Published: Sat, November 03, 2018
Health Care | By Cedric Leonard

Targeted neurotechnology restores walking in humans with spinal cord injury

Targeted neurotechnology restores walking in humans with spinal cord injury

Last Updated: October 31, 2018.

The Swiss team said that their work might have gone even further than previous efforts with evidence that their patients' spinal nerves formed new connections.

A paralyzed man is back on his feet thanks to a newly developed spinal cord implant. The field of spinal cord injury is poised to take a giant leap forward in the treatment of what was until very recently considered incurable: "paralysis". In the STIMO study, the team was able to utilize an "unprecedented level of precision" in stimulating the spinal cords.

"If you think about cutting the head off a chicken, it can still walk around".

"The thought is that somehow there's a command coming down from the brain telling the lower limbs to move, and somehow the stimulation is enabling that", she says. Researchers say the biggest challenge for the participants was to learn coordination of the intention to walk in their brain with the targeted electrical stimulation. The process took some time as the patients went through rehabilitation to improve performance and get paralyzed muscles moving again, but after a while they were up and moving without assistance. That in turn makes it hard for the spinal cord to coordinate movement, says Jocelyne Bloch, a neurosurgeon at Lausanne University Hospital who worked on the new studies. These circuits also lead to the target muscles, but their signals aren't blocked by injuries, so some treatments seek to stimulate the ones below the injury site. After a few months, they regained the ability to walk without any electrical stimulation at all.

"When you close your eyes, you know where your leg is, without having to look at it", Oxley said. In most spinal cord injuries the spine is not severed, but bruised. 'Stimulators cause the nerves to fire in both directions: a natural direction but also backwards, like going down the wrong way on a one-way street, ' Moritz says.

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Moreover, they exhibited no leg-muscle fatigue, and so there was no deterioration in stepping quality, researchers said.

"All the patients could walk using body weight support within one week".

"They figured out how to deliver these pulses of stimulation into the spinal cord at the right pace, at the right beat, that would not disrupt that proprioceptive sensory system", Oxley said.

These longer, high-intensity training sessions proved crucial for triggering activity-dependent plasticity - the nervous system's intrinsic ability to reorganise nerve fibres - which leads to improved motor function even when the electrical stimulation is turned off. After five months of physical therapy and training with the technology, all three were able to voluntarily control their leg muscles and walk for as long as an hour without muscle exhaustion.

The impulse generator is controlled, surprisingly, with the patient's watch.

But none of the researchers would say that a full cure for paralysis is on its way, based on this research. "Our goal is to develop a widely accessible treatment", Courtine said. "They might not walk around, but they will feel better and will have a lot of health benefits associated with this mobilization of their body". BBC news has made research in this aspect and they had got special access to the patients who were getting treated in the clinic. "This is the first possible treatment that can potentially change the course of rehabilitation outcome in terms of walking". The results of the experiment were published in the latest issue of the journal Nature and an accompanying article was published in the Nature Neuroscience.

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