Article

Paralysis of the upper limbs from spinal cord injury results in an
enormous loss of independence in an individual's daily life. Meaningful
improvement in hand function is rare after 1 year of tetraparesis. Therapeutic
developments that result in even modest gains in hand volitional function will
significantly affect the quality of life for patients afflicted with high
cervical injury. The ability to neuromodulate the lumbosacral spinal circuitry
via epidural stimulation in regaining postural function and volitional control of
the legs has been recently shown. A key question is whether a similar
neuromodulatory strategy can be used to improve volitional motor control of the
upper limbs, that is, performance of motor tasks considered to be less
"automatic" than posture and locomotion. In this study, the effects of cervical
epidural stimulation on hand function are characterized in subjects with chronic
cervical cord injury. OBJECTIVE: Herein we show that epidural stimulation can be
applied to the chronic injured human cervical spinal cord to promote volitional
hand function. METHODS :
Two subjects implanted with a cervical
epidural electrode array demonstrated improved hand strength (approximately
3-fold) and volitional hand control in the presence of epidural stimulation.
CONCLUSIONS: The present data are sufficient to suggest that hand motor function
in individuals with chronic tetraplegia can be improved with cervical cord
neuromodulation and thus should be comprehensively explored as a possible
clinical intervention.
CI - (c) The Author(s) 2016.

Langue : ANGLAIS