Updated on 2/23/2023 at 9:35 am
- After a stroke, everything is different for many patients.
- Movements like brushing your teeth turn out to be a huge challenge.
- A research team has now succeeded in using a procedure to enable those affected to gain more strength, mobility and coordination.
In Germany alone, around 270,000 people suffer a stroke every year. The number is likely to increase in the future, due to demographic change, but also due to certain lifestyle factors such as lack of exercise and obesity. A large proportion of the survivors later have deficits in the motor control of their arms and hands.
Grasping objects, eating with cutlery, opening locks: a procedure should enable such movements for patients who can no longer control their arms and hands following a stroke. As US researchers report in the journal “Nature Medicine”.spinal cord stimulation improved the strength, mobility and coordination of two study participants with chronic muscle weakness in a study – and surprisingly quickly.
Also read: Recognizing a stroke quickly: interpreting symptoms precisely with the FAST test
Spinal cord stimulation restores patient control of arms and hands
Spinal cord stimulation might help some of these people in the future. A team led by Marco Capogrosso from the University of Pittsburgh adapted the method, which has been used to treat chronic pain for years, and successfully tested it on two patients. Thin metal electrodes resembling spaghetti were implanted along their necks.
These electrodes deliver electrical pulses that activate nerve cells in the areas of the spinal cord responsible for muscle control of the limbs. Actually, such impulses are sent out by the brain. However, a stroke can lead to this communication being disrupted and the impulses no longer being sufficient to stimulate activities.
“We asked ourselves how we might amplify the signals, and we didn’t focus on the brain but on the spinal cord,” explains Capogrosso. Therefore, the system does not replace the function of the brain, but only supports existing signals.
After the implantation, the patients quickly regained control of their arms and hands. One of them was able to open and close her hand once more on the first day following the procedure – a movement she was unable to do for nine years. Both she and the research team reacted accordingly emotionally. “We all cried,” Capogrosso recalls.
Stimulation “feels like a tickle and never hurts”
As the 29-day trial progressed, continuous spinal cord stimulation improved participants’ arm and hand strength, range of motion, and fine motor skills. For example, they might safely grab a can or eat with cutlery.
“Even mild deficits following a stroke can isolate people from social and professional life and can be very limiting, with motor impairments of arms and hands being particularly distressing and hampering simple daily activities such as writing, eating and dressing,” says co-author Elvira Pirondini.
Patient Heather Rendulic confirms this: The spinal cord stimulation gives her the feeling of having control of her arm and hand once more for the first time in nine years. “It feels like a tickle and never hurts, but you have to get used to it,” she describes.
Safety and effectiveness are to be tested in the next steps
Unexpectedly, improvements in stimulation lasted up to four weeks following implant removal. The researchers don’t know why that is. The technology may not be permanently necessary, at least for those affected with moderate muscle weakness. But even constant use of the system should not be a problem, as experience with pain patients has suggested, says Elvira Pirondini.
Co-author Douglas Weber emphasizes that the spectrum of patients with strokes is very diverse. Accordingly, the next steps would not only consist of confirming the safety and effectiveness of the approach. Rather, it must also be examined which people benefited the most from the therapy.
The research group is continuing its trials with additional patients. But Heather Rendulic has already asked when she can get a permanent implant, says Weber and says: “It will take a few years, but it’s already a nice sign.” (Alice Lanzke, dpa/sbi)
After her stroke, Ina from the YouTube duo Coupleontour first needed a wheelchair and then a walker. Now she took the first steps alone. “Did you just take a step free? No! What’s wrong with you?” Her wife Vanessa marveled