Extended activity-based training with epidural stimulation resulted in ability to stand and move without stimulation
A research participant at the University of Louisville with a complete spinal cord injury, who had lost motor function below the level of the injury, has regained the ability to move his legs voluntarily and stand six years after his injury.
A study published today in Scientific Reports describes the recovery of motor function in a research participant who previously had received long-term activity-based training along with spinal cord epidural stimulation (scES). In the article, senior author Susan Harkema, Ph.D., professor and associate director of the Kentucky Spinal Cord Injury Research Center (KSCIRC) at the University of Louisville, and her colleagues, report that over the course of 34.5 months following the original training, the participant recovered substantial voluntary lower-limb motor control and the ability to stand independently without the use of scES.
“Activity-dependent plasticity can re-establish voluntary control of movement and standing after complete paralysis in humans even years after injury,” Harkema said. “This should open up new opportunities for recovery-based rehabilitation as an agent for recovery, not just learning how to function with compensatory strategies, even for those with the most severe injuries.”
Previous research at KSCIRC involving four participants with chronic clinically motor-complete spinal cord injury found that activity-based training with the use of scES – electrical signals delivered to motor neurons in the spine by an implanted device – allowed the participants to stand and to perform relatively fine voluntary lower limb movements when the scES device was activated. Andrew Meas was one of the four participants in that study.
The original training protocol included daily one-hour activity-based training sessions with the aid of epidural stimulation. During these sessions, the participant trained on standing activity for several months, followed by several months of training on stepping.
After completing a nine-month training program in the lab, Meas continued activity-based stand training at home. After a year of independent training, he returned to the lab to train for three months in a revised activity-based training schedule. The revised training called for two daily one-hour training sessions and included both stand and step training each day, all with the aid of epidural stimulation.
After that training, Meas was able to voluntarily extend his knees and his hip flexion was improved. In addition, using his upper body and minimal additional assistance to reach a standing position, he was able to remain in a standing position without assistance and even stand on one leg, without the use of epidural stimulation.
“We observed that in participants we have worked with so far, eight months of activity-based training with stimulation did not lead to any improvement without stimulation,” said Enrico Rejc, Ph.D., assistant professor in the UofL Department of Neurological Surgery and the article’s first author. “This participant kept training at home and, after several months, he came back to the lab and we tried a different training protocol. After a couple of months of training with the new protocol, we surprisingly observed that he was able to stand without any stimulation – with two legs and with one leg – using only his hands for balance control.”
The authors suggest that several mechanisms may be responsible for Meas’s recovery of mobility, including the sprouting of axons from above the point of injury into areas below the lesion. Another possible explanation may be that the activity-based training with scES promoted remodelling of connections among neurons in the spinal cord.
In addition, they suggest that the participant’s own effort at voluntary movement may have been a factor in the recovery. During the revised training, Meas was attentive and focused on the trained motor task, actively attempting to contribute to the motor output.
“The voluntary component of him trying constantly with spinal stimulation on and while performing motor tasks can lead to unexpected recovery,” Rejc said.
“The human nervous system can recover from severe spinal cord injury even years after injury. In this case, he was implanted with the stimulator four years after his injury. We saw motor recovery two years later—so six years after injury,” Rejc said. “It is commonly believed that one year from injury, you are classified as chronic and it’s likely that you will not improve any more. This data is proof of principle that the human nervous system has much greater recovery capabilities than expected.”
The Latest on: Spinal cord injury
- Putting a protein into overdrive to heal spinal cord injurieson March 5, 2021 at 8:04 am
Using genetic engineering, researchers at UT Southwestern and Indiana University have reprogrammed scar-forming cells in mouse spinal cords to create new nerve cells, spurring recovery after spinal ...
- Healing spinal cord injuries by reprogramming scar-forming cellson March 5, 2021 at 8:00 am
Researchers at UT Southwestern and Indiana University used genetic engineering to reprogram specific cells called NG2 glia to overproduce the protein Sox2 in mouse models of spinal cord injury. The ...
- How Clark's Botanicals' Founder Francesco Clark Turned a Life-Altering Event Into a Powerhouse Skin-Care Brandon March 5, 2021 at 5:03 am
Landing major press coverage before his line even had a name, Clark's focus on personal connection and authenticity propelled his business to the top. "What was your big break?" It's a question people ...
- NervGen Pharma Provides Regulatory Update on Development Program For NVG-291on March 5, 2021 at 4:15 am
Plans to Dose First Human Subjects in Phase 1 in Q2 2021 Vancouver, British Columbia--(Newsfile Corp. - March 4, 2021) - NervGen Pharma Corp. (TSXV: NGEN) (OTCQX: NGENF) ("NervGen" or the "Company"), ...
- Patient’s own stem cells may repair spinal cord injuryon March 3, 2021 at 2:51 am
Using a patient's own stem cells may offer a way to repair spinal cord injuries. In a new study, researchers saw improved walking and motor function.
- Levetiracetam treatment leads to functional recovery after thoracic or cervical injuries of the spinal cordon March 2, 2021 at 7:28 am
Spinal cord injury (SCI) leads to dramatic impairments of motor, sensory, and autonomic functions of affected individuals. Following the primary injury, there is an increased release of glutamate that ...
- Ryan Shazier feels “blessed,” so he helps other spinal cord patients get treatmenton February 24, 2021 at 12:36 pm
Steelers linebacker Ryan Shazier’s football career came to a sudden end when he suffered a serious spinal cord injury. But rather than viewing himself as unlucky to have encountered such a fate, ...
- New evidence stem cell therapy helps spinal injury patientson February 23, 2021 at 4:00 pm
A detailed analysis of 13 case histories has found intravenous injections of stem cells lead to substantial motor function improvements in patients suffering spinal cord injury. The research also ...
- Doctors might have figured out how to cure spinal cord injurieson February 23, 2021 at 4:00 pm
The worst type of spinal cord injuries can lead to permanent loss of sensory and motor function, meaning people will lose feeling below the region of the injury as well as movement. As it stands ...
- Scientists use patients' own stem cells to restore function after spinal cord injuryon February 22, 2021 at 3:49 pm
Intravenous injection of bone marrow derived stem cells (MSCs) in patients with spinal cord injuries led to significant improvement in motor functions, researchers from Yale University and Japan ...
via Google News and Bing News