January 18, 2019

Electrical Spinal Cord Stimulation Lets 3 Men With Paralysis Walk Again

02 November 2018, 09:57 | Edward Lowe

Enlarge A composite image showing David Mzee standing and walking with

Multiple combined images of a man starting out in a wheelchair progressing to using a wheeled walker

Courtine plans to move trials into Europe and America over the next five years, and to continue improving the precision on the technology.

Created by a team at École Polytechnique Fédérale de Lausanne (EPFL), the device was part of the work done in a clinical trial, as published in the journal Nature.

"Our findings are based on a deep understanding of the underlying mechanisms which we gained through years of research on animal models", stated Courtine. It's very rare to see a spinal cord that was this silent, ' says Grégoire Courtine, a neuroscientist at the Swiss Federal Institute of Technology, referring to an nearly undetectable level of electrical activity in Tobler's lower spine. Within a week, the men could stand up and walk using supports.

"This little device that is an impulse generator is giving impulses to the electrode that is located on the spinal cord", Dr. Jocelyne Bloch, a neurosurgeon at Lausanne University, said.

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The study published in the journal Nature on October 31 revealed that the technique has already demonstrated significant progress in people who have spinal cord injuries. 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. Selected configurations of electrodes were then activating specific regions of the spinal cord, mimicking the signals that the brain would deliver to produce walking. But that did not take long.

The effects of the treatment lasted beyond when the electrical signals stopped, and "all of the participants retained some improvement in muscle movement even after the stimulation therapy", according to Nature.

The handful of results "is giving us a lot of confidence that this solution is real and even people with complete paralysis can regain stepping movements", says Chet Moritz, an associate professor of rehabilitation medicine at the University of Washington, who wrote an accompanying editorial in Nature about the most recent findings.

The new rehabilitation protocols lead to improved neurological function by allowing the participants to actively train natural overground walking capabilities for extensive periods of time, as opposed to passive training like exoskeleton-assisted stepping.

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In fact, two of the patients can take several steps without electrical stimulation, a sign that there's been growth of new nerve connections, said senior researcher Gregoire Courtine, chair of spinal cord fix at the Swiss Federal Institute of Technology in Lausanne.

Moreover, they exhibited no leg-muscle fatigue, and so there was no deterioration in stepping quality, researchers said. As soon as the stimulation is turned off, the patients immediately return to their previous state of paralysis and are no longer able to activate leg movements.

"We are building next-generation neurotechnology that will also be tested very early post-injury, when the potential for recovery is high and the neuromuscular system has not yet undergone the atrophy that follows chronic paralysis. Our goal is to develop a widely accessible treatment", Courtine said. -B., Goff-Mignardot, C. G.

The resulting movement also encouraged the growth of new sensory pathways in the brain and spinal cord - restoring connections damaged by the injury.

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Formento, E., Minassian, K., Wagner, F., Mignardot, J.

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