{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:31:56Z","timestamp":1793140316359,"version":"4.5.0"},"reference-count":78,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Clinical Research Program of the Luxembourgish Ministry of Health and Social Security for the spastiCRYO"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background: Post-stroke upper-limb spasticity can cause pain, hinder passive care, and lead to secondary musculoskeletal complications. Current minimally invasive treatments have important limitations. Cryoneurolysis, which creates a controlled cold lesion of peripheral nerves, may offer a partially reversible focal denervation alternative. Methods: We conducted a feasibility case series in the outpatient department of a rehabilitation centre. Three adults with chronic post-stroke hemiparesis and a non-functional spastic upper limb underwent ultrasound- and nerve stimulation-guided cryoneurolysis of the musculocutaneous, median, and\/or ulnar nerves. All had demonstrated a positive response to diagnostic nerve blocks beforehand. Feasibility outcomes included completion of planned nerve targets, tolerability under local anesthesia, absence of serious adverse events, and completion of 6-month follow-up. Secondary outcomes were Modified Ashworth Scale (MAS), qualitatively assessed passive joint mobility (video-documented), pain measured by visual analogue scale, sensory testing, and electroneuromyography (ENMG). Results: All procedures were completed as planned. Treatment was well tolerated under local anesthesia, and no serious adverse events occurred. MAS decreased by at least 2 points in targeted patterns, with immediate improvement in passive mobility; these effects persisted at 6 months. Pain remained unchanged in two participants and improved in one. Sensory testing at 6 weeks was stable. ENMG findings were heterogeneous, including reduced ulnar sensory action potential amplitude and biceps denervation activity in one participant. Conclusions: In this small series, cryoneurolysis for post-stroke upper-limb spasticity was feasible and associated with sustained tone reduction and improved passive mobility. Larger controlled studies are required to better define safety, optimize targeting strategies, and assess patient-centred outcomes.<\/jats:p>","DOI":"10.3390\/neurolint18050078","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T17:26:18Z","timestamp":1777051578000},"page":"78","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Upper-Limb Cryoneurolysis for Painful Post-Stroke Spasticity in Severely Impaired Upper Limbs: A Feasibility Case Series"],"prefix":"10.3390","volume":"18","author":[{"given":"Jos\u00e9 Alexandre","family":"Pereira","sequence":"first","affiliation":[{"name":"Medical Department, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"},{"name":"RehaLAB, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Chantraine","sequence":"additional","affiliation":[{"name":"Medical Department, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"},{"name":"RehaLAB, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9877-1863","authenticated-orcid":false,"given":"C\u00e9line","family":"Schreiber","sequence":"additional","affiliation":[{"name":"RehaLAB, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Classen","sequence":"additional","affiliation":[{"name":"RehaLAB, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"},{"name":"Physiotherapy Department, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia","family":"Agneskis","sequence":"additional","affiliation":[{"name":"Occupational Therapy Department, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Medinger","sequence":"additional","affiliation":[{"name":"Physiotherapy Department, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Morini","sequence":"additional","affiliation":[{"name":"Medical Department, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"},{"name":"RehaLAB, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Areno","sequence":"additional","affiliation":[{"name":"RehaLAB, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"},{"name":"Physiotherapy Department, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Masson","sequence":"additional","affiliation":[{"name":"RehaLAB, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"},{"name":"Physiotherapy Department, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2061-0968","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9ric","family":"Dierick","sequence":"additional","affiliation":[{"name":"RehaLAB, Centre National de R\u00e9\u00e9ducation Fonctionnelle et de R\u00e9adaptation\u2014Rehazenter, Rue Andr\u00e9 V\u00e9sale 1, 2674 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"ref_1","unstructured":"Barnes, M.P., and Johnson, G.R. 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