Cortical stimulation for upper limb recovery following ischemic stroke: A small phase II pilot study of a fully implanted stimulator

Mark Huang, Richard L. Harvey, Mary Ellen Stoykov, Sean Ruland, Martin E Weinand, David Lowry, Robert Levy

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Objective: To evaluate the feasibility of a fully implanted cortical stimulator for improving hand and arm function in patients following ischemic stroke. Method: Twenty-four chronic stroke patients with hemiplegia were randomized to targeted implanted cortical electrical stimulation of the motor cortex with upper limb rehabilitation therapy or rehabilitation therapy alone. Results: Using repeated measures regression models, we estimated and compared treatment effects between groups over the study follow-up period. The investigational group had significantly greater mean improvements in Upper Extremity Fugl-Meyer (UEFM) scores during the 6-month follow-up period (weeks 1-24 following therapy), as compared to the control group (difference in estimated means = 3.8, p = .042). Box and Block (B & B) test improvement from baseline scores were also significantly better in the investigational group across the 6-month follow-up assessments (difference in estimated means = 3.8, p = .046). There was one report of seizure after device implant but prior to cortical stimulation and rehabilitation therapy, but no reports of neurologic decline. There were no improvements seen in the other measures assessed. Conclusion: Evidence suggests that cortical stimulation with rehabilitation therapy produces a lasting treatment effect in upper extremity motor control and is not associated with serious neurological complications. A larger multicenter study is underway.

Original languageEnglish (US)
Pages (from-to)160-172
Number of pages13
JournalTopics in Stroke Rehabilitation
Volume15
Issue number2
DOIs
StatePublished - Mar 2008

Fingerprint

Upper Extremity
Stroke
Rehabilitation
Therapeutics
Hemiplegia
Motor Cortex
Nervous System
Electric Stimulation
Multicenter Studies
Seizures
Arm
Hand
Equipment and Supplies
Control Groups

Keywords

  • Cortical stimulation
  • Motor control
  • Outcome
  • Rehabilitation
  • Stroke
  • Therapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Rehabilitation

Cite this

Cortical stimulation for upper limb recovery following ischemic stroke : A small phase II pilot study of a fully implanted stimulator. / Huang, Mark; Harvey, Richard L.; Stoykov, Mary Ellen; Ruland, Sean; Weinand, Martin E; Lowry, David; Levy, Robert.

In: Topics in Stroke Rehabilitation, Vol. 15, No. 2, 03.2008, p. 160-172.

Research output: Contribution to journalArticle

Huang, Mark ; Harvey, Richard L. ; Stoykov, Mary Ellen ; Ruland, Sean ; Weinand, Martin E ; Lowry, David ; Levy, Robert. / Cortical stimulation for upper limb recovery following ischemic stroke : A small phase II pilot study of a fully implanted stimulator. In: Topics in Stroke Rehabilitation. 2008 ; Vol. 15, No. 2. pp. 160-172.
@article{2362895ef6bd42f3809ceac1e65ffa8f,
title = "Cortical stimulation for upper limb recovery following ischemic stroke: A small phase II pilot study of a fully implanted stimulator",
abstract = "Objective: To evaluate the feasibility of a fully implanted cortical stimulator for improving hand and arm function in patients following ischemic stroke. Method: Twenty-four chronic stroke patients with hemiplegia were randomized to targeted implanted cortical electrical stimulation of the motor cortex with upper limb rehabilitation therapy or rehabilitation therapy alone. Results: Using repeated measures regression models, we estimated and compared treatment effects between groups over the study follow-up period. The investigational group had significantly greater mean improvements in Upper Extremity Fugl-Meyer (UEFM) scores during the 6-month follow-up period (weeks 1-24 following therapy), as compared to the control group (difference in estimated means = 3.8, p = .042). Box and Block (B & B) test improvement from baseline scores were also significantly better in the investigational group across the 6-month follow-up assessments (difference in estimated means = 3.8, p = .046). There was one report of seizure after device implant but prior to cortical stimulation and rehabilitation therapy, but no reports of neurologic decline. There were no improvements seen in the other measures assessed. Conclusion: Evidence suggests that cortical stimulation with rehabilitation therapy produces a lasting treatment effect in upper extremity motor control and is not associated with serious neurological complications. A larger multicenter study is underway.",
keywords = "Cortical stimulation, Motor control, Outcome, Rehabilitation, Stroke, Therapy",
author = "Mark Huang and Harvey, {Richard L.} and Stoykov, {Mary Ellen} and Sean Ruland and Weinand, {Martin E} and David Lowry and Robert Levy",
year = "2008",
month = "3",
doi = "10.1310/tsr1502-160",
language = "English (US)",
volume = "15",
pages = "160--172",
journal = "Topics in Stroke Rehabilitation",
issn = "1074-9357",
publisher = "Thomas Land Publishers Inc.",
number = "2",

}

TY - JOUR

T1 - Cortical stimulation for upper limb recovery following ischemic stroke

T2 - A small phase II pilot study of a fully implanted stimulator

AU - Huang, Mark

AU - Harvey, Richard L.

AU - Stoykov, Mary Ellen

AU - Ruland, Sean

AU - Weinand, Martin E

AU - Lowry, David

AU - Levy, Robert

PY - 2008/3

Y1 - 2008/3

N2 - Objective: To evaluate the feasibility of a fully implanted cortical stimulator for improving hand and arm function in patients following ischemic stroke. Method: Twenty-four chronic stroke patients with hemiplegia were randomized to targeted implanted cortical electrical stimulation of the motor cortex with upper limb rehabilitation therapy or rehabilitation therapy alone. Results: Using repeated measures regression models, we estimated and compared treatment effects between groups over the study follow-up period. The investigational group had significantly greater mean improvements in Upper Extremity Fugl-Meyer (UEFM) scores during the 6-month follow-up period (weeks 1-24 following therapy), as compared to the control group (difference in estimated means = 3.8, p = .042). Box and Block (B & B) test improvement from baseline scores were also significantly better in the investigational group across the 6-month follow-up assessments (difference in estimated means = 3.8, p = .046). There was one report of seizure after device implant but prior to cortical stimulation and rehabilitation therapy, but no reports of neurologic decline. There were no improvements seen in the other measures assessed. Conclusion: Evidence suggests that cortical stimulation with rehabilitation therapy produces a lasting treatment effect in upper extremity motor control and is not associated with serious neurological complications. A larger multicenter study is underway.

AB - Objective: To evaluate the feasibility of a fully implanted cortical stimulator for improving hand and arm function in patients following ischemic stroke. Method: Twenty-four chronic stroke patients with hemiplegia were randomized to targeted implanted cortical electrical stimulation of the motor cortex with upper limb rehabilitation therapy or rehabilitation therapy alone. Results: Using repeated measures regression models, we estimated and compared treatment effects between groups over the study follow-up period. The investigational group had significantly greater mean improvements in Upper Extremity Fugl-Meyer (UEFM) scores during the 6-month follow-up period (weeks 1-24 following therapy), as compared to the control group (difference in estimated means = 3.8, p = .042). Box and Block (B & B) test improvement from baseline scores were also significantly better in the investigational group across the 6-month follow-up assessments (difference in estimated means = 3.8, p = .046). There was one report of seizure after device implant but prior to cortical stimulation and rehabilitation therapy, but no reports of neurologic decline. There were no improvements seen in the other measures assessed. Conclusion: Evidence suggests that cortical stimulation with rehabilitation therapy produces a lasting treatment effect in upper extremity motor control and is not associated with serious neurological complications. A larger multicenter study is underway.

KW - Cortical stimulation

KW - Motor control

KW - Outcome

KW - Rehabilitation

KW - Stroke

KW - Therapy

UR - http://www.scopus.com/inward/record.url?scp=43049105747&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=43049105747&partnerID=8YFLogxK

U2 - 10.1310/tsr1502-160

DO - 10.1310/tsr1502-160

M3 - Article

C2 - 18430685

AN - SCOPUS:43049105747

VL - 15

SP - 160

EP - 172

JO - Topics in Stroke Rehabilitation

JF - Topics in Stroke Rehabilitation

SN - 1074-9357

IS - 2

ER -