Published: Fri, November 02, 2018
Research | By Raquel Erickson

Precise electrical stimulation helps to treat paralysis in three patients

Precise electrical stimulation helps to treat paralysis in three patients

More than four years prior, the men had all suffered major spinal cord injuries that left them with limited or no movement in their legs.

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

After several months of training with the targeted pulses however, "our three participants were able to activate their previously paralyzed muscles without electrical stimulation", said Courtine.

In fact, two of the patients can take several steps without electrical stimulation, a sign that there's been growth of new nerve connections, said senior researcher Gregoire Courtine, chair of spinal cord fix at the Swiss Federal Institute of Technology in Lausanne.

"Not so long ago, the hope that someone paralyzed for years by a severe spinal-cord injury would ever be able to walk again was just that - hope", the journal said in an editorial about the new research. In a separate study published the same day, researchers at the Mayo Clinic showed that they had achieved similar results in another person.

Grégoire Courtine, from the Swiss Federal Institute of Technology, said that the technique should be moved from experimental trials into hospitals... "It's not that we're taking over control of the leg".

With rehabilitation, the patients eventually regained voluntary leg movement even without EES, but whether that means the brain and spinal cord had restored neural links remains to be seen. "The targeted stimulation must be as precise as a Swiss watch". 'Toward the end is when they were improving the best, ' he says.

The research represents cutting-edge progress in the field of spinal cord injuries, according to Sylvia Gustin, neuroscientist and psychologist at Neuroscience Research Australia (NeuRA) and the University of New South Wales, who was not involved in the study.

The signal between the brain and the legs can become weakened, preventing movement. After intensive therapy all three patients were also able to take steps even when the stimulation was switched off. "It is also this spatiotemporal coincidence that triggers the growth of new nerve connections". There are some connections still intact, but might not be enough to allow mobility. "We were thus able to mimic in real time how the brain naturally activates the spinal cord". "It's turning up the volume, turning up the excitability of the spinal circuits below the injury".

"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.

The basis of the technique, called epidural electrical stimulation (EES), is not new at all-it's been investigated as a potential treatment for paralysis for decades, with a lot of success in animals.

Courtine and his team used the tablet to turn the pattern of stimulation on and off depending on where the participants' feet were in relation to the ground.

While the results are exciting, it's important to keep in mind that paraplegics have other needs that go beyond walking, Moritz adds. Walking actually came in fourth, behind sexual function, bladder and bowel movement, and the ability to control body posture.

"It was a very emotional moment the first time they walked", he said.

Even within the small group of three patients, the results have been markedly different.

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