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drkgodess t1_j9bz6zw wrote

Shared access of Nature journal article in pdf: here

Key excerpts from Telegraph article:

> Scientists recruited Ms Rendulic, now 33, and one other stroke survivor, a 47-year-old woman, to be the first people to try out electrical stimulation of the spinal cord with the aim of improving arm and hand motor movements...

>Scientists created a device that inserts two electrodes into the spinal cord in between vertebrae in the neck area.

>The electrodes stayed in place for 29 days. When these were activated, the patients - the first ever to experience this technology - had 40 per cent more grip force and 40 per cent more speed in their injured hands...

> “We discovered that electrical stimulation of specific spinal cord regions enables patients to move their arm in ways that they are not able to do without the stimulation.”

> ...The researchers said the stimulation procedure, known as epidural electrical stimulation of the cervical spinal cord, does not require invasive surgery and appears to have no negative side effects.

That it worked after such a long time and it was minimally invasive seem to be the major breakthroughs in this case study.

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m-s-c-s t1_j9ca82x wrote

One that jumped out at me:

“Importantly, the patient retains full control of their movements. The stimulation is assistive and strengthens muscle activation only when patients are trying to move.”

Doesn't this also carry major implications for prosthesis used by amputees?

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kallistini t1_j9cp71v wrote

Yup. Being able to activate and control the residual muscles is super useful, especially for advanced prosthetics. A lot of people lose the ability because they have no other reason to use those neural pathways and muscles before they’re fitted for prosthetics, but also because there’s no (or limited) biofeedback. There’s some research into using VR to provide visual feedback to help people, but it requires a baseline level of control that some people simply don’t have without neural stimulation like this. The lack of feedback and control is also one of the proposed mechanisms of phantom limb pain

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upsidedownbackwards t1_j9dk4ug wrote

Only vaguely in the same realm but I was lucky enough to be able to use VR while in the hospital for a month waiting for spine surgery and it was such a great break from life. My breathing and heartrate would be much better while using it and it would get me away from my real body that was covered in wires/tubes. It was the strongest my SO2 levels could get (I got pneumonia from not being able to walk for so long).

REALLY hope that VR becomes a thing for people in the hospital and with limited mobility.

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kallistini t1_j9e8h62 wrote

I know a couple people that are doing it for stroke rehab with a mobile unit about the size of a shoe (plus VR headset and laptop). When I was involved in the field, we did visit a few spinal cord injury clinics, but we had a devil of a time getting usable EMG signals from the patients we worked with. Maybe it was just bad luck, but we couldn’t get any more funding for that project without promising preliminary data.

I’m also really excited for the tech to move forward. Everyone we worked with seemed to genuinely have fun and get lost in the game/training they were doing.

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whichwitch9 t1_j9dizg6 wrote

....

I want to be mature about this but I can't help the part of me that's like "We're so close to automail"

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gazow t1_j9czqe7 wrote

i mean only if you have a few million dollars lieing around

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No-FreeLunch t1_j9d839f wrote

Turns out scientific breakthroughs ain’t cheap and cost effective alternatives take years to develop

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cdrewing t1_j9cvnu0 wrote

As being a person who is suffering from multiple sclerosis I'd love to have this device on my weak leg.

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skater15153 t1_j9edexs wrote

Was thinking the same thing for me father. I'm also curious if there's something in this same path for the muscle tone many suffer from. Like if you could use this to help the opposite muscle to overcome tone issues. My dad has his legs basically locked up without drugs and the drugs knock him out.

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cdrewing t1_j9f7l2w wrote

Ever tried cannabis by prescription? Your dad can take it before going to bed and doesn't need to be stoned while awake.

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skater15153 t1_j9flmr8 wrote

I don't think he's tried it. Does it help with muscle tone?

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cdrewing t1_j9gjt33 wrote

Yep. My wife tells me since I take it on a daily basis before going to bed I have less twitches in my legs. And from my own experience I can tell you: your sleep will become much more restful and longer. At the weekends sleeping for ten hours per night won't be a challenge - on average.

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firstbreathOOC t1_j9er1ub wrote

Most PT offices use a much smaller version of electric stim. I’ve done it often for my knees. Helps tremendously, even if it feels weird in the moment.

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Leor_11 t1_j9ekeff wrote

There's a group in Lausanne (Switzerland) who did the same thing to help a man walk again after a partial spinal chord injury. I watched a presentation by the group PI in a congress and we were all speechless and emotional.

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PepiHax t1_j9dc0kw wrote

Okay I guess the summary is fine, but it doesn't say why they are the first

Electrical stimulation of the spinal cord is old tech, it even resulted in the orgasm button.

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drkgodess t1_j9dedql wrote

The technology has never been applied in this specific way.

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PepiHax t1_j9dh4hc wrote

Okay, so how does it differ from this review from 2020 where they found 13 other articles about spinal cord stimulation? https://journals.sagepub.com/doi/pdf/10.1177/1545968319893298

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drkgodess t1_j9dj0h8 wrote

Well, those studies were done with people who had spinal cord injuries, not strokes, and the electrodes were transcutaneous (i.e. outside of the body), not implanted in the spinal cord. This study likely built on those findings, though.

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magenk t1_j9e6pd6 wrote

It may not be super cutting edge tech, but it's far from perfected. There are still lots of potential serious complications from this "minimally invasive" procedure.

While the risks may be worth it for many, I don't think minimizing the risks is very responsible. The nervous system is very complex and for all of our knowledge, we're still stabbing in the dark a lot of the time.

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Pillynap t1_j9ckbjt wrote

This is so amazing to me. My mother was a gifted pianist, loved in our community and every school kid knew her because she played at school assembly, concerts etc. One day she had a seizure out of nowhere. She kept having them. The doctor told her that they had identified the problem and they performed a surgery. She came round from the surgery and then almost immediately had a stroke due to a brain bleed from an area the surgeon had missed. They rushed her back in for emergency surgery, the result of which was she survived, barely, but completely lost the use of her left side. I'd visit her every day, massaging her hand, doing exercises with her. Everything I could, hoping and praying through physio she'd regain use of her arm and leg. She never did, but learned to live around it thanks to the amazing care my father gave her. I would have done anything for something to give her back that mobility, and independence, and to hear her play again. Although my mother isn't alive to benefit from this, it does my heart good knowing that someday people will.

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babalonbear t1_j9dh36r wrote

I'd really like to know how to get in touch with one of these studies, my sister had a stroke in her mid 20's and her left arm is completely dead. She's completely given up on life considering she used to work with her hands, I just wish there was something to give that back to her.

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Half-Naked_Cowboy t1_j9ef7te wrote

It's an exciting time to be alive with so many new medical procedures becoming available lately - tell her to never lose hope!

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Poorbilly_Deaminase t1_j9fbfry wrote

These clinical trials are happening all over the country so keep looking even if you can’t get in touch with these authors.

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shiruken t1_j9c0seq wrote

Direct link to the peer-reviewed study: M. P. Powell, et al., Epidural stimulation of the cervical spinal cord for post-stroke upper-limb paresis, Nature Medicine (2023).

>Abstract: Cerebral strokes can disrupt descending commands from motor cortical areas to the spinal cord, which can result in permanent motor deficits of the arm and hand. However, below the lesion, the spinal circuits that control movement remain intact and could be targeted by neurotechnologies to restore movement. Here we report results from two participants in a first-in-human study using electrical stimulation of cervical spinal circuits to facilitate arm and hand motor control in chronic post-stroke hemiparesis (NCT04512690). Participants were implanted for 29 d with two linear leads in the dorsolateral epidural space targeting spinal roots C3 to T1 to increase excitation of arm and hand motoneurons. We found that continuous stimulation through selected contacts improved strength (for example, grip force +40% SCS01; +108% SCS02), kinematics (for example, +30% to +40% speed) and functional movements, thereby enabling participants to perform movements that they could not perform without spinal cord stimulation. Both participants retained some of these improvements even without stimulation and no serious adverse events were reported. While we cannot conclusively evaluate safety and efficacy from two participants, our data provide promising, albeit preliminary, evidence that spinal cord stimulation could be an assistive as well as a restorative approach for upper-limb recovery after stroke.

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Sans45321 t1_j9c4bi3 wrote

As someone who suffers from the long term effects of Potts spine , I'm looking forward to this .

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ThrowaWayneGretzky99 t1_j9cl8ze wrote

Hoping for some good news for my niece.

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Parvanu t1_j9csg5f wrote

And my partner, he’s been nearly bed bound since a series of strokes and has dysarthria (swallowing/speech issues caused by muscle weakness)

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leonffs t1_j9daev7 wrote

A major stroke at 22 is pretty crazy.

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laveshnk t1_j9dwsja wrote

My uncle had a similar stroke in his early fiftys. He was this wonderful old man who could only move his finger, so we attached a bell to his wheelchair arm. Unfortunately he was killed in a bomblast in his very own nursing home.

I can still remember sound of the dings he used to make.

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leonffs t1_j9dx1t8 wrote

I understood that reference.

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bobjr94 t1_j9e83xp wrote

My wife had 6 more more strokes by 42 and several major brain surgeries to restore profusion. She has MoyaMoya a uncommon disease that causes vessels in the brain to shrink and block blood flow. It can effect children from 6 months to several years old as well then seems to take a brake then hit people in their 40s to 50s.

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TheTelegraph OP t1_j9bkfej wrote

From our Science Correspondent Joe Pinkstone ⤵️

A stroke survivor has been able to use cutlery to cut food and feed herself for the first time in a decade, thanks to insertions of electricity into her spine.
Heather Rendulic, who had a stroke in 2012 when she was 22, was left with no mobility in her left hand as a result of chronic post-stroke muscle weakness.
Scientists recruited Ms Rendulic, now 33, and one other stroke survivor, a 47-year-old woman, to be the first people to try out electrical stimulation of the spinal cord with the aim of improving arm and hand motor movements.
The system has been used previously to improve lower leg functionality in people with nerve damage. However, very little research has been done on using it to help people suffering with upper limb impediments.
Scientists created a device that inserts two electrodes into the spinal cord in between vertebrae in the neck area.

Continue reading this article in full, for free here ⤵️

https://www.telegraph.co.uk/news/2023/02/20/stroke-survivor-moves-hand-first-time-decade-groundbreaking/

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tornpentacle t1_j9c5dg3 wrote

And yet when the link is clicked the article is blocked and purchase of a subscription is demanded...

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KittenCanaveral t1_j9eflvy wrote

So, the devices were only left in for just under a month, and some of the benefits remained. Why not leave it in longer?

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Gojisoji t1_j9df418 wrote

All I can think of is that she's gonna try and eat with the mask on without removing it.

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TLOU2bigsad t1_j9e6bk4 wrote

This seems strange to be news right now. Maybe because it’s more generalized?

My brother got a TBI back in 08 and was in a coma then bed ridden for almost a year. Because of the injuries and subsequent foot drop and couldn’t walk but once they got to standing and stuff again they out these boots in him then used electric stimulation to point his foot upward when he stepped so it wouldn’t drag.

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TheawesomeQ t1_j9fq2l5 wrote

If the company who did this disappears and these people lose their motor function again like those people with the eye implants did I'm gonna lose my mind

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communitytcm t1_j9ft13y wrote

not quite "groundbreaking" treatment. Acupuncturists have been using e-stim for decades on stroke patients with success. In fact, there are entire hospital wings reserved for this all over China.

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Registered_User666 t1_j9cqdwz wrote

That doesn’t look like a heart healthy meal.

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