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A combination of electrical stimulation of the spinal cord and physiotherapy helped two men with incomplete paraplegia walk a little further. one-third needed a walking cadre. This is demonstrated by a study by Fabien Wagner et al., Who appeared in Nature. The head of research was Grégoire Courtine, a Swiss expert in the field of nerve damage and paraplegia.
Three men participated in the experiment: one could not move both legs, the other had the left leg paralyzed and the third could not move the legs so that walking is still possible. All three, a probe was placed in the spinal cord to activate the control of the leg muscles; in addition, patients received a pacemaker and foot sensors. These sensors feed the pacemaker, which then sends an electrical signal to the implant. The combination of this stimulation and gait training also contributes to the repair of the damaged nerves, so that the muscles can eventually contract without stimulation. There is no constant electrical stimulation, as in previous experiments. In animals, that is to say, according to a publication of the same research group in Nature Neuroscience (Emanuele Formento et al.): Epidural electrical stimulation (ESR) of the nerves of the spinal cord restores the ability to walk in rats with partial lesions of the spinal cord. The fact that people do not work in this way is probably due to interference between continuous EES and proprioceptive information. In the Nature study, patients must first (want to) initiate a movement themselves; so there must be a "walking pulse" – from where the foot sensors – followed by electrical stimulation. In fact, the system works as a kind of amplifier.
The theory is correct. At least a week later, patients could take action in this way. This form of stimulation allowed to regain control of their muscles, even in the absence of stimulation. In other words, some essential functional compounds have been restored to the brain and spinal cord. 35-year-old Gert-Jan Oskam (Sint Maartenskliniek, Nijmegen) was paralyzed by partial paraplegia seven years ago. He can now walk 80 meters on crutches in 6 minutes.
Important point of view: this is a concept validation study carried out on a subgroup of patients, some of whose nerves are still intact. Researchers need to fish much deeper which has helped the (partial) recovery of two of the three patients. Many seem to depend on the amount of sensory information that the damaged spinal cord can transmit to the brain. The question is also about how permanent recovery is and, of course, whether this approach can also be applied to larger patient groups.
Targeted neurotechnology restores walking in men with spinal cord injury
Electrical stimulation of the spinal cord must preserve proprioception to allow locomotion in men with spinal cord injury [19659007] Related:
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