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Abstract
Spinal cord stimulation enhanced restoration of motor function following spinal cord injury (SCI) in unblinded studies. To determine whether training combined with transcutaneous electrical spinal cord stimulation (tSCS), with or without systemic serotonergic treatment with buspirone (busp), could improve hand function in individuals with severe hand paralysis following SCI, we assessed ten subjects in a double-blind, sham-controlled, crossover study. All treatments—busp, tSCS, and the busp plus tSCS—reduced muscle tone and spasm frequency. Buspirone did not have any discernible impact on grip force or manual dexterity when administered alone or in combination with tSCS. In contrast, grip force, sinusoidal force generation and grip-release rate improved significantly after 6 weeks of tSCS in 5 out of 10 subjects who had residual grip force within the range of 0.1–1.5 N at the baseline evaluation. Improved hand function was sustained in subjects with residual grip force 2–5 months after the tSCS and buspirone treatment. We conclude that tSCS combined with training improves hand strength and manual dexterity in subjects with SCI who have residual grip strength greater than 0.1 N. Buspirone did not significantly improve the hand function nor add to the effect of stimulation.
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1 University of California, Los Angeles, Neurosurgery Department, David Geffen School of Medicine, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718); University of California, Los Angeles, Neuroplasticity and Repair Laboratory, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718)
2 University of California, Los Angeles, Neurosurgery Department, David Geffen School of Medicine, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718); University of California, Berkeley, School of Information, Berkeley, USA (GRID:grid.47840.3f) (ISNI:0000 0001 2181 7878)
3 University of California, Los Angeles, Department of Neurobiology, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718)
4 University of California, Los Angeles, Neurosurgery Department, David Geffen School of Medicine, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718)
5 Houston Methodist Hospital, Houston, USA (GRID:grid.63368.38) (ISNI:0000 0004 0445 0041)
6 University of California, Los Angeles, Neurosurgery Department, David Geffen School of Medicine, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718); University of California, Los Angeles, Brain Research Institute, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718)
7 University of California, Los Angeles, Department of Computer Science, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718)
8 University of California, Los Angeles, Brain Research Institute, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718); University of California, Los Angeles, Department of Integrative Biology and Physiology, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718); University of California, Los Angeles, Department of Neurobiology, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718)
9 White River Junction VA Medical Center, White River Junction, USA (GRID:grid.413726.5) (ISNI:0000 0004 0420 6436)
10 University of California, Los Angeles, Neurosurgery Department, David Geffen School of Medicine, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718); University of California, Los Angeles, Neuroplasticity and Repair Laboratory, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718); University of California, Los Angeles, Brain Research Institute, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718); University of California, Los Angeles, Department of Orthopedic Surgery, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718); University of California, Los Angeles, Neuromotor Recovery and Rehabilitation Center, Los Angeles, USA (GRID:grid.19006.3e) (ISNI:0000 0000 9632 6718)