Chattanooga Times Free Press

In test, electrodes help move the arms of 2 stroke survivors

- BY LAURAN NEERGAARD

WASHINGTON — A stroke left Heather Rendulic with little use of her left hand and arm, putting certain everyday tasks out of her reach.

“You don’t realize how many things you need two hands for until you only have one good one,” the Pittsburgh woman told The Associated Press.

So Rendulic volunteere­d for an experiment: Researcher­s implanted a device that zaps her spinal cord in spots that control hand and arm motion. When they switched it on, she could grasp and manipulate objects.

It’s not a cure and the pilot study included only Rendulic and one other stroke survivor. But the preliminar­y results mark a step toward one day restoring mobility for this extremely common type of paralysis.

“They’re not just getting flickers of movement. They’re getting something important,” said Dr. Jason Carmel, a Columbia University neurologis­t who wasn’t involved with the new experiment but also studies ways to recover upper-limb function. “It’s a very exciting proof of concept.”

Nearly 800,000 people in the U.S. alone suffer a stroke each year. Even after months of rehabilita­tion, more than half are left with permanentl­y impaired arm and hand function that can range from muscle weakness to paralysis.

“People ... retain some of this connection ... just not enough to enable movement,” said University of Pittsburgh assistant professor Marco Capogrosso, who led the new research with colleagues at Carnegie Mellon University. “These messages are weaker than normal.”

His idea: Stimulate a pathway of related nerve cells so they’re better able to sense and pick up the brain’s weak signal.

“We’re not bypassing their control. We’re enhancing their capabiliti­es to move their own arm,” he said.

Researcher­s turned to implants the size of spaghetti strands that already are used to stimulate the spine for chronic pain treatment. The implants carry electrodes that are placed on the surface of the spinal cord to deliver pulses of electricit­y to the targeted nerve cells — which for hand and arm control are in the spine’s neck region.

Rendulic and a second, more severely impaired volunteer could move better as soon as the stimulator was switched on — and by the study’s end showed improved muscle strength, dexterity and range of motion, researcher­s reported Monday in the journal Nature Medicine. Surprising­ly, both participan­ts retained some improvemen­t for about a month after the implants were removed.

Rendulic, now 33, was performing some finemotor tasks for the first time since suffering a stroke in her 20s. That unusually young stroke, caused by weak blood vessels that bled inside her brain, initially paralyzed her entire left side. She learned to walk again but — with the exception of those four weeks with spinal stimulatio­n — cannot fully open her left hand or completely raise that arm.

“You feel like there’s a barrier between your brain and your arm,” Rendulic said. But with the stimulatio­n on, “I could immediatel­y sense that, like, oh my arm and hand are still there.”

Two other researcher­s who helped pioneer experiment­s stimulatin­g the lower limbs of people with spinal cord injuries say it’s logical to now try the technology for stroke.

While bigger and longer studies are needed, the new results “are really promising,” said Mayo Clinic assistant professor Peter Grahn.

Scientists have learned from research with lower limbs that “it may not matter where that injury occurs, if it’s something in the brain or it’s a spinal cord injury,” added University of Louisville professor Susan Harkema. “Targeting the human spinal cord circuitry has a lot of potential.”

 ?? TIM BETLER/UPMC AND PITT HEALTH SCIENCES VIA AP ?? In 2021, neurosurge­on Dr. Peter Gerszten tells study participan­t Heather Rendulic how electrodes will be implanted on her spinal cord at UPMC Presbyteri­an in Pittsburgh.
TIM BETLER/UPMC AND PITT HEALTH SCIENCES VIA AP In 2021, neurosurge­on Dr. Peter Gerszten tells study participan­t Heather Rendulic how electrodes will be implanted on her spinal cord at UPMC Presbyteri­an in Pittsburgh.

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