Paralysis of the upper extremity severely restricts independence and quality of life after spinal cord injury. Regaining control of hand and arm movements is the highest treatment priority for people with paralysis, 6-fold higher than restoring walking ability. Nevertheless, current approaches to improve upper extremity function typically do not restore independence. Spinal cord stimulation is an emerging neuromodulation strategy to restore motor function. Recent studies using surgically implanted electrodes demonstrate impressive improvements in voluntary control of standing and stepping. Here we show that transcutaneous electrical stimulation of the spinal cord leads to rapid and sustained recovery of hand and arm function, even after complete paralysis. Notably, the magnitude of these improvements matched or exceeded previously reported results from surgically implanted stimulation. Additionally, muscle spasticity was reduced and autonomic functions including heart rate, thermoregulation, and bladder function improved. Perhaps most striking is that all six participants maintained their gains for at least three to six months beyond stimulation, indicating functional recovery mediated by long-term neuroplasticity. Several participants resumed their hobbies that require fine motor control, such as playing the guitar and oil painting, for the first time in up to 12 years since their injuries. Our findings demonstrate that non-invasive transcutaneous electrical stimulation of the spinal networks restores movement and function of the hands and arm for people with both complete paralysis and long-term spinal cord injury.

中文翻译：

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脊髓损伤后经皮脊髓刺激可恢复手和手臂的功能

上肢麻痹严重限制了脊髓损伤后的独立性和生活质量。瘫痪患者的重中之重是重新控制手和手臂的运动，这比恢复步行能力高6倍。尽管如此，当前改善上肢功能的方法通常不能恢复独立性。脊髓刺激是恢复运动功能的新兴神经调节策略。最近使用外科植入电极的研究表明，在自主控制站立和踩踏方面取得了令人瞩目的改进。在这里，我们显示，即使完全瘫痪，脊髓的经皮电刺激也会导致手和手臂功能的快速持续恢复。尤其，这些改善的幅度达到或超过了以前通过外科手术植入刺激所报告的结果。此外，减少了肌肉的痉挛，并改善了包括心率，体温调节和膀胱功能在内的自主功能。也许最引人注目的是，所有六个参与者在刺激后至少三到六个月都保持了自己的增益，表明长期的神经可塑性介导了功能恢复。自受伤以来，这是近十二年来的第一次，几名参与者恢复了需要精细运动控制的爱好，例如弹吉他和油画。