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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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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.

710

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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m-s-c-s t1_j9ca82x wrote

Replying to drkgodess (#1,889,405)

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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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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kallistini t1_j9cp71v wrote

Replying to m-s-c-s (#1,890,510)

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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leonffs t1_j9daev7 wrote

A major stroke at 22 is pretty crazy.

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PepiHax t1_j9dc0kw wrote

Replying to drkgodess (#1,889,405)

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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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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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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drkgodess t1_j9dj0h8 wrote

Replying to PepiHax (#1,894,605)

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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upsidedownbackwards t1_j9dk4ug wrote

Replying to kallistini (#1,891,828)

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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laveshnk t1_j9dwsja wrote

Replying to leonffs (#1,893,917)

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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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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magenk t1_j9e6pd6 wrote

Replying to PepiHax (#1,894,066)

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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bobjr94 t1_j9e83xp wrote

Replying to leonffs (#1,893,917)

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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kallistini t1_j9e8h62 wrote

Replying to upsidedownbackwards (#1,894,929)

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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skater15153 t1_j9edexs wrote

Replying to cdrewing (#1,892,472)

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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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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Leor_11 t1_j9ekeff wrote

Replying to drkgodess (#1,889,405)

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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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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cdrewing t1_j9gjt33 wrote

Replying to skater15153 (#1,901,872)

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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