Tuesday , January 31 2023

Swiss breakthrough in the treatment of spinal cord injury – the brain with a microscope


The breakthrough achieved by the team of Swiss neuroscientists and clinicians (Professor Courteine ​​and Bloch), who speak French, is the most recent accomplishment of understanding and treating the spinal cord injury that allows the patient to remain in a wheelchair for life. Thanks to state-of-the-art techniques that provide direct electrical stimulation to the spinal cord and intensive physical therapy, the spinal cord injury patient begins to walk.

What is different from previous research?

Two recent studies have restored the movement of patients who paralyzed or partially paralyzed by applying sustained electrical stimulation to the spinal cord.

The new report from the authoritative journal Nature is the first demonstration of discontinuous stimulation. The implant sends an explosion of the target stimulus to the spinal cord and the spinal cord stimulates the muscles to move. In fact, stimuli can roughly mimic the signaling mechanisms of the body.

Treatment is still experimental and the effect on other patients with complete or partial paralysis should still be determined. All three patients participating in the Swiss study felt a sense of legs before the start of the study. After several months of intensive training, they took the first tough step. They still rely on wheelchairs. Two people can go out by using a walker.

Is there enough electric stimulation?

In all recent studies, complete and long-term rehabilitation was essential for success. Participants attended 100-278 sessions of stimulation and rehabilitation for 5 to 21 months. Therefore, electric stimulation alone was not a "magic bullet".

How did the research start?

The authors of the new report have previously discovered that a rat that has lost the use of hindquarters can be trained to function again when sustained current is applied to the muscle through the spinal cord.

But in humans, persistent stimuli appear to mix signals to the muscles to activate some and confuse others. For this reason, rupture of the electrical stimulus was more successful in the three patients with less severe spinal cord injury.

What is the mechanism?

One of the interesting findings is that each of the three patients has learned to move smooth muscles in the past without the help of implants. Perhaps electrical stimulation can cause nerve re-growth due to injury.

What is the future?

More participants need to be tested and new stimulation skills may be needed for other types of injuries. In any case, Professor Courtine's group at EPFL is strengthening the bright future of spinal cord injury treatment.

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