Chandrasekaran Santosh, Bhagat Nikunj A, Ramdeo Richard, Ebrahimi Sadegh, Sharma Pawan D, Griffin Doug G, Stein Adam, Harkema Susan J, Bouton Chad E
Neural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States.
Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center, Houston, TX, United States.
Front Neurosci. 2023 Jul 17;17:1210544. doi: 10.3389/fnins.2023.1210544. eCollection 2023.
Peripheral nerve injury can lead to chronic pain, paralysis, and loss of sensation, severely affecting quality of life. Spinal cord stimulation has been used in the clinic to provide pain relief arising from peripheral nerve injuries, however, its ability to restore function after peripheral nerve injury have not been explored. Neuromodulation of the spinal cord through transcutaneous spinal cord stimulation (tSCS), when paired with activity-based training, has shown promising results towards restoring volitional limb control in people with spinal cord injury. We show, for the first time, the effectiveness of targeted tSCS in restoring strength (407% increase from 1.79 ± 1.24 N to up to 7.3 ± 0.93 N) and significantly increasing hand dexterity in an individual with paralysis due to a peripheral nerve injury (PNI). Furthermore, this is the first study to document a persisting 3-point improvement during clinical assessment of tactile sensation in peripheral injury after receiving 6 weeks of tSCS. Lastly, the motor and sensory gains persisted for several months after stimulation was received, suggesting tSCS may lead to long-lasting benefits, even in PNI. Non-invasive spinal cord stimulation shows tremendous promise as a safe and effective therapeutic approach with broad applications in functional recovery after debilitating injuries.
周围神经损伤可导致慢性疼痛、瘫痪和感觉丧失，严重影响生活质量。脊髓刺激已在临床上用于缓解周围神经损伤引起的疼痛，然而，其在周围神经损伤后恢复功能的能力尚未得到探索。通过经皮脊髓刺激（tSCS）对脊髓进行神经调节，与基于活动的训练相结合时，已显示出在恢复脊髓损伤患者的自主肢体控制方面取得了有希望的结果。我们首次展示了靶向tSCS在恢复一名因周围神经损伤（PNI）而瘫痪的个体的力量（从1.79±1.24 N增加407%至高达7.3±0.93 N）以及显著提高手部灵活性方面的有效性。此外，这是第一项记录在接受6周tSCS后，周围损伤触觉感觉临床评估中持续出现3分改善的研究。最后，运动和感觉增益在接受刺激后持续了几个月，这表明tSCS可能会带来持久的益处，即使在PNI中也是如此。非侵入性脊髓刺激作为一种安全有效的治疗方法，在衰弱性损伤后的功能恢复中具有广泛应用前景，显示出巨大的潜力。
