Enabling hand function in chronic spinal cord injury patients with non-invasive transcutaneous stimulation and buspirone: A double-blinded, sham controlled pilot study

Spinal cord injury (SCI) is one of the leading causes of long term paralysis. For patients with a chronic SCI treatment options are limited. Physical therapy can help maintain general health but little to no functional improvement is expected after the first year of injury. Epidural electrical stimulation of the spinal cord via an implanted epidural electrode array can improve leg function, stabilize posture, and enable volitional movement. Epidural stimulation can result in functional improvement of the hand in quadriplegic patients. In this study, we sought to determine if transcutaneous electrical stimulation of the cervical spinal cord along with oral monoaminergic agonist could result in similar functional improvement of the hand. Twelve subjects were recruited that had been injured for at least a year. Of the recruited subjects, ten of the twelve subjects were motor complete (ASIA score of A or B). It has been reported that training with a handgrip alone did not result in significant improvement in these subjects after chronic testing (Hoffman et al. 2017). For this study, subjects received transcutaneous stimulation alone or in combination with the partial 5HT1A agonist buspirone while training with the handgrip device. Transcutaneous stimulation significantly improved hand function in seven of the twelve enrolled. While buspirone did not improve hand function, in some subjects it reduced spasm severity.

Authors: *L. MOORE1, S. ZDUNOWSKI1, E. MORIKAWA1, T. SIERRO1, D. SAYENKO1, P. GAD1, T. HOMSEY1, M. NUWER1, D. REINKENSMEYER2, M. SARRAFZADEH1, D. MCARTHUR1, Y. GERASIMENKO1,3, V. R. EDGERTON1, D. C. LU1;
1Univ. of California, Los Angeles, CA; 2Univ. of California, Irvine, CA; 3Pavlov Inst. of Physiol., St. Petersburg, Russian Federation
Disclosures: L. Moore: None. S. Zdunowski: None. E. Morikawa: None. T. Sierro: None. D. Sayenko: None. P. Gad: None. T. Homsey: None. M. Nuwer: None. D. Reinkensmeyer: E. Ownership Interest (stock, stock options, royalty, receipt of intellectual property rights/patent holder, excluding diversified mutual funds); Flint Rehabilitation Devices, Hocoma. F. Consulting Fees (e.g., advisory boards); Hocoma. M. Sarrafzadeh: E. Ownership Interest (stock, stock options, royalty, receipt of intellectual property rights/patent holder, excluding diversified mutual funds); MediSens handgrip. D. McArthur: None. Y. Gerasimenko: E. Ownership Interest (stock, stock options, royalty, receipt of intellectual property rights/patent holder, excluding diversified mutual funds); NeuroRecovery Technologies. V.R. Edgerton: E. Ownership Interest (stock, stock options, royalty, receipt of intellectual property rights/patent holder, excluding diversified mutual funds); NeuroRecovery Technologies. D.C. Lu: E. Ownership Interest (stock, stock options, royalty, receipt of intellectual property rights/patent holder, excluding diversified mutual funds); NeuroRecovery Technologies.

Grant Support
J. Yang & Family Foundation
NIH: EB15521 and R01EB007615 grants, funded by NIBIB, NINDS, and NICHD
UCLA Clinical and Translational Research Center (CTRC)

NIH/National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant

Society for Neuroscience LINK

Los Angeles Magazine Article

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