Frontiers in Neuroscience (Jul 2023)

Targeted transcutaneous spinal cord stimulation promotes persistent recovery of upper limb strength and tactile sensation in spinal cord injury: a pilot study

  • Santosh Chandrasekaran,
  • Nikunj A. Bhagat,
  • Nikunj A. Bhagat,
  • Richard Ramdeo,
  • Sadegh Ebrahimi,
  • Pawan D. Sharma,
  • Doug G. Griffin,
  • Adam Stein,
  • Susan J. Harkema,
  • Susan J. Harkema,
  • Susan J. Harkema,
  • Susan J. Harkema,
  • Chad E. Bouton,
  • Chad E. Bouton

DOI
https://doi.org/10.3389/fnins.2023.1210328
Journal volume & issue
Vol. 17

Abstract

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Long-term recovery of limb function is a significant unmet need in people with paralysis. Neuromodulation of the spinal cord through epidural stimulation, when paired with intense activity-based training, has shown promising results toward restoring volitional limb control in people with spinal cord injury. Non-invasive neuromodulation of the cervical spinal cord using transcutaneous spinal cord stimulation (tSCS) has shown similar improvements in upper-limb motor control rehabilitation. However, the motor and sensory rehabilitative effects of activating specific cervical spinal segments using tSCS have largely remained unexplored. We show in two individuals with motor-complete SCI that targeted stimulation of the cervical spinal cord resulted in up to a 1,136% increase in exerted force, with weekly activity-based training. Furthermore, this is the first study to document up to a 2-point improvement in clinical assessment of tactile sensation in SCI after receiving tSCS. Lastly, participant gains persisted after a one-month period void of stimulation, suggesting that targeted tSCS may lead to persistent recovery of motor and sensory function.

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