Regaining use of hands –

MADRID (EFE).—A noninvasive spinal cord stimulation device has improved arm and hand function in 43 people with tetraplegia (paralysis of the upper and lower body), according to the results of a clinical trial published yesterday in the journal “Nature Medicine.”

The trial, completed by sixty patients at fourteen centers in the United States, United Kingdom, Switzerland, the Netherlands and Canada, has demonstrated the safety and efficacy of the device and has shown improvements in strength, function and mobility of the upper limbs of patients with chronic tetraplegia.

Spinal cord injuries interfere with the relationship between the brain and spinal cord that regulates neurological functions and, when they occur in the cervical region, they primarily affect the function of the hands and arms. Electrical stimulation of the spinal cord can restore neurological functions when the stimulation is applied to the spinal segments that contain the neurons involved in controlling these functions.

However, these therapies require the implantation of electrodes in specific regions of the spinal cord through invasive surgical procedures.

As an alternative, Gregoire Courtine of the Swiss Federal Institute of Technology (EPFL) and colleagues designed a noninvasive device, called ARCEX, that delivers an electrical current to the spinal cord via surface electrodes that can modulate neurons within targeted spinal segments. To compare the device’s effect on arm and hand function with the outcomes of rehabilitation alone, they conducted a multicenter, open-label clinical trial in 65 patients with tetraplegia from a spinal cord injury that had occurred at least one year prior to the trial.

Participants first underwent a two-month clinical rehabilitation program and then repeated the rehabilitation program, this time with added ARCEX therapy, for a further two months.

Of the sixty patients who completed the trial with ARCEX therapy, 43 demonstrated clear improvements in strength and function.

“The results of the Up-LIFT trial far exceeded our hypotheses,” said Chet Moritz, senior author of the study, co-principal investigator and professor of electrical and computer engineering and rehabilitation medicine at the University of Washington. “Just two months later, more than half of the Up-LIFT participants achieved average improvements in grip strength greater than that needed to lift a full object and in pinch strength, the strength needed to pick up an object with a fork or insert a key,” Moritz said. In addition, study participants reported reduced muscle spasm frequency, improvements in sleep, and overall upper body improvement, including their sense of touch.

In fact, 87% of patients said ARC-EX therapy had improved their overall quality of life.

The authors argue that ARCEX therapy is safe and effective and suggest that it might serve as a novel treatment to improve neurological recovery of hand and arm function for people living with chronic cervical spine injury.