Paralyzed man regains voluntary leg movement with electrode array implant

By Darren Quick

From: http://www.gizmag.com

Rob Summers, 25, in the harness that provides support while he receives electrical stimulation to his spinal cord (Image: Rob Summers)
Image Gallery (4 images)

In a move that gives cautious hope to the millions of people suffering some form of paralysis, a team of researchers from UCLA, Caltech and the University of Louisville has given a man rendered paralyzed from the chest down after a hit-and-run accident in 2006 the ability to stand and take his first tentative steps in four years. The team used a stimulating electrode array implanted into the man's body to provide continual direct electrical stimulation to the lower part of the spinal cord that controls movement of the hips, knees, ankles and toes, to mimic the signals the brain usually sends to initiate movement.

Instead of bypassing the nervous system to directly stimulate the leg muscles, the electrical signals provided by the array stimulate the spinal cord's own neural network so it can use the sensory input derived from the legs to direct muscle and joint movements. The stimulation therefore doesn't induce movement, but taps into a network of spinal cord nerves that are capable of initiating movement on their own without the help of the brain, which then work together with cues from the legs to direct muscle movement.

The research team's work builds on previous research at UCLA that showed animals with spinal-cord injuries could stand, balance, bear weight and take coordinated steps while the outermost part of the spinal canal - or epidural space - is stimulated.

Thanks to the breakthrough the test subject, 25 year old Rob Summers, is able to supply the muscular push required to stand up and remain standing for up to four minutes at a time. With periodic assistance, Summers is able to stand for up to an hour, and with the aid of a harness support and some assistance from a therapist he is able to take steps on a treadmill.

Prior to implantation with the epidural stimulating array, Summers, who suffered a complete motor injury at the C7/T1 level of the spinal cord, was unable to move even his toes. But after implantation he was able to not only stand and make repeated stepping motions on a treadmill with the assistance of a harness, but also regained the ability to voluntarily move his toes, ankles, knees, and hips on command. However, once the stimulation is turned off, Summers loses the voluntary control of his limbs.

Over time, Summers also experienced improvements in several types of autonomic function, including bladder and bowel control and temperature regulation. The researchers say these autonomic functions began to return before there was any sign of voluntary movement, which took around seven months after he began receiving epidural stimulation to emerge.

Although the researchers still aren't yet fully sure how these autonomic functions were regained, the results indicate the treatment could help improve the quality of life of spinal cord injury sufferers other than those with the strength to undergo the rigorous physical training Summers did as part of his treatment. The researchers say the relief from secondary complications of complete spinal cord injury - including impairment or loss of bladder control, sphincter control and sexual response - could even prove to be ultimately as, or more important in terms of improving the quality of life of such patients

While obviously encouraged by the results, the researchers are quick to point out that the study represents just one case and that there's no way to tell how other patients may react. They also point out that Summers, who was an athlete in comparatively excellent physical condition before his accident, retained some sensation in his lower extremities after his injury indicating his spinal cord was not completely severed, which may have played a part in the level of success he was able to attain.

However, the researchers are hopeful that their work could one day provide some individuals suffering spinal cord injuries with the ability to stand independently, maintain balance and take effective steps through the use of a portable stimulation unit and the assistance of a walker. Additionally, the researchers believe the approach could potentially also help in the treatment of stroke, Parkinson's, and other disorders affecting motor function.

The team has received approval from the FDA to test five spinal-cord injury patients and will next try and replicate their initial results with a patient that matches Summers in terms of age, injury, and physical ability. They will then turn to patients who have no sensation to see how that influences the outcome.

Interestingly, the device implanted into Summers is FDA-approved for back pain only and its use was meant only as a test to see if the researcher's concepts would work. As a result, the researchers say the current implants have many limitations and that further advances in the technology should lead to better control of the standing and stepping process. They are also looking at whether it might be possible to move the array higher up on the spinal column to see if it could also be used to affect the arms and hands.

The UCLA, Caltech and University of Louisville researcher's work is detailed in the paper, "Epidural stimulation of the lumbosacral spinal cord enables voluntary movement, standing, and assisted stepping in a paraplegic human," which is published in The Lancet.

Professor V. Reggie Edgerton discusses the breakthrough in the following UCLA video:

Blue Rats and M&Ms

From: http://blogs.discovery.com/

We all know that albino animals have pink eyes and skin.  So why is this albino lab rat blue?


Medical researchers have discovered that the blue dye used in food products such as M&Ms, Jell-O and Gatorade can actually help heal spinal injuries.  Injured rats regained the ability to walk after receiving an injection of the dye.  The side effect, of course, is that the rodents themselves turned blue.

Apparently, Americans eat over 100 million lbs. of this blue dye every year. Luckily, it seems the dye has to be injected in order to turn skin blue.

Paralysed dog walks again after pioneering treatment that could help humans with spinal injuries

By Daily Mail Reporter

A paralysed dog has been put back on his feet again, raising hopes of a treatment for humans with severe spinal injuries.

Henry the miniature dachshund was unable to walk after discs ruptured in his spine last November.

In a pioneering treatment, scientists at Cambridge University took cells from his nose and injected them into his spine.

Back on four legs: Henry the miniature dachshund, who was paralysed, has taken his first steps after pioneering treatment by scientists at Cambridge University

These cells are used because they aid the growth of new nerve fibres.

Now the six-year-old dog is walking and wagging his tail again.

Scientists originally found the treatment worked on rats. Professor Nick Jeffery and Professor Robin Franklin, who are running the trial, then decided to try the procedure on dogs because spinal injuries are common in many breeds.

Henry has also received physiotherapy and is monitored on a treadmill.

More...

• Tiny porkers with a big price tag: £700 'micro-pigs' are the latest celebrity pet craze

Dr Jeffrey said: 'We hope if the results are positive in a few years time the treatment could perhaps be used to help people.'

Scientists at Cambridge Veterinary School took cells from Henry's nose and injected them back into his spine.

'It's incredible, I didn't think Henry would ever be able to walk again, but over the last few months he has been wagging his tail and taking small steps,' said owner Sarah Beech, 34, from Birmingham.

'The vet told me to put him to sleep because he wouldn't have a very good quality of life and he was very depressed. But this treatment has really helped.'

Scientists took cells from Henry's nose and injected them into his spine

Henry had always enjoyed going for walks but suddenly lost the use of his legs about a year ago.

'One day he yelped when I picked him up and two days later he couldn't walk,' she added.

'The discs in his back were pushing into his spinal cord and eventually he lost the use of his back legs and continence.

'I think he may have fallen down the stairs at some point before I bought him as his spine was quite badly damaged.' Henry was given an operation to ease the pressure on his spine, but it didn't work.

Then Sarah heard about the new treatment for severe spinal cord injuries and decided to enlist him in the trial.

Cells were harvested from his nose in March and injected back into his spine after four weeks.

Just a month later Henry took his first steps.

Step by step: Henry undergoes treatment

'He can take at least four steps now so he is making good progress,' said Sarah.

'His tail is also starting to get back to its original shape which shows he is getting some feeling back.'

Dr Jeffery said: ''Most dogs with spinal injuries can be treated conventionally and make a good recovery, but this procedure is intended for particularly severe cases.

'Cells are collected from inside the back of the nose as these special cells are capable of supporting the growth of new nerve fibres.

'We then increase the cell numbers, purify them and place them back into the damaged region of the spinal cord, where they help new fibres to grow.'

After the procedure dogs are given physiotherapy and monitored on a treadmill to see how much movement has returned to their legs.

'The potential of this procedure is enormous,' Dr Jeffery added.

'We hope if the results are positive in a few years time the treatment could perhaps be used to help people.'

Read more: http://www.dailymail.co.uk/news/article-1218810/Paralysed-dog-walks-pioneering-treatment-help-humans-spinal-injuries.html#ixzz0TTLceXSw

Paralyzed Rats Walk Again

Three-pronged treatment let their legs move, bear weight without brain signals

By Jennifer Thomas, HealthDay Reporter

SUNDAY, Sept. 20 (HealthDay News) -- A three-pronged approach to treating spinal cord injuries allowed paralyzed rats to walk without receiving signals from the brain, scientists report.

Spinal cord injuries result in paralysis when the nerve fibers that carry information to and from the brain are damaged or severed. Much of the focus of research into spinal cord injuries has been exploring ways of regenerating those nerve fibers and connections, which has so far met with limited success in people.

In the new study, rats were treated with a combination of drugs, electrical stimulation of the spinal cord and locomotor training, a rehabilitation technique. The combined treatment enabled the rats to walk with a near-normal gait on a treadmill, without the muscles receiving signals from the brain.

"The study demonstrates that the lower spinal cord has circuitry that is sufficient to support virtually normal, weight-bearing locomotion," said senior study author V. Reggie Edgerton, a professor of physiological sciences and neurobiology at the University of California, Los Angeles.

The study appears in the Sept. 20 online edition of Nature Neuroscience.

Previous research has been able to coax a stepping motion using one or two of those techniques, said Susan Howley, executive vice president of research for the Christopher & Dana Reeve Foundation, which provided some funding for the current research. But this is the first study to achieve actual weight-bearing walking, as opposed to the motions of walking.

"The thing that's very exciting about this is that for the first time they actually showed they can get these rats, with no input from the brain, to step near normally," Howley said. "On the treadmill, they were able to bear weight and step virtually as well as they had been prior to the injury. That's a remarkable achievement."

In the study, researchers put rats whose lower legs were paralyzed in a harness on a slow-moving treadmill and gave them a drug called quipazine, a serotonin agonist that enhances the function of the spinal nerve circuitry. The researchers then used an epidural to apply electrical currents to the dura of the spinal cord, the protective membrane that surrounds it, below the point of injury.

The combination of drugs and electrical stimulation caused the rats to begin walking. Several weeks of daily locomotor training on the treadmill enabled near-normal weight-bearing walking -- including backward, sideways and running.

Because the brain was still unable to direct the walking, the rats could only walk when hooked up to electrical stimulation on the treadmill.

Previous studies have shown that the nerve circuitry of the spinal cord is able to generate rhythmic activity that can direct leg muscles to step, the researchers said. With the right input, the nerves can learn to interpret sensory information from the stepping motion even without help from the brain.

"Previous research has shown the spinal cord can learn whatever task it's being trained to do," Edgerton said. "The spinal cord can interpret the sensory information associated with the stepping, respond to that sensory information and sustain the stepping based on the sensory information."

Locomotive training is a rehabilitation technique that uses that concept to retrain the spinal cord circuitry after injury. Widely used in some European countries, locomotor training involves placing people with spinal cord injuries in harnesses while physical therapists move their legs in a walking motion.

People who undergo locomotor training often see improvements in respiration, bladder function, blood sugar levels and circulation below the level of the lesion, which can help prevent the skin breakdown that can occur as a result of paralysis, Howley said. Others even recover trunk stability, which can enable them to move from a bed to a wheelchair, or a wheelchair to a car, without assistance.

Though a treatment using the three-pronged approach is at least several years away, the study suggests the potential of using neuroprosthetic devices to activate spinal cord rhythmic circuitry, said study author Gregoire Courtine, a professor in the department of neurology at the University of Zurich in Switzerland. His team is currently developing a device that they hope to begin testing in small clinical trials in three to four years.

About 5.6 million Americans, or one in 50, has some level of paralysis, according to a survey released in April of 33,000 U.S. households by the Christopher & Dana Reeve Foundation. About one-quarter of the nearly 2 percent of the U.S. population living with paralysis is due to a spinal cord injury.

More information

The Christopher & Dana Reeve Foundation has more on the latest spinal cord injury research.

SOURCES: Susan Howley, executive vice president, research, Christopher & Dana Reeve Foundation, Short Hills, N.J.; V. Reggie Edgerton, Ph.D., professor, physiological sciences and neurobiology, University of California, Los Angeles; Gregoire Courtine, professor, University of Zurich, Switzerland; Sept. 20, 2009, Nature Neuroscience, online

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Colbert: Blue M&Ms Heal Spinal Injuries

posted by: Matt Tobey

On last night's Colbert Report, Stephen shared the amazing news that a chemical in blue M&Ms can heal spinal injuries. Personally, I can attest that it also prevents them. Same goes for quadruple bacon cheeseburgers and whole cans of frosting. Remember, you can't fall if you're too fat to get off the floor.

The Colbert Report airs Monday through Thursday at 11:30pm / 10:30c.

Blue M&Ms 'mend spinal injuries'

The food dye that gives blue M&Ms their colour can help mend spinal injuries, researchers have claimed after tests on rats.

On the downside, the treatment causes the skin to temporarily turn bright blue and BBG needs to be injected soon after the trauma

The compound Brilliant Blue G blocks a chemical that kills healthy spinal cord cells around the damaged area - an event that often causes more irreversible damage than the original injury.

BBG not only reduced the size of the lesion but also improved the recovery of motor skills, the rodent tests showed.

Those treated with BBG were later able to walk, although with a limp. Rats that did not receive the BBG solution never regained the ability to walk.

On the downside, the treatment causes the skin to temporarily turn bright blue and BBG needs to be injected soon after the trauma. The test injections were given within 15 minutes.

The new findings by researchers at the University of Rochester Medical Centre in New York build on work reported five years ago by the same team.

They discovered that adenosine triphosphate (ATP) - a chemical that keeps our cells alive - quickly pours into the area surrounding a spinal cord injury.

But they found it overstimulated otherwise healthy neurons and caused them to die from metabolic stress, creating a secondary injury.

Injecting oxidised ATP into the site of the injury helped stop this, they found.

But neurosurgeon Prof Maiken Nedergaard, who led the research, said: "No one wants to put a needle into a spinal cord that has just been severely injured so we knew we needed another way."

The new approach of using BBG has answered this problem because it can be administered intravenously.

More tests will be needed to prove the safety of BBG before human clinical trials can begin.

But researchers are optimistic new treatments for acute spinal cord injuries could emerge in the next few years.

FDA Clears Embryonic Stem Cell Therapy Trials

Geron will begin clinical trials of its therapy for spinal cord injury this summer.

Friday, January 23, 2009

By Emily Singer

Repair work: This animation shows glial progenitor cells, made from human embryonic stem cells, repairing nerve damage. Credit: University of California, Irvine

Geron, a California-based cell therapy company that has been working with embryonic stem cells for the last decade, finally received clearance from the US Food and Drug Administration to begin clinical trials of its cell-based therapy for spinal cord injury.

The trial is limited to eight patients with newly acquired spinal cord injuries who will receive injections of the cell therapy, called GRNOPC1, within two weeks of their accident. GRNOPC1 is made by transforming embryonic stem cells into oligodendrocytes -- a type of brain cell that wraps itself around neurons, forming a fatty insulation layer that allows electrical messages to be conducted throughout the nervous system. In many spinal cord injuries, these cells are damaged but the underlying nerve cells remain intact. These cells are then injected into the site of the injury, coating exposed nerves and restoring communication to the nervous system.

Scientists published the results of successful study testing the therapy in animals in 2005, showing that paralyzed rats injected with the cells were able to walk again. Since then, the company has been conducting numerous studies intended to show the safety of the cell-based therapy, as well as developing production methods that would make the cells as easy to use as more traditional treatments--Geron researchers have also developed a way to reliably freeze and thaw brain cells, so that they can be manufactured in a central location, and then shipped to the hospitals where they will be used.

Because embryonic stem cell based therapies are so new, the FDA has had trouble deciding how to evaluate new drug applications. (Geron's president and CEO, Thomas Okarma, thought approval was imminent when I spoke with him in 2006. See 'Human Tests of Embryonic Stem Cell Treatments Planned'.) The initial trial is designed to assess safety, but doctors will also measure its effectiveness, such as improved neuromuscular control or sensation in the trunk or lower extremities.

The announcement comes amid general excitement in the stem cell field, thanks to Barack Obama's promise to lift funding restrictions for embryonic stem cell research. (See Braving Medicine's Frontier.)

Thomas Okarma, Ph.D., M.D., Geron's president and CEO, said in a statement: "This marks the beginning of what is potentially a new chapter in medical therapeutics - one that reaches beyond pills to a new level of healing: the restoration of organ and tissue function achieved by the injection of healthy replacement cells. The ultimate goal for the use of GRNOPC1 is to achieve restoration of spinal cord function by the injection of hESC-derived oligodendrocyte progenitor cells directly into the lesion site of the patient's injured spinal cord."

This video illustrates how Geron's cell therapy works in rats.