Monday, 19 November, 2018

Spinal Implants Are Helping Paralyzed People Walk Again

Multiple combined images of a man starting out in a wheelchair progressing to using a wheeled walker Enlarge A composite image showing David Mzee standing and walking with
Melissa Porter | 03 November, 2018, 07:12

"Selected configurations of electrodes are activating specific regions of the spinal cord, mimicking the signals that the brain would deliver to produce walking", said Prof Jocelyne Bloch, a neuroscientist at Lausanne University Hospital (CHUV/Unil). When it's on, he's able to walk more than half a mile.

"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", he wrote. It involves an electrical stimulator surgically implanted at the base of the spine, under the bones but over the spinal cord.

Implants have been used precisely in order to overcome gaps in the spinal cord and transmit signals from the brain through the damaged areas of the spine.

"If you stimulate the entire spinal cord, you will activate all the muscles at the same time and block leg movement", Courtine said.

The results, published in the journal Nature, come on the heels of two reports last month of similar therapies that were able to help people with major spinal cord injuries walk for the first time in years.

Second, and even more important, the research team fine-tuned the stimulation to work in conjunction with the patients' proprioceptive sensory system. However, scientists warned that talking about the unambiguous success so far, because studies are at an early stage.

"This opens a completely novel avenue for spinal cord injury rehabilitation".

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

The University of Technology Sydney will have a research centre capable of administering this treatment in trials within the next year, according to Professor Vissel.

Because of that engagement, the treatment also resulted in voluntary movement being restored over time, as connections through the nervous system were re-established.

"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. While he can take a few steps with crutches or stand up with another person for support, "I should be able to have a BBQ standing on my own in the near future".

Gert-Jan Oskam, who lost the use of both his legs in a cycling accident, had also made very limited progress in rehabilitation before the study.

First, patients were implanted with an array of electrodes down the spinal cord, which allowed researchers to target individual muscle groups in the legs. For Sebastian Tobler, the five months haven't been long enough to restore much voluntary movement without EES. The researchers developed a voice-activated system that allowed their patients to switch EES on and off themselves, and they calibrated it to different modes for walking, standing, or cycling on a hand-and-leg-powered tricycle. The real life procedures are not almost as extreme, but they have helped three patients get back on their feet through what it called patterned stimulation.