Breakthrough therapy allows 4 paraplegic men to voluntarily move their legs
The study, conducted by researchers from the
All four participants were classified as suffering from chronic, motor complete spinal cord injuries and were unable to move their lower extremities prior to the implantation of an epidural stimulator. The stimulator delivers a continuous electrical current to the participants' lower spinal cords, mimicking signals the brain normally transmits to initiate movement.
The research builds on an initial study, published in
Now, three years later, the key findings documented in Brain detail the impact of epidural stimulation in a total four participants, including new tests conducted on Summers. Summers was paralyzed after being struck by a vehicle, and the other three participants were paralyzed in auto or motorcycle accidents.
What is revolutionary, the scientists said, is that the second, third and fourth participants -
The participants' results and recovery time were unexpected, which led researchers to speculate that some pathways may be intact post-injury and therefore able to facilitate voluntary movements.
"Two of the four subjects were diagnosed as motor and sensory complete injured with no chance of recovery at all," said lead author
In epidural stimulation, the electrical current is applied at varying frequencies and intensities to specific locations on the lumbosacral spinal cord, corresponding to the dense neural bundles that largely control the movement of the hips, knees, ankles and toes. With the participants, once the signal was triggered, the spinal cord reengaged its neural network to control and direct muscle movements.
When coupling the intervention with rehabilitative therapy, the impact of epidural stimulation intensified. Over the course of the study, the researchers noted that the participants were able to activate movements with less stimulation, demonstrating the ability of the spinal network to learn and improve nerve functions.
"We have uncovered a fundamentally new intervention strategy that can dramatically affect recovery of voluntary movement in individuals with complete paralysis, even years after injury," said
Beyond regaining voluntary movement, the research participants have displayed a myriad of improvements in their overall health, including increases in muscle mass and regulation of their blood pressure, as well as reduced fatigue and dramatic improvements to their sense of well-being.
Additionally, all four men were able to bear weight independently, as reported by the team, which also includes
"This research brings up an amazing number of possibilities for how we can develop interventions that will help people recover movement they have lost," said Edgerton, a distinguished professor of integrative biology and physiology, neurobiology, and neurosurgery at
Providing hope for people living with paralysis
The study offers hope that clinical therapies can be developed to advance treatment for the nearly 6 million Americans living with paralysis, including nearly 1.3 million with spinal cord injuries.
The four paralyzed participants ranged in neurological level from C7-T5 and were at least two years post-injury at the time of the intervention. Two of them had been rated "A" on the
However, with the application of epidural stimulation, all four participants recovered voluntary control of their lower extremities, surprising the scientists, who believed at least some of the sensory pathway must be intact for epidural stimulation to be successful.
"With this study, the investigators show that their findings about a motor complete patient regaining movement, as published three years ago in The Lancet, were not an anomaly," said
Investing in epidural stimulation
The research was funded by the
"When we first learned that a patient had regained voluntary control as a result of the therapy, we were cautiously optimistic," said
"This is a wake-up call for how we see motor complete spinal cord injury," said Edgerton, who has been conducting fundamental research in this area for 38 years and is a member of the
The scientists are optimistic that the therapy intervention will continue to result in improved motor functions. In fact, based on observations from the research, there is strong evidence that with continued advancements of the epidural stimulator, individuals with complete spinal cord injuries will be able to bear weight independently, maintain balance and work towards stepping, the scientists said.
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