Hope for stroke sufferers: Spinal cord stimulation can help

Updated 2/23/2023 at 9:35 am

  • After a stroke, everything is different for many patients.
  • Movements such as brushing your teeth are quite a challenge.
  • The research team has now succeeded in using a procedure to enable those affected to gain more strength, movement and coordination.

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In Germany alone, about 270,000 people suffer a stroke each year. The number is likely to increase in the future, due to demographic change, but also due to some lifestyle factors such as lack of exercise and obesity. A large percentage of survivors later experience motor control deficits in their arms and hands.

Grasping objects, eating with cutlery, opening locks: the procedure should allow such movements for patients who can no longer control their arms and hands after a stroke. As reported by American researchers in the journal “Nature Medicine”.In one study, spinal cord stimulation improved the strength, movement, and coordination of two study participants with chronic muscular weakness — and surprisingly quickly.

Also read: Recognizing a stroke quickly: Accurately interpreting symptoms with the FAST test

Spinal cord stimulation restores patient control of the arms and hands

Spinal cord stimulation could help some of these people in the future. A team led by Marco Capogrosso of the University of Pittsburgh adapted this method, which has been used to treat chronic pain for years, and successfully tested it on two patients. Thin, spaghetti-like metal electrodes were implanted along their necks.

These electrodes deliver electrical impulses that activate neurons in areas of the spinal cord that control the muscles of the limbs. In fact, these impulses are sent by the brain. However, a stroke can disrupt this connection and the impulses are no longer sufficient to stimulate activities.

“We asked ourselves how we might amplify the signals, and we focused not on the brain but on the spinal cord,” Capogroso explains. Therefore, the system does not replace brain function, but only supports existing signals.

After transplantation, patients quickly regained control of their arms and hands. One of them was able to open and close her hand again the first day after the operation – a movement she had not been able to do for nine years. She and the research team reacted emotionally accordingly. “We all cried,” Capogroso recalls.

Stimulation “feels like a tickle and never hurts”

As the 29-day experiment progressed, continuous stimulation of the spinal cord improved the participants’ arm and hand strength, range of motion, and fine motor skills. For example, they can grab a can or eat food safely with cutlery.

“Even mild disabilities after a stroke can isolate people from social and professional life and can be very limiting, with motor impairments of the arms and hands being particularly painful and impeding simple daily activities such as writing, eating, and dressing,” says co-author Elvira Berondini.

Patient Heather Randulik confirms this: Spinal cord stimulation is giving her the feeling of control over her arm and hand again for the first time in nine years. “It feels ticklish and never hurts, but you have to get used to it,” she describes.

Safety and efficacy must be tested in the following steps

Unexpectedly, improvements in stimulation persisted for up to four weeks after implant removal. Researchers don’t know why. This technique may not be permanently necessary, at least for those with mild muscle weakness. But even continued use of the regimen shouldn’t be a problem, as experience with pain patients indicates, says Elvira Berundini.

Co-author Douglas Weber stresses that the spectrum of patients who suffer strokes is very diverse. Accordingly, the following steps will not be limited to confirming the safety and efficacy of the approach. Instead, people who benefited most from treatment should also be screened.

The research group continues its experiments with additional patients. But Heather Rendulik has already asked when she can get a permanent implant, says Weber, and says, “It’s going to take a few years, but it’s really a good sign.” (Alice Lanzki, dpa/sbi)

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