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Epidural Stimulation after Spinal Cord Injury: Restoration of Motor and Autonomic Function

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Engaging cervical spinal circuitry with non-invasive spinal stimulation and buspirone to restore hand function in chronic motor complete patients

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Abstract

The combined effects of cervical electrical stimulation alone or in combination with the monoaminergic agonist buspirone on upper limb motor function were determined in six subjects with motor complete (AIS B) injury at C5 or above and more than one year from time of injury. Voluntary upper limb function was evaluated through measures of controlled hand contraction, handgrip force production, dexterity measures, and validated clinical assessment batteries. Repeated measure analysis of variance was used to evaluate functional metrics, EMG amplitude, and changes in mean grip strength. In aggregate, mean hand strength increased by greater than 300% with transcutaneous electrical stimulation and buspirone while a corresponding clinically significant improvement was observed in upper extremity motor scores and the action research arm test. Some functional improvements persisted for an extended period after the study interventions were discontinued. We demonstrate that, with these novel interventions, cervical spinal circuitry can be neuromodulated to improve volitional control of hand function in tetraplegic subjects. The potential impact of these findings on individuals with upper limb paralysis could be dramatic functionally, psychologically, and economically.

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$13.48M Awarded To Johns Hopkins Scientists To Develop Implantable Ultrasound Devices For Patients With Spinal Cord Injury

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Newswise — A team of Johns Hopkins neurosurgeons and biomedical engineers has received $13.48 million from the Defense Advanced Research Projects Agency (DARPA) to develop implantable ultrasound and other devices that could revolutionize care for people suffering from spinal cord injuries. The results could benefit thousands of U.S. service members and civilians who sustain spinal cord injuries every year. (excerpt)