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Spinal Cord Injury. Rehabilitation Institute of Michigan. Get Started Now.
A New Cell Therapy Successfully Restored Movement in Paralyzed Patients
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Nature , 65—71; And this is not just in controlled laboratory conditions: they have been able to take walks outside again. Researchers have long pursued diverse strategies to repair and reactivate the spinal cord after injury. Many approaches are remarkably effective in regenerating and achieving functional recovery in mice and other animals, but fail to translate to human therapies. The advance in the current study was that, rather than delivering a constant electric current — as had been tried before — the researchers applied patterns of stimulation calculated to activate the correct groups of leg muscles at the correct time during stepping.
In this way, specific locations in the spinal cord could be targeted, to activate the muscles in a coordinated fashion. This patterned stimulation protocol not only allowed the unprecedented restoration of walking ability, but also enabled the individuals to regain control over previously paralysed muscles when electrical stimulation was turned off. This indicates that the brain and spinal cord had re-established functional connections, revealing an unexpected degree of plasticity.
In light of such progress, the prognosis for what was long considered an irreversible condition seems a lot brighter. But there is much more work to do. Spinal injuries vary enormously in their location, severity and outcome, and it will take many more studies to understand who will benefit from this technology.
The current research is a proof of concept in a small number of participants who had a range of residual leg function at the start of the study. A major challenge is to understand what determines successful recovery.
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For example, one source of variability might be how much sensory information the damaged spinal cord can still transmit to the brain. Formento et al.
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Nature Neurosci. This is another reason why temporally patterned stimulation could be more effective, and might have been one key to success for the three participants in the Nature study. However, different stimulation methods might turn out to be more or less useful for different individuals. According to the World Health Organization, between , and , people around the globe are affected by a spinal-cord injury each year — most caused by road accidents, falls or violence.
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