Nat Med: Recovery of motor function after complete paralysis in 3 men with spinal cord injury

A breakthrough neuromodulation system rapidly restores motor function in patients with severe spinal cord injury (SCI) , according to a study published February 7 in Nature Medicine .
The study's epidural electrical stimulation (EES) system developed specifically for spinal cord injury enabled three fully paralyzed men to stand, walk, cycle, swim, and control the trunk within 1 d .

A breakthrough neuromodulation system from
Nature Medicine rapidly restores motor function in patients with severe spinal cord injury (SCI) .

The study's epidural electrical stimulation (EES) system developed specifically for spinal cord injury enabled 3 fully paralyzed men to stand, walk, cycle, swim and control their trunk within 1 d A breakthrough neuromodulation system enables rapid recovery Motor function in patients with severe spinal cord injury (SCI)

SCI involves the connection between the brain and the limbs being severed
.

To make up for these lost connections, researchers have looked at stem cell therapy, brain-machine interfaces and powered exoskeletons

Stem Cell Therapy, Brain-Computer Interfaces, and Powered Exoskeletons

The researchers discovered that even "completely" injured patients may have low-functioning connectivity and began work on epidural stimulators designed to treat chronic pain
.

Recent research—including three published in 2018—suggests that these pain-related stimuli hold promise for patients with incomplete SCI

To develop this new method, the researchers designed a paddle lead with electrode arrays that target the sacrum, lumbar spine, and low thoracic dorsal roots involved in leg and trunk movement
.

They also built a personalized computational framework that could optimize surgical placement of this paddle wire

As part of an ongoing clinical trial, they tested the neurotechnology in three men with complete sensorimotor paralysis
.

Participants, aged 29, 32, and 41, suffered SCI from motorcycle accidents 3, 9, and 1 year before enrollment

All 3 patients exhibited complete sensorimotor paralysis, unable to take any steps, and muscles remained stationary during the attempt
.

Neurosurgeons implant electrodes along the subject's spinal cord
.

The leads from these electrodes connect to a neurostimulator implanted under the skin of the abdomen

Within 1 day of surgery, participants were able to stand, walk, cycle, swim, and control trunk movements
.

"At this stage, not all paralyzed patients are eligible for surgery, and implantation of electrodes requires at least 6 cm of healthy spinal cord below the lesion," explained researcher Bloch
.

"The age of the patient affects the outcome, as younger patients may have a more severe condition than older patients.
Patients are better and more motivated

"This stimulation system may be useful in the treatment of conditions commonly associated with spinal cord injury, such as high blood pressure, bladder control, and may also be useful in patients with Parkinson's disease," said researcher Courtine
.

The technology is "a huge step forward" and "really moves the field forward," said Peter
J.

Forward Medical, which developed the technology, received Breakthrough Device Designation from the U.

S.

Original source:

Original source:

Rowald, A.
, Komi, S.
, Demesmaeker, R.
et al.
Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis .
Nat Med (2022).
https://doi.
org/10.
1038/ s41591-021-01663-5.

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