Targeted nerve stimulation restores single-finger movements in a person with tetraplegia

Targeted nerve stimulation restores single-finger movements in a person with tetraplegia | Research Square Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Brief Communication Targeted nerve stimulation restores single-finger movements in a person with tetraplegia Silvestro Micera, Elena Losanno, Filippo Agnesi, Gabriele Righi, and 15 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6188325/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract The loss of hand function is one of the most devastating impairments for individuals with paralysis. While current neurotechnologies can partially restore prehensile control, they fall short of enabling independent finger movements — an essential requirement for full hand dexterity. Achieving this level of precision demands highly selective activation of individual muscles or muscle groups. In this first-in-human study, we explored a novel approach in an individual with chronic tetraplegia. Our method combined targeted surgery to isolate functionally relevant branches of the median and radial nerves with custom intrafascicular electrodes to interface with them. By precisely stimulating motor fibers within these nerves, we successfully restored independent movement in four fingers, including the thumb. The combination of these movements allowed the recreation of the lateral, hook, and palmar grasps with smoothly modulated forces. Furthermore, the participant regained the ability to perform functional tasks, such as pouring water from a bottle. These findings hold significant promise for individuals with hand paralysis, paving the way for neurotechnologies that can bypass spinal cord injuries and restore fine motor control. Health sciences/Medical research/Translational research Health sciences/Health care/Therapeutics/Rehabilitation Full Text Additional Declarations The authors declare potential competing interests as follows: SM holds various patents related to the present work (WO2015097623A1, EP3522773A1, WO2024105559A1). EL, FA, SS, and SM are co-founders of Action Potential Neurotechnology Srl, a startup company with direct relations to the presented intervention. All the other authors declare that they have no competing interests. Supplementary Files S1singlefingers.mp4 Single finger movements achieved with targeted nerve stimulation. S2grasps.mp4 Grasping movements achieved with targeted nerve stimulation. S3forcecontrol.mp4 Modulation of the grasp force by the stimulation amplitude. S49holepegtest.mp4 Functional tasks: 9-hole peg test. S5jaropening.mp4 Functional tasks: jar opening. S6waterpouring.mp4 Functional tasks: water pouring and coin manipulation. NMEDBC140130rs.pdf Reporting Summary NMEDBC140130epc.pdf Editorial Policy Checklist Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information

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