The latest news and information about what's going on with SCI science and research. Brought to you by Sam Maddox, author of the Christopher & Dana Reeve Foundation Paralysis Resource Guide.

Stimulation News: Four For Four

Quite the research story broke today, and I’m sure you’re not hearing this first from me: Four paraplegics who had no ability to move anything below their spinal cord injury level were able to voluntarily move their legs. Go here for more (read the full paper from Brain, plus FAQs, patient and scientist bios, etc.).

Each of the four young men was fitted with an implanted stimulation unit placed over the lower spinal cord; when the stimulator was activated, nerve networks in the spinal cord were reanimated.
Of course there have been numerous media reports today.
NBC News
CNN  -- wherein lead researcher Susan Harkema, Ph.D. of the University of Louisville shares her “holy s**t,” moment, when patient number one, Rob Summers, first moved a toe voluntarily. From that report:
Harkema says she hopes to have more "holy s**t" moments in her research. "I'll never live that down, and now it's the mantra of the lab," she says with a laugh.
Nothing more for me to add except an underscore of a couple of points. First, this set of experiments shows that the unprecedented Rob Summers recovery three years ago was not a fluke. The scientists are four for four.

It also shows convincingly that the ages-old pronouncement to so called completely injured people that “there’s nothing we can do for you,” simply doesn’t hold water any more. Two of the four in this study were ASIA A -- no motor, no sensory. The results don’t mean every new injury now gets a stimulator unit. It means that every person with a spinal cord injury should get, at the minimum, a course of rigorous physical therapy and the presumption that recovery is possible.
Another point: the Brain paper was all about voluntary movement. We know from what the four guys in the study have been saying that they got a lot more than that back; they all got a ton of autonomic recovery. That includes bowel, bladder, sexual function and temperature control. The autonomic data, the research team says, is not yet locked down enough for publication, but will be fairly soon.
What’s next: Harkema and lead author Claudia Angeli, Ph.D., told me they have the funds now to enroll eight more patients. Four will mirror the first four as closely as possible (age, time since injury, etc.). The other four will be tested for response to epidural stimulation on cardio function. This derives from one of the first four patients, Andrew Maes, who had blood pressure issues related to autonomic dysreflexia. Significantly, when the stim was on his BP normalized. If this cardio application can be more widely demonstrated, that’s going to be a much clearer path to the clinic than voluntary movement alone.
To be sure, getting a device approved and covered by insurance won’t be easy. More than eight more patients will have to be tested. Moreover, the research group knows the Medtronic device they are now implanting is super suboptimal. There are efforts underway to create and market new stimulation devices, primarily by a team from UCLA, Cal Tech and the University of Louisville. A California company, NeuroRecovery Technologies, has obtained the rights to the intellectual property from the three universities.
Posted by Sam Maddox on Apr 8, 2014 11:19 PM America/New_York