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Neurological disease

Facilitating limb movement after stroke

Nature Medicine volume 29, pages 535–536 (2023)Cite this article

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Epidural spinal cord stimulation improved upper limb function in two participants after stroke, revealing a potentially exciting new tool for stroke recovery.

Roughly 100 million people currently living have experienced a stroke. One of the most common consequences is hemiparesis, a patterned weakness and lack of control on one side of the body. Such sensorimotor deficits can substantially degrade function and profoundly impact quality of life. Severely hemiparetic arms are notoriously difficult to treat because of the combination of deficits in voluntary muscle activation paired with involuntary, aberrant muscle excitation (resulting in increased tone, heightened reflex sensitivity and abnormal synergies)1. In this issue of Nature Medicine, Powell et al.2 report an exciting new means to simultaneously address both of these impairment mechanisms through epidural spinal cord stimulation (SCS) — which uses electrical stimulation of afferent (sensory) nerve fibers at the dorsal rootlets, near the connection with the spinal cord.

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Fig. 1: Effect of SCS on upper limb movement after stroke.

References

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Authors and Affiliations

  1. Department of Mechanical and Aerospace Engineering, University of California, Irvine, Irvine, CA, USA

    David J. Reinkensmeyer & Andria J. Farrens

  2. Department of Anatomy and Neurobiology, University of California, Irvine, Irvine, CA, USA

    David J. Reinkensmeyer

  3. UNC/NC State Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA

    Derek G. Kamper

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  1. David J. Reinkensmeyer
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  2. Andria J. Farrens
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  3. Derek G. Kamper
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Correspondence to David J. Reinkensmeyer.

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Competing interests

D.J.R. has a financial interest in Hocoma A.G. and Flint Rehabilitation Devices LLC, companies that develop and sell rehabilitation devices. The terms of these arrangements have been reviewed and approved by the University of California, Irvine, in accordance with its conflict of interest policies.

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Reinkensmeyer, D.J., Farrens, A.J. & Kamper, D.G. Facilitating limb movement after stroke. Nat Med 29, 535–536 (2023). https://doi.org/10.1038/s41591-023-02233-7

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