Abstract
BackgroundFew patients recover full hand dexterity after an acquired brain injury such as stroke. Repetitive somatosensory electrical stimulation (SES) is a promising method to promote recovery of hand function. However, studies using SES have largely focused on gross motor function; it remains unclear if it can modulate distal hand functions such as finger individuation.ObjectiveThe specific goal of this study was to monitor the effects of SES on individuation as well as on cortical oscillations measured using EEG, with the additional goal of identifying neurophysiological biomarkers.MethodsEight participants with a history of acquired brain injury and distal upper limb motor impairments received a single two-hour session of SES using transcutaneous electrical nerve stimulation. Pre- and post-intervention assessments consisted of the Action Research Arm Test (ARAT), finger fractionation, pinch force, and the modified Ashworth scale (MAS), along with resting-state EEG monitoring.ResultsSES was associated with significant improvements in ARAT, MAS and finger fractionation. Moreover, SES was associated with a decrease in low frequency (0.9-4 Hz delta) ipsilesional parietomotor EEG power. Interestingly, changes in ipsilesional motor theta (4.8–7.9 Hz) and alpha (8.8–11.7 Hz) power were significantly correlated with finger fractionation improvements when using a multivariate model.ConclusionsWe show the positive effects of SES on finger individuation and identify cortical oscillations that may be important electrophysiological biomarkers of individual responsiveness to SES. These biomarkers can be potential targets when customizing SES parameters to individuals with hand dexterity deficits. Trial registration: NCT03176550; retrospectively registered.
Highlights
Few patients recover full hand dexterity after an acquired brain injury such as stroke
somatosensory electrical stimulation (SES) was associated with significant improvements in Action Research Arm Test (ARAT), modified Ashworth scale (MAS) and finger fractionation
We show the positive effects of SES on finger individuation and identify cortical oscillations that may be important electrophysiological biomarkers of individual responsiveness to SES
Summary
Few patients recover full hand dexterity after an acquired brain injury such as stroke. Studies using SES have largely focused on gross motor function; it remains unclear if it can modulate distal hand functions such as finger individuation. There remains a lack of effective therapies readily available to the patient with acquired brain injury for Sensory threshold somatosensory electrical stimulation (SES) is a promising therapeutic modality for targeting hand motor recovery [5]. Poor finger individualization is an important therapeutic target because it is commonly present even after substantial recovery and may account for chronic hand dysfunction [16]. It is unclear if SES is associated with compensatory or restorative mechanisms. We aimed to determine the functional effects, and the kinematic effects, of SES on chronic hand dysfunction
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