Spinal Cord Stimulation for Poststroke Hemiparesis: A Scoping Review

Overview

Journal Am J Occup Ther

Specialties Occupational Medicine
Rehabilitation Medicine

Date 2024 Mar 13

PMID 38477681

Authors

Jonathan R Allen

Swathi R Karri

Chen Yang

Mary Ellen Stoykov

Affiliations

Soon will be listed here.

Abstract

Importance: Spinal cord stimulation (SCS) is a neuromodulation technique that can improve paresis in individuals with spinal cord injury. SCS is emerging as a technique that can address upper and lower limb hemiparesis. Little is understood about its effectiveness with the poststroke population.

Objective: To summarize the evidence for SCS after stroke and any changes in upper extremity and lower extremity motor function.

Data Sources: PubMed, Web of Science, Embase, and CINAHL. The reviewers used hand searches and reference searches of retrieved articles. There were no limitations regarding publication year.

Study Selection And Data Collection: This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The inclusion and exclusion criteria included a broad range of study characteristics. Studies were excluded if the intervention did not meet the definition of SCS intervention, used only animals or healthy participants, did not address upper or lower limb motor function, or examined neurological conditions other than stroke.

Findings: Fourteen articles met the criteria for this review. Seven studies found a significant improvement in motor function in groups receiving SCS.

Conclusions And Relevance: Results indicate that SCS may provide an alternative means to improve motor function in the poststroke population. Plain-Language Summary: The results of this study show that spinal cord stimulation may provide an alternative way to improve motor function after stroke. Previous neuromodulation methods have targeted the impaired supraspinal circuitry after stroke. Although downregulated, spinal cord circuitry is largely intact and offers new possibilities for motor recovery.

Citing Articles

The effect of unaffected side resistance training on upper limb function reconstruction and prevention of sarcopenia in stroke patients: a randomized controlled trial.

Feng T, Zhao C, Dong J, Xue Z, Cai F, Li X Sci Rep. 2024; 14(1):25330.

PMID: 39455849 PMC: 11512051. DOI: 10.1038/s41598-024-76810-2.

References

Lin A, Shaaya E, Calvert J, Parker S, Borton D, Fridley J . A Review of Functional Restoration From Spinal Cord Stimulation in Patients With Spinal Cord Injury. Neurospine. 2022; 19(3):703-734. PMC: 9537842. DOI: 10.14245/ns.2244652.326. View

August K, Lewis J, Chandar G, Merians A, Biswal B, Adamovich S . FMRI analysis of neural mechanisms underlying rehabilitation in virtual reality: activating secondary motor areas. Conf Proc IEEE Eng Med Biol Soc. 2007; 2006:3692-5. DOI: 10.1109/IEMBS.2006.260144. View

Kaiser J, Maibach M, Salpeter I, Hagenbuch N, de Souza V, Robinson M . The Spinal Transcriptome after Cortical Stroke: In Search of Molecular Factors Regulating Spontaneous Recovery in the Spinal Cord. J Neurosci. 2019; 39(24):4714-4726. PMC: 6561692. DOI: 10.1523/JNEUROSCI.2571-18.2019. View

Powell M, Verma N, Sorensen E, Carranza E, Boos A, Fields D . Epidural stimulation of the cervical spinal cord for post-stroke upper-limb paresis. Nat Med. 2023; 29(3):689-699. PMC: 10291889. DOI: 10.1038/s41591-022-02202-6. View

Wang R, Tsai M, Chan R . Effects of surface spinal cord stimulation on spasticity and quantitative assessment of muscle tone in hemiplegic patients. Am J Phys Med Rehabil. 1998; 77(4):282-7. DOI: 10.1097/00002060-199807000-00003. View

Bachmann L, Lindau N, Felder P, Schwab M . Sprouting of brainstem-spinal tracts in response to unilateral motor cortex stroke in mice. J Neurosci. 2014; 34(9):3378-89. PMC: 6795311. DOI: 10.1523/JNEUROSCI.4384-13.2014. View

Lu D, Edgerton V, Modaber M, AuYong N, Morikawa E, Zdunowski S . Engaging Cervical Spinal Cord Networks to Reenable Volitional Control of Hand Function in Tetraplegic Patients. Neurorehabil Neural Repair. 2016; 30(10):951-962. PMC: 5374120. DOI: 10.1177/1545968316644344. View

Mercier L, Audet T, Hebert R, Rochette A, Dubois M . Impact of motor, cognitive, and perceptual disorders on ability to perform activities of daily living after stroke. Stroke. 2001; 32(11):2602-8. DOI: 10.1161/hs1101.098154. View

Cioni B, Meglio M, Zamponi A . Effect of spinal cord stimulation on motor performances in hemiplegics. Stereotact Funct Neurosurg. 1989; 52(1):42-52. DOI: 10.1159/000099485. View

10.

Michielsen M, Selles R, van der Geest J, Eckhardt M, Yavuzer G, Stam H . Motor recovery and cortical reorganization after mirror therapy in chronic stroke patients: a phase II randomized controlled trial. Neurorehabil Neural Repair. 2010; 25(3):223-33. DOI: 10.1177/1545968310385127. View

11.

Doucet B . Neurorehabilitation: are we doing all that we can?. Am J Occup Ther. 2012; 66(4):488-93. PMC: 3552324. DOI: 10.5014/ajot.2012.002790. View

12.

Eng J, Dawson A, Chu K . Submaximal exercise in persons with stroke: test-retest reliability and concurrent validity with maximal oxygen consumption. Arch Phys Med Rehabil. 2004; 85(1):113-8. PMC: 3167868. DOI: 10.1016/s0003-9993(03)00436-2. View

13.

Nair D, Renga V, Lindenberg R, Zhu L, Schlaug G . Optimizing recovery potential through simultaneous occupational therapy and non-invasive brain-stimulation using tDCS. Restor Neurol Neurosci. 2011; 29(6):411-20. PMC: 4425274. DOI: 10.3233/RNN-2011-0612. View

14.

Ang K, Guan C, Phua K, Wang C, Teh I, Chen C . Transcranial direct current stimulation and EEG-based motor imagery BCI for upper limb stroke rehabilitation. Annu Int Conf IEEE Eng Med Biol Soc. 2013; 2012:4128-31. DOI: 10.1109/EMBC.2012.6346875. View

15.

McComas A, Sica R, Upton A, Aguilera N . Functional changes in motoneurones of hemiparetic patients. J Neurol Neurosurg Psychiatry. 1973; 36(2):183-93. PMC: 1083552. DOI: 10.1136/jnnp.36.2.183. View

16.

Picelli A, Brugnera A, Filippetti M, Mattiuz N, Chemello E, Modenese A . Effects of two different protocols of cerebellar transcranial direct current stimulation combined with transcutaneous spinal direct current stimulation on robot-assisted gait training in patients with chronic supratentorial stroke: A single blind,.... Restor Neurol Neurosci. 2019; 37(2):97-107. DOI: 10.3233/RNN-180895. View

17.

Demeurisse G, DEMOL O, Robaye E . Motor evaluation in vascular hemiplegia. Eur Neurol. 1980; 19(6):382-9. DOI: 10.1159/000115178. View

18.

Wolf S, Catlin P, Ellis M, Archer A, Morgan B, Piacentino A . Assessing Wolf motor function test as outcome measure for research in patients after stroke. Stroke. 2001; 32(7):1635-9. DOI: 10.1161/01.str.32.7.1635. View

19.

Schaechter J, Kraft E, Hilliard T, Dijkhuizen R, Benner T, Finklestein S . Motor recovery and cortical reorganization after constraint-induced movement therapy in stroke patients: a preliminary study. Neurorehabil Neural Repair. 2002; 16(4):326-38. DOI: 10.1177/154596830201600403. View

20.

Taylor C, McHugh C, Mockler D, Minogue C, Reilly R, Fleming N . Transcutaneous spinal cord stimulation and motor responses in individuals with spinal cord injury: A methodological review. PLoS One. 2021; 16(11):e0260166. PMC: 8601579. DOI: 10.1371/journal.pone.0260166. View