Paralysis Patients Move Again in Shocking Breakthrough

An accidental discovery is giving four paralyzed men a new lease on life. During experiments with paralysis patients that entailed electrically stimulating their nerves, a neuroscientist made a shocking discovery when a patient made a breakthrough that allowed him to move his legs again. While none of the four men have regained the ability to walk, the fact that they have regained substantial lower body functioning is astonishing to researchers.

The breakthrough came about through an accidental discovery. Neuroscientist Susan Harkema was conducting research on the nerve pathways of patients with paralysis. One day, to her great shock, the electrical stimulator she was using allowed a man paralyzed below the neck to move his toes.

For a total of five years, Harkema and her team worked with four different men with paralysis, and all of them regained significant abilities. While they have not regained the ability to walk, they can pull themselves into sitting positions without support, and lift their legs and move them. Rob Summers, the original patient, has regained the ability to stand.

Summers says that the electrical stimulator treatment has changed his life in dramatic ways. He has regained a great deal of movement and sensation, and he is now able to travel and live in a more independent fashion. Summers is not alone: patient Dustin Shilcox said the device has greatly improved his bladder and bowel functions, and his sexual function.

The breakthrough has come as a shock to scientists, because the way in which it has allowed patients with paralysis to move again overturns previous ideas about how the spinal cord works, and how it is damaged in those who are paralyzed. Researchers now think that the treatment works by effectively retraining the nerves that it stimulates, teaching them to work with the brain. Harkema has come to the conclusion that the spinal cord has the ability to, in effect, decide to move on its own.

Previously, scientists thought that repairing injury to the spinal cord would require the re-growth of neurons, or else their replacement with stem cells. Electrical stimulation proves that this is not necessary. This is a very fortunate discovery for patients with paralysis who wish to regain functionality, given the difficulties and impracticalities encountered with the other two approaches.

The electrical stimulator is a device about the size of a pacemaker, which is implanted under the skin of the abdomen. It sends electrical pulses to the spinal cord. The fact that it doesn’t actually touch the brain, generally held to be the source of motor activity, is why it was so shocking when the electrical stimulation allowed the men to overcome their paralysis enough to move again. The stimulator was originally developed to treat chronic pain.

Electrical treatment with the stimulator does have limits. None of the men have regained the ability to walk, at least not yet. The stimulator can only allow one leg at a time to function. Still, the difference has been very dramatic for the four men, and examinations have revealed that they are healthier overall, thanks to improvements to heart and respiratory function.

However, scientists believe that electrical stimulation treatment could be an important part of a broader approach to treating paralysis. The four men in question were all believed to have been “hopeless” with respect to overcoming their paralysis, and the treatment has already proved this to be in error. Harkema and her team are already recruiting another four volunteers for a second round of testing with the device.

Harkema and others believe that these shocking breakthroughs offer a great deal of hope for helping other patients with paralysis who have been told they will never move again. According to these scientists, it may be possible to improve the electrical stimulation technology, and other techniques could be developed to work in combination with it. In the meantime, the four patients with paralysis have all reported that the treatment has greatly enhanced their quality of life.

source: Liberty voice

Bangalore hospital treats paralyzed patients with stem cell therapy

In what could signal a leap forward in the treatment of spinal cord injuries, the Bangalore Institute of Regenerative Medicine at Live 100 Hospital claims to have successfully used stem cell therapy to restore feeling to people paralysed by injuries, accidents or natural causes.

According to the hospital, its doctors have been treating paralysed below the neck patients using the concept of regenerative medicine and stem cell therapy for quite some time before making the results public. The patients who benefited by the treatment walk out of the hospital using a crutch or walker, with some showing “tremendous improvement”.

Balakrishan Baldev, 42, had been bedridden for the last ten years on account of damaged spine and wrong treatment. The first patient to be benefitted by the stem cell therapy, his eyes glistened with tears as he walked again after he underwent the surgery of spinal cord in May this year and has gained 95 per cent sensation. The development raises the possibility that spinal injury victims could walk again.

Dr H N Nagaraj, chairman and managing director, Live 100 Hospital, told India Medical Times, “The concept of regenerative medicine was started by me way back in 2002 in a laboratory environment until 2010. We started treating patients in 2010 and approximately 40-42 patients have undergone stem cell surgery since then. The results have been satisfactory and few have recovered to a great extent. While it might take less time for some, for others the healing and regeneration could take a long time.”

“As the spine injuries lead to acute loss of spinal cord vascularity and damage spinal cord, we identify and treat them using great precautions that repair the patients’ spinal cords and encourage the cords to heal,” he said.

“The hospital receives patients from different parts of the country and the world. People from Pakistan, Mexico and Yemen have been pouring in for the treatment. The conception that the treatment is expensive is not entirely true. As the treatment gives you focused therapy, a patient does not spend his money on wrong and unnecessary treatments hence every penny spent is worth the results he get. But still, at our hospital, we do take into account the income factor of the patient and do give subsidy to the needy. Our objective is to help everybody,” he added.

The therapy has also given a new lease of life to Khalid Abdullah, a 40-year-old soldier from Yemen who underwent a surgery of the spinal cord at the hospital after a bullet hit him four years ago. Before choosing India, he had visited several countries for the treatment. Paralysed waist down, he partly regained sensation in the legs after the surgery.

“Two levels of his spinal cord were crushed, a part of the spinal cord was removed in the surgery as it was damaged. He underwent stem cell treatment six months ago and has regained sensation in his lower limbs,” Dr Nagaraj said.

“My future plan is evolve the stem cell therapy and regenerative medicine in a fully functional department and involve some of the finest doctors in the field. We want to use stem cell for the treatment of other diseases too like diabetes etc. We want to make a strong team of doctors that would also include a neuro psychiatrist as the patients affected by trauma are generally disturbed and have a tendency to go into depression,” Dr Nagaraj said.

Several breakthrough researches in this area have corroborated that stem cells can develop into replacement cells for damaged organs or body parts. Unravelling the potential that stem cells hold, an answer to several diseases that are at present incurable could be discovered.

source: Twikle

Tongue controller for the paralyzed offers greater independence

In an advance that promises to improve the lives of the more than 250,000 people in the United States who are paralyzed from the neck down, researchers announced on Wednesday that they have developed a wireless device that operates specially rigged chairs by means of a tiny titanium barbell pierced through the tongue.

Merely by moving their tongues left or right across their mouths, essentially using it as a joystick, paralyzed patients have been able to move their motorized wheelchairs, as well as computer cursors. Tapping tongue against cheek, quickly or slowly, controls the chair’s speed.

The advance “is more than just a wheelchair control,” said Jason Disanto, 39, who has been paralyzed from the neck down since a 2009 diving accident and tested the device. “It’s an independence system.”

The innovation is especially meaningful for the most seriously paralyzed. Tetraplegics cannot use a joystick to operate their wheelchairs, as people with less severe paralysis can, and in many cases cannot even use voice commands: their voices are often so weak that recognition systems work poorly or not at all.

Even more advanced assistive technologies fall short. Brain-computer interfaces (BCIs), which translate brain waves from the scalp into electrical signals that move a motorized wheelchair or computer cursor, require intense concentration, have slow response times and are vulnerable to electronic interference. The implantable versions are more reliable but can damage brain tissue.

The most popular technology for operating a motorized wheelchair, called sip-and-puff devices and based on inhaling or exhaling into a tube, offers only four commands – forward, back, left and right—and is also slow and cumbersome.

Way faster, way more agency

Engineer Maysam Ghovanloo of the Georgia Institute of Technology in Atlanta thought he could do better. About five years ago he and his colleagues began developing the tongue-based system. An early version used magnets glued to the tongue, but they fell off. Dr Anne Laumann of the Feinberg School of Medicine at Northwestern University, a co-author of the new paper, had an idea: use piercing to anchor the magnets in place.

The device they came up with is a small magnetic barbell, which creates a magnetic field in the mouth. When users flick their tongues, it alters that field. The change is picked up by four small sensors on a headset with twin extensions curving around the cheeks, and relayed wirelessly to a smart phone, computer or iPod. The software translates the signals and sends them to a powered wheelchair or computer.

For the new study, published in Science Translational Medicine, Ghovanloo and his team tested the tongue system on 11 tetraplegia patients from rehabilitation centers in Chicago and Atlanta and 23 able-bodied volunteers who already wore tongue jewelry.

After just 30 minutes of training, everyone was able to move a computer cursor, clicking on targets on a laptop screen, playing video games and dialing phone numbers. Accuracy and speed improved with practice, even though subjects used the system only one day a week. After six weeks the tetraplegics were, on average, three times faster with the tongue system than with sip-and-puff, which six of the 11 (including Disanto) had been using. It was equally accurate.

Using only tongue movements, the volunteers also navigated a powered wheelchair through a 50-meter-long course with 13 turns, 24 obstacles and occasional alarms signaling “Stop! Emergency!” Here, too, on average the 11 tetraplegics drove the course three times faster with the tongue system than with sip-and-puff, and just as accurately.

“The learning was very, very fast,” Ghovanloo said. “There was a huge improvement in performance from the first session to the second.”

To Disanto, an electrical engineer, the appeal of the system is aesthetic as well as functional.

“With all the equipment that’s in my face” with the sip-and-puff system, “people saw that and not me,” he said.

The tongue system is a vast improvement, but he encouraged the researchers to go even further, and they have: they are developing a version that dispenses with the headset and instead fits inside the mouth, like a retainer.

The tongue system’s ability to operate numerous devices also promises more agency, Disanto said. He currently uses a voice-recognition system and a “head mouse” (an optical sensor that translates head movements into cursor movements) to use his computer, “but this is going to allow people like me to use one system instead of multiple ones,” he said. “I’ll be able to drive my wheelchair and connect to my computer seamlessly, and eventually connect to home devices, using it to work lights, curtains, TV and heat. I’ll be more independent.”

Those home systems already exist, with many smartphones offering apps that control home appliances, lights and heating-and-cooling systems.

“This is another example of how the field of rehab engineering and assistive devices is continuously evolving and benefiting from incorporating the emerging new technologies,” said Dr Daofen Chen, program director at the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health.

The researchers plan to test the tongue system “using Atlanta as our laboratory,” said Joy Bruce, manager of spinal cord injury at the Shepherd Center, a rehab center in Atlanta where the study was conducted. “We’ll see if patients can use it to navigate in the community – taking the bus, going to work and doing other things they haven’t been able to.”

Ghovanloo’s startup company, Bionic Sciences, is working with Georgia Tech to commercialize the barbell device. The $1 million he got from the 2009 economic stimulus bill is gone, and government science funding has plummeted, so Georgia Tech is setting up a website and planning to use social media to raise money. If Ghovanloo gets the funds, he hopes to test the system in the streets of Atlanta next year

Source: GMA News

New treatment ‘could help spine injury patients walk’

Scientists say they have discovered that breathing low oxygen levels in short bursts could help improve the mobility of people with spinal cord injuries. This is according to a study published in the journal Neurology.

Spinal cord injury (SCI) is defined as disruption to the nerves attached to the spinal cord in the back. When the nerves are damaged, this can lead to reduced feeling in the body and loss of mobility, such as the inability to walk.

According to the National Spinal Cord Injury Statistical Center (NSCISC), there are approximately 12,000 new cases of spinal cord injury in the US every year.

Randy D. Trumbower, of Emory University in Atlanta, GA, and a study author of this most recent research, says that around 59% of all spinal injuries are incomplete. This means damage to the spinal cord is not absolute, so there is potential for the spinal cord to recover.

“Unfortunately, usually a person affected by this type of spinal injury seldom recovers the ability to walk normally,” Trumbower adds.

But the investigators believe their new research may give promise to those who have lost mobility as a result of spinal cord injuries.

Patients exposed to hypoxia treatment

To reach their findings, the investigators analyzed 19 individuals who suffered spine injuries between levels C2 (in the neck) and T12 (in the thoracic vertebrae) of the spine.

Participants had no joint shortening, some controlled ankle, knee and hip movements, and they had the ability to walk a minimum of one step without human help.

The subjects were split into two groups. In the first group, nine people were exposed to either hypoxia – short periods of breathing low oxygen levels – or a sham treatment (control treatment) in which they received only normal oxygen levels. After 2 weeks, they received the other treatment.

The hypoxia treatment involved subjects breathing low oxygen levels through a mask for 90 seconds, followed by 60 seconds of normal oxygen levels, and they were required to do this for 40 minutes a day for 5 days.

The second group received either the hypoxia or sham treatment, then they were asked to walk as fast as they could for 30 minutes within 1 hour of the treatment. They were also switched to the other treatment 2 weeks later.

The researchers monitored the participants’ walking speed and endurance before the study began, on the first and fifth days of treatment, and 1 and 2 weeks after treatment ceased.

Endurance ‘increased by 250%’

The findings revealed that on a 10-meter walking test, participants who received the hypoxia treatment walked an average of 3.8 seconds faster, compared with when they breathed only normal oxygen levels.

On a test of how far subjects could walk in 6 minutes, those who received the hypoxia treatment plus walking increased their endurance by an average of 100 meters – a 250% increase, compared with those who received sham treatment plus walking.

Overall, it was found that all participants showed improved walking ability. In detail, over 30% increased their walking speed by a minimum of 1/10 of a meter per second, and 70% increased their endurance by at least 50 meters.

In an editorial linked to the study, Michael G. Fehlings, of the University of Toronto in Canada, hypothesizes how the hypoxia treatment may work:

“One question this research brings to light is how a treatment that requires people to take in low levels of oxygen can help movement, let alone in those with compromised lung function and motor abilities.

A possible answer is that spinal serotonin, a neuro transmitter, sets off a cascade of changes in proteins that help restore connections in the spine.”

The investigators warn that chronic or sustained hypoxia should only be carried out by trained individuals within a supervised medical environment, or it could cause serious injury

Source: Medical News today