THURSDAY, May 19 (HealthDay News) -- A patient completely
paralyzed below the chest after an road accident has been able to
stand up by himself, move his legs and feet and take some assisted
steps on a treadmill, thanks to electrical stimulation of his lower
The technique -- called epidural spinal cord stimulation --
mimics signals the brain normally sends to start movement. In
addition to returning voluntary movement to his hips, knees, ankles
and toes, the treatment also was able to give the patient back some
sexual and bladder function.
"This does not represent a cure for spinal cord injury, but it represents some very new ideas -- something to build on," lead researcher Reggie Edgerton, from the Department of Integrative Biology and Comparative Physiology at the University of California, Los Angeles, said during a press conference Thursday.
Edgerton said that the research demonstrated that patients could
regain voluntary control over their movements, although so far only
with the aid of stimulation.
"We have no idea what the mechanisms are," Edgerton said. "But it is pretty certain that the stimulation and the training have resulted in changes in the brain and changes in the spinal cord. We are really anxious to find out what the mechanism is -- we need to know how this occurred."
"This is a first-generation approach, but there will be many generations to come, which will improve on what has been done," he added.
While experts expressed excitement about the findings, they
stressed that no one yet knows whether this procedure will work for
patients with the most serious spinal injuries and that the results
need to be replicated in other studies.
For the patient, Rob Summers, however, this is already a major
breakthrough. "This procedure has completely changed my life," he
said in a statement to the press.
"For someone who for four years was unable to even move a toe, to have the freedom and ability to stand on my own is the most amazing feeling. To be able to pick up my foot and step down again was unbelievable, but beyond all of that my sense of well-being has changed. My physique and muscle tone has improved greatly, so much that most people don't even believe I am paralyzed," he said.
In Summers' case, the researchers explained that when his spinal
cord was stimulated in this way, nerves in the cord -- plus feeling
in the legs -- directed the muscle and joint movement that is
needed to allow him to stand and walk on a treadmill.
This was done with assistance, the researchers added. In
addition, Summers has been able to stand and take steps, also with
In addition to epidural spinal cord stimulation to help retrain
nerves there to send signals to produce certain movements, Summers
underwent repeated motion training to retrain his muscles, the
It took more than two years to complete the retraining project.
After that, the device that causes electrostimulation was implanted
in Summers' back. Before that, Summers had no voluntary control
over his movement, the investigators said.
The report was published in the May 20 online edition of
Whether epidural spinal cord stimulation will work with most
spine injured patients is unknown. Summers was classified "B" on
the American Spinal Injury Association system, meaning he had some
sensation below the point of the injury.
However, if epidural spinal cord stimulation will have any
benefit to patients classified as "A" -- where there is no
sensation below the injury -- is unclear, the researchers said.
Other concerns focus on whether it will be possible to develop
better hardware -- currently, the researchers are using a
stimulation device originally designed to relieve pain. In
addition, experiments in animals have shown that some drugs might
improve the response, but right now they are not approved for human
use, the researchers noted.
Gregoire Courtine, from the Experimental Neurorehabilitation
Laboratory in the Department of Neurology at the University of
Zurich in Switzerland and co-author of an accompanying journal
editorial, said that "this is good evidence that the human spinal
cord responds to stimulation, [a technique that] was observed in
Courtine thinks it's too early to know what this bodes for the
treatment of spinal cord injury. "This is only one patient," he
said. "But this is the first time someone with a chronic complete
paralysis has shown recovery of some movement."
Whether it will work with patients with the most serious
injuries is uncertain, Courtine said. "But there are patients with
less serious injury in whom you may expect even better recovery,"
"We are entering a new era, but it's only the beginning," Courtine said. While this is not a cure, it could lead the way to help patients regain movement, he said, adding that improved technology and clinical trials will be needed.
Another expert, Dr. Steven Vanni, an assistant professor of
clinical neurosurgery, Spine Service, at the University of Miami
Miller School of Medicine, said that "if they can replicate this,
[it] would be something we could offer our patients currently, with
patients with these type of spinal cord injuries."
As for Summers, he is optimistic that the procedure will
transform his life still further. "I believe that epidural
stimulation will get me out of this chair," he said.
For more information on spinal cord injury, visit the
U.S. National Library of Medicine.
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