Section: New Results

Selective Neural Electrical Stimulation to restores Hand and Forearm Movements in Individuals with Complete Tetraplegia

Participants : David Guiraud, Charles Fattal, Christine Azevedo, Mélissa Dali, Jacques Teissier [Beau Soleil clinic, Montpellier] , Anthony Gélys [Propara Rehab. Center, Montpellier] .

Selective neural electrical stimulation of radial and median nerves enables the activation of functional movements in the paralyzed hand of individuals with tetraplegia. In eight participants (Clinique Beau Soleil and Propara Rehabilitation Center, Montpellier) with complete tetraplegia, during a programmed surgery and under complete anesthesia, we demonstrated that selective stimulation based on multicontact cuff electrodes and optimized current spreading over the active contacts provided isolated, compound, functional and strong movements. Several configurations were needed to target different areas within the nerve to obtain all the envisioned movements. We further confirmed that the upper limb nerves have muscle specific fascicles, which makes possible to activate isolated movements. The future goal is to provide patients with functional restoration of object grasping and releasing with a minimally invasive solution: only two cuff electrodes above the elbow. This will be the objective of AGILIS project supported by EIT Health.

Figure 9. Neural electrical stimulation of radial or median nerve using a multi-contact cuff electrode allows to elicit different individual or grouped muscle contractions inducing different fingers and wrist movements.