Authors
Kenneth B Baker, Ela B Plow, Sean Nagel, Anson B Rosenfeldt, Raghavan Gopalakrishnan, Cynthia Clark, Alexandria Wyant, Madeleine Schroedel, John Ozinga IV, Sara Davidson, Olivia Hogue, Darlene Floden, Jacqueline Chen, Paul J Ford, Lauren Sankary, Xuemei Huang, David A Cunningham, Frank P DiFilippo, Bo Hu, Stephen E Jones, Francois Bethoux, Steven L Wolf, John Chae, André G Machado
Publication date
2023/9
Journal
Nature medicine
Volume
29
Issue
9
Pages
2366-2374
Publisher
Nature Publishing Group US
Description
Upper-extremity impairment after stroke remains a major therapeutic challenge and a target of neuromodulation treatment efforts. In this open-label, non-randomized phase I trial, we applied deep brain stimulation to the cerebellar dentate nucleus combined with renewed physical rehabilitation to promote functional reorganization of ipsilesional cortex in 12 individuals with persistent (1–3 years), moderate-to-severe upper-extremity impairment. No serious perioperative or stimulation-related adverse events were encountered, with participants demonstrating a seven-point median improvement on the Upper-Extremity Fugl-Meyer Assessment. All individuals who enrolled with partial preservation of distal motor function exceeded minimal clinically important difference regardless of time since stroke, with a median improvement of 15 Upper-Extremity Fugl-Meyer Assessment points. These robust functional gains were …
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