Groundbreaking Study Highlights Technological Advances in the Development of Spinal Cord Injury Recovery
By Melissa D. Carter
November 28, 2018
Two years ago, we reported on a medical study at the Keck Medical Center at USC in which a young man, 21-year old Kristopher Boesen, who was paralyzed from the neck down following a motor vehicle collision, regained the use of his arm and hand following experimental stem cell treatment within months of his injury. See the December 2016 article.
Since that time, we have continued to monitor and support research in the area of spinal cord injury in the hopes of bettering the lives of patients with spinal cord injury.
A spinal cord injury is an insult to the spinal cord resulting in a change, either temporary or permanent, in the cord’s normal motor, sensory, or autonomic function. Patients with spinal cord injury usually have permanent and often devastating neurologic deficits and disability.
On October 31, 2018, scientists reported to Nature journal a breakthrough medical trial in the study and efforts in restoring motion to paralyzed or partially paralyzed patients by applying continuous electrical stimulation to the spinal cord. The report followed three men who were all paralyzed and lost the complete use of their legs for more than 4 years, and each regained the ability to walk with the help of an experimental pace-maker like device.
The authors of the new report are based at the Swiss Federal Institute of Technology, in Lausanne. This team previously demonstrated that rats that had lost the use of their hind legs could be trained to run again when continuous current was applied through the spinal cord to the muscles. Other research teams recently have reported that continuous stimulation could also restore some movement in human patients.
The treatment of the men began with surgery. Doctors implanted a small patch of electrodes on the surface of the spinal cord in the lower back, below where each injury had occurred. The patch was connected to a pacemaker device, which was placed in the abdomen.
As described in Nature, the implant sent bursts of targeted stimulation to the muscles that intend to move on an as-needed basis, roughly mimicking the body’s own signaling mechanism.
The implanted device, when turned on, delivered bursts of stimulation to individual muscles as they were called into use. The intention to lift a knee generated a certain pattern of nerve firing; stepping forward generated a different one. In effect, the device provided the pattern of stimulation that the body delivered before the injury occurred. Over time — with intensive physical therapy, on a treadmill with hand supports — the stimulation appeared to engage the brain’s motor cortex through nerves that were spared from injury.
This treatment is still in the experimental phase. The three subjects did have some level of sensation in their legs before the trial began, and required months of intensive training to achieve their first steps. They do still rely on wheelchairs; two can walk in the community now with walkers. Each subject has learned to move previously limp muscles without help from the implant; an indication that the electrical stimulation prompted nerves to regrow.
Adler Giersch is committed to supporting the developments in the area of spinal cord injury research and development. If you would like more information about where and how to help, please contact us.
Nature volume 563, pages65–71 (2018), Fabien B. Wagner, Jean-Baptiste Mignardot, et al.