Paralysis research and treatment

[waltky]

Good ol' U of L...

Study reports breakthrough in treating paralysis
20 May`11 - A 25-year-old man paralyzed in a hit-and-run accident five years ago can stand on his own again, and with help, can walk a few steps, says a new study. He can also voluntarily move his hips, knees, ankles and toes.

Scientists from the University of Louisville, UCLA and the California Institute of Technology reported their research, which involved electronic stimulation of the spinal cord, Thursday in the online version of the British medical journal TheLancet. "I was afraid to believe it when I first saw it," said study co-author Reggie Edgerton, professor of integrative biology, physiology and neurobiology at UCLA, and a member of the Brain Research Institute there. "To everyone's disbelief, I was able to stand independently the third day they turned it on," said patient Rob Summers, who was initially completely paralyzed below the chest. Rob Summers, standing with the aid of supports during therapy in Louisville Kentucky.

Summers had what's called epidural stimulation. In December 2009, an electrode array — a long, thin tape with electrodes on it — was implanted internally over the top of his spinal cord. A wire attached to the array was threaded internally down his back to a pouch on his back hip containing the stimulating device, Edgerton said. The box can be programmed to give continuous electrical currents — sensory cues — to specific locations on the lower spinal cord that correspond to nerve cell bundles linked to the hips, legs, and feet, said Jonathan Hodes, chairman of the department of neurosurgery at the University of Louisville.

Doctors have used these implants for years to manage pain, but this is a new innovation, said John McDonald, director of the International Center for Spinal Cord Injury at the Kennedy Krieger Institute in Baltimore. McDonald treated the late actor Christopher Reeve after he was paralyzed in a riding accident. "This is very exciting. It will make a big impact. If it works in one person, it's going to work in many people," said McDonald, who believes the technology may help about 10% to 15% of people with spinal cord injuries. The surgical procedure was followed up with daily physical therapy sessions, and Summers has regained some sexual and bladder function, doctors said.

The procedure is not ready for the clinic, cautioned Susan Harkema, of the University of Louisville's Department of Neurosurgery and Frazier Rehab Institute, where Summers was treated. The scientists will test the treatment in a second patient this summer. McDonald said the technology won't help everyone. "This has the potential to dramatically change the lives," McDonald said. "It's not a perfect cure, but it doesn't need to be." The study was funded by the National Institutes of Health and the Christopher and Dana Reeve Foundation.

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Restoring independent breathing after spinal cord injury...

Spinal cord repair restores independent breathing
13 July 2011 - Damage to the spinal cord in the neck can result in problems breathing

The ability to breathe has been restored to mice with spinal cord injuries, in what US researchers describe as a medical first. Some patients with damaged spinal cords need ventilators as they are unable to breathe on their own. A report in the journal Nature showed a nerve graft, coupled with a protein, could restore breathing. Human trials could begin soon, which the charity Spinal Research said could be "potentially life-changing". Damage at the top of the spinal cord, around the neck, can interrupt messages to the diaphragm - a layer of muscle involved in breathing.

Challenge

The cord is notoriously resistant to repair. Techniques such as nerve grafts, which worked in the arms and legs, had shown limited success with the spinal cord, doctors at the Case Western Reserve University said. The spinal cord scars after it is damaged, and molecules - chondroitin sulphate proteoglycans - prevent nerves repairing and forming new connections. The researchers used a nerve graft to form a bridge across the scar at the same time as injecting an enzyme - chondoitinase ABC - which attacked the inhibitory molecules. Three months later, tests showed the mice had recovered 80-100% of breathing function.

Professor of neuroscience and lead researcher Jerry Silver said: "The use of the enzyme, that's helped get the nerve fibres out and we were amazed at, once they get out, how well they can reconnect. "The spinal cord can just figure things out and restore really beautiful functional breathing patterns." Researchers hope to begin trials in humans. They are also investigating whether bladder function can be restored, which can be lost when the lower spine is damaged.

Dr Mark Bacon, from the charity Spinal Research, said: "Long distance regeneration has remained quite elusive in the field of spinal cord injury repair, so to achieve this and at the end of it establish functional connections that actually do something useful - restore breathing - is remarkable. "It is potentially life-changing if this or similar techniques can be translated to the clinic."

BBC News - Spinal cord repair restores independent breathing

 

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New disk treatment in research phase...

Bioengineered Spinal Disc Could Relieve Back Pain
August 05, 2011 - Existing surgical treatments lack flexibility

Researchers at Cornell University in New York have developed an artificial spinal disc that may help patients with chronic back pain and other disc problems. The spine is a column of bones alternating with flexible spinal discs. When those discs do their job properly, you feel great. But when the disc is injured, the result can be pain in the neck or lower back.

Now, a research team led by a neurosurgeon and a biomedical engineer has developed an artificial spinal disk that seems to work well in experiments using laboratory animals. Current treatments include a metal and plastic artificial disk and spinal fusion surgery, but they don't really duplicate the structure of the natural spinal disk. Cornell University neurosurgeon Roger Härtl says the disc has a gel-like interior surrounded by a stiffer outer section, which gives it a valuable combination of properties.

"That structure together - the disc, made up of the annulus on the outside and the nucleus inside - is a very stable structure, Härtl says. "However, it provides a certain amount of motion. That's why our spine is so incredibly flexible, if you look at the whole spine." Härtl's engineering colleague, Lawrence Bonassar developed the artificial discs, which are grown from cells, not manufactured, and Härtl says they perform very much like the natural discs they replace.

"So the engineering team have been able to replicate the normal structure of the disc, and we think that the combination of those two components - namely the nucleus and the annulus together - mimics to a very, very high degree what the normal spinal disc looks like and goes through in the human anatomy." These artificial discs were implanted in the tails of laboratory rats, where they performed much like natural discs. The researchers say bioengineered discs could represent a major advance for many patients with disc problems.

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[waltky]

Progress in reversing paralysis...

Nose cell transplant enables paralysed dogs to walk
18 November 2012 - Scientists have reversed paralysis in dogs after injecting them with cells grown from the lining of their nose.

The pets had all suffered spinal injuries which prevented them from using their back legs. The Cambridge University team is cautiously optimistic the technique could eventually have a role in the treatment of human patients. The study is the first to test the transplant in "real-life" injuries rather than laboratory animals. In the study, funded by the Medical Research Council and published in the neurology journal Brain, the dogs had olfactory ensheathing cells from the lining of their nose removed. These were grown and expanded for several weeks in the laboratory.

Treadmill

Of 34 pet dogs on the proof of concept trial, 23 had the cells transplanted into the injury site - the rest were injected with a neutral fluid. Many of the dogs that received the transplant showed considerable improvement and were able to walk on a treadmill with the support of a harness. None of the control group regained use of its back legs. The research was a collaboration between the MRC's Regenerative Medicine Centre and Cambridge University's Veterinary School.

Professor Robin Franklin, a regeneration biologist at the Wellcome Trust-MRC Stem Cell Institute and report co-author, said: 'Our findings are extremely exciting because they show for the first time that transplanting these types of cell into a severely damaged spinal cord can bring about significant improvement. "We're confident that the technique might be able to restore at least a small amount of movement in human patients with spinal cord injuries but that's a long way from saying they might be able to regain all lost function. ' Prof Franklin said the procedure might be used alongside drug treatments to promote nerve fibre regeneration and bioengineering to substitute damaged neural networks.

Partial repair