Targeted neurotechnology restores walking in humans with spinal cord injury

Mindy Sparks
November 2, 2018

The pulses are produced by an implant placed over the spine in careful alignment with areas that control the muscles in the lower body.

"Not so long ago, the hope that someone paralyzed for years by a severe spinal-cord injury would ever be able to walk again was just that - hope", the journal said in an editorial about the new research.

The study, called STIMO (STimulation Movement Overground) - led by the Ecole Polytechnique Fédérale de Lausanne (EPFL) and the Lausanne University Hospital (CHUV) and scientists Grégoire Courtine and Jocelyne Bloch - saw the patients involved recover voluntary control of leg muscles with neurological function shown to continue beyond training sessions, even after electrical stimulation was turned off.

A man with a spinal-cord injury leaving him wheelchair bound has been able to walk thanks to a revolutionary new spinal implant.

An unfortunate result of spinal cord injuries is that nervous system communication can become severely disrupted, resulting in the loss of neurological functions and ultimately, paralysis. All the participants continued to improve during the five-month course of the study, Courtine says.

The other two men who have successfully walked after the implant was inserted are Gertan Oskan, a 35-year-old man from Netherlands who had had a road traffic accident seven years back and Sebastian Tobler, a 48-year-old German who had had a cycle accident a few years back.

Previous trials have used so-called continuous electrical stimulation of the spine, which worked well in rats, but produced less impressive results in humans. "It doesn't need the brain to walk", Oxley said. 'Stimulators cause the nerves to fire in both directions: a natural direction but also backwards, like going down the wrong way on a one-way street, ' Moritz says. "I was like, should we enroll this participant?"

"I think you have to try and do the impossible to make the possible, possible", Mzee said, "and I think we're doing that and it feels good".

Dr Gustin, meanwhile, cautioned the new treatment was not a miracle cure - and the patients in this first trial all had incomplete spinal cord injuries, which means they had some surviving neural pathways between the brain and spinal cord. "Our goal is to develop a widely accessible treatment", Courtine said.

However Professor Courtine warned the new treatment was not a "magic pill" for people with spinal cord injuries.

"We provide the tools to help the brain help itself, and then the rest is in the hands of our patients."
All movement was under voluntary control; EES doesn't generate movement on its own.

"Some of the people who come into the experiments here in Australia will be seeing recovery that they never thought was possible", he said. Scientists in Switzerland developed a spinal implant that's helping paralyzed people walk again. When an injury interrupts the connection between the spinal cord and brain, it prevents signals from reaching below the site of the injury, EES can help to bridge the gap by providing electrical signals to the spinal cord below the injury site. And so the researchers set about understanding how the nervous system responded to movements in every joint in healthy individuals, building up a "map" of what these activation patterns looked like.

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