For the first time in at least two years, four people were able to flex their toes, ankles and knees, thanks to a new therapy that involves stimulation of the spine.
“When we first learned that a patient had regained voluntary control as a result of spinal stimulation, we were cautiously optimistic,” said Roderic Pettigrew, director of the National Institute of Biomedical Imaging and Bioengineering at the National Institutes of Health. “Now that spinal stimulation has been successful in four out of four patients, there is evidence to suggest that a large cohort of individuals, previously with little realistic hope of any meaningful recovery from spinal cord injury, may benefit from this intervention.”
Even the patients who had complete motor and sensory paralysis, who were meant to be the controls in the experiment, were able to move, surprising the researchers and giving hope for a future “cocktail” of therapies that could help paralyzed people move.
In the patients with complete motor and sensory paralysis, pathways that send information to and from the brain are disrupted. It was previously thought that stimulation therapy wouldn’t work without those pathways being functional. But all four participants were able to synchronize body movements in time with a wave displayed on a computer screen. Three were also able to change the force of their movements.
“The fact that the brain is able to take advantage of the few connections that may be remaining, and then process this complicated visual, auditory, and perceptual information, is pretty amazing,” said V. Reggie Edgerton, a UCLA professor of integrative biology and physiology,who developed the approach. “It tells us that the information from the brain is getting to the right place in the spinal cord, so that the person can control, with fairly impressive accuracy, the nature of the movement.”
The study, published today in the journal Brain, follows the trial begun in 2009 of a man paralyzed below the chest who underwent spinal stimulation therapy in conjunction with daily treadmill training and regained some voluntary control of his legs.
“Right now, the clinical perspective for individuals with complete motor paralysis is that there is nothing we can do,” said researcher Susan Harkema, the director of rehabilitation research at the Kentucky Spinal Cord Injury Research Center at the University of Louisville. “I think we need to rethink that. In our study, we demonstrated potential beyond any expectation. We need to relook at what the perceived potential is for this group of individuals.”