Reversing 21 years of chronic paralysis via non-invasive spinal cord neuromodulation: a case study.

Alam, M; Ling, YT; Wong, AYL; Zhong, H; Edgerton, VR; Zheng, Y-P

Reversing 21 years of chronic paralysis via non-invasive spinal cord neuromodulation: a case study.

Alam, M Ling, YT Wong, AYL Zhong, H Edgerton, VR Zheng, Y-P

Permalink

Publisher:: Wiley
Publication Type:: Journal Article
Citation:: Annals of clinical and translational neurology, 2020, 7, (5), pp. 829-838
Issue Date:: 2020-05-20

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

Adobe PDF

Download full textAdobe PDF (2.26 MB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Alam, M
dc.contributor.author	Ling, YT
dc.contributor.author	Wong, AYL
dc.contributor.author	Zhong, H
dc.contributor.author	Edgerton, VR
dc.contributor.author	Zheng, Y-P
dc.date.accessioned	2021-01-14T05:23:14Z
dc.date.available	2020-04-06
dc.date.available	2021-01-14T05:23:14Z
dc.date.issued	2020-05-20
dc.identifier.citation	Annals of clinical and translational neurology, 2020, 7, (5), pp. 829-838
dc.identifier.issn	2328-9503
dc.identifier.issn	2328-9503
dc.identifier.uri	http://hdl.handle.net/10453/145434
dc.description.abstract	OBJECTIVE:The objective of the current study was to investigate if a non-invasive spinal cord neuromodulation modality could restore sensorimotor functions in a patient with chronic spinal cord injury (SCI). METHODS:In this study, transcutaneous electrical stimulation (tES) to the spinal cord was utilized to restore sensorimotor functions in a chronic SCI patient who sustained a traumatic C7 cervical cord injury 21 years ago. At baseline, the patient had very limited volitional movement in her right leg, and her left leg was completely paralyzed. tES parameters were optimized in eight stimulation sessions before the treatment. The therapeutic stimulation involved biphasic tES, applied to T11 and L1 spinal levels during a 1-hour standing and walking training, 2-4 times per week for 16 weeks. RESULTS:Our pre-treatment tests indicated that a shorter burst duration (100 µsec) was more effective than a longer burst duration of tES in improving functional movements. After 32 training sessions with tES, the patient regained significant left-leg volitional movements (grade 0 to grade 10 according to the ISNCSCI scale). Right-leg motor scores also increased from 17 to 21. The tES treatment also improved her pinprick sensation (from 73 to 79). Upon completion of the treatment (52 sessions), the patient's standing ability noticeably improved. She could stabilize her knee to stand without any assistance. She could also squat while holding onto a walker. INTERPRETATION:These promising results demonstrate beneficial effects of non-invasive tES in regaining volitional control of plegic lower limbs in patients with chronic paralysis.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	Annals of clinical and translational neurology
dc.relation.isbasedon	10.1002/acn3.51051
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1109 Neurosciences
dc.title	Reversing 21 years of chronic paralysis via non-invasive spinal cord neuromodulation: a case study.
dc.type	Journal Article
utslib.citation.volume	7
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
utslib.for	1109 Neurosciences
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2021-01-14T05:22:57Z
pubs.issue	5
pubs.publication-status	Published
pubs.volume	7
utslib.citation.issue	5

Abstract:

OBJECTIVE:The objective of the current study was to investigate if a non-invasive spinal cord neuromodulation modality could restore sensorimotor functions in a patient with chronic spinal cord injury (SCI). METHODS:In this study, transcutaneous electrical stimulation (tES) to the spinal cord was utilized to restore sensorimotor functions in a chronic SCI patient who sustained a traumatic C7 cervical cord injury 21 years ago. At baseline, the patient had very limited volitional movement in her right leg, and her left leg was completely paralyzed. tES parameters were optimized in eight stimulation sessions before the treatment. The therapeutic stimulation involved biphasic tES, applied to T11 and L1 spinal levels during a 1-hour standing and walking training, 2-4 times per week for 16 weeks. RESULTS:Our pre-treatment tests indicated that a shorter burst duration (100 µsec) was more effective than a longer burst duration of tES in improving functional movements. After 32 training sessions with tES, the patient regained significant left-leg volitional movements (grade 0 to grade 10 according to the ISNCSCI scale). Right-leg motor scores also increased from 17 to 21. The tES treatment also improved her pinprick sensation (from 73 to 79). Upon completion of the treatment (52 sessions), the patient's standing ability noticeably improved. She could stabilize her knee to stand without any assistance. She could also squat while holding onto a walker. INTERPRETATION:These promising results demonstrate beneficial effects of non-invasive tES in regaining volitional control of plegic lower limbs in patients with chronic paralysis.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/145434