评估了 10 名受试者。所有治疗 - 丁螺环酮、tSCS 和丁螺环酮加 tSCS - 均降低了肌肉张力和痉挛频率。丁螺环酮单独或与 tSCS 联合使用时，对手握力或手动灵巧性没有任何明显影响。相比之下，在基线评估中手握力在 0.1-1.5N 范围内的 10 名受试者中的 5 名，经过 6 周的 tSCS 治疗后，握力、正弦力产生和握放率显著提高。在 tSCS 和丁螺环酮治疗后 2-5 个月，具有残余握力的受试者的手部功能得到持续改善。我们得出结论，tSCS 结合训练可以改善 SCI 患者的手部力量和灵巧性，这些患者的残余握力大于 0.1N。丁螺环酮对手部功能没有显著改善作用，也没有增加刺激的效果。
