Cervical spinal cord stimulation and poststroke arm function

Overview

A feasibility trial involving 7 patients with chronic poststroke hemiparesis demonstrated a 32% increase in strength and a 5.6-point improvement in Fugl-Meyer Assessment scores during cervical epidural stimulation. No serious adverse events were reported.

Background

Cerebrovascular accidents are a leading cause of upper limb paralysis, affecting approximately 400,000 individuals annually in the United States. Restoration of arm and hand functionality is a critical need for these patients, as post-stroke hemiparesis results in significant motor deficits. Cervical spinal cord stimulation may offer new avenues for rehabilitation.

Data Highlights

Key Findings

• 32% increase in strength during cervical epidural stimulation.
• 5.6-point improvement in Fugl-Meyer Assessment scores from baseline with stimulation activated.
• Improvements in upper-limb motor function were observed regardless of baseline impairment severity.
• Spasticity decreased in all participants during the study period.
• Three of seven participants demonstrated improved hand and finger movement during stimulation.
• Selective stimulation of specific cervical spinal segments was crucial for achieving meaningful motor effects.

Clinical Implications

Further research is needed to establish efficacy and explore the underlying neurological characteristics that influence treatment response.

Conclusion

This feasibility trial provides preliminary evidence supporting the safety of cervical spinal cord stimulation for enhancing upper limb function in chronic poststroke hemiparesis.

Related Resources & Content

1. Roberto M. de Freitas, Nature Medicine, 2026 -- Cervical spinal cord stimulation for upper limb motor function in people with chronic post-stroke hemiparesis: a feasibility trial
2. Frontiers in Neurology — Effects of postoperative electrical stimulation for quadriceps muscular atrophy of patients with incomplete Cervical Spinal Cord Injury. A Retrospective Study
3. Annals of Neurology — Neurophysiological Recovery Following Nerve Transfer Surgery to Restore Upper Limb Function after Cervical Spinal Cord Injury
4. Pain Medicine — Early outcomes with a flexible ECAP based closed loop using multiplexed spinal cord stimulation waveforms—single-arm study with in-clinic randomized crossover testing
5. Spinal cord stimulation for upper limb motor function in people with chronic post-stroke hemiparesis: a feasibility trial - PMC
6. European Stroke Organisation (ESO) guideline on motor rehabilitation - PMC
7. Study Details | NCT07153536 | Spinal Cord Stimulation Combined With Physical Therapy in Post-Stroke Upper-Limb Motor Hemiparesis | ClinicalTrials.gov