Paralyzed Man Regains Hand Function After Breakthrough Nerve Rewiring Procedure

An anonymous reader writes "A 71-year-old man who became paralyzed from the waist down and lost all use of both hands in a 2008 car accident has regained motor function in his fingers after doctors rewired his nerves to bypass the damaged ones in a pioneering surgical procedure, according to a case study published on Tuesday."

Comments

I'm not a doctor

[Anonymous Coward]

Do surgeons not need any kind of approval to do procedures, like drugs need to be tested and approved over like a decade?

It just seems like I've heard of one or two drugs that do something like this every year, for as long as I can remember.

Re:I'm not a doctor

[Razgorov Prikazka]

A new procedure is a (usually) physical procedure on 1 single person who is consenting. If it goes wrong only 1 person is harmed (or not improving at least)
A new drug is something (bio)chemical of which the long term implications are more difficult to oversee. Aspirin is with us now since 1860 or so and still we find out new benefits and drawbacks of it. Further still, it is to be given as a treatment to a much larger set of individuals, so the potential harm done is therefore greater and thus needs more and rigorous testing before it can be deployed.
So I think (although I am not at all a medic) that therefore the consent of only the patient is enough if the applicable law's and Hipocratic oath is not broken in such matters.

Re:I'm not a doctor

[Impy the Impiuos Imp]

That's good chin-rubbing reasoning. Should it rule the day, though?

How many people would die because drugs and procedures got onto the market too fast?

Compare that to how many die because good drugs get delayed by a year or two or five or ten.

I wouldn't be so quick to jump on the FDA-saves-lives bandwagon. They could turn out to be one of the biggest mass-murders, net, in all history.

Re:I'm not a doctor

[Charliemopps]

The FDA is just an arm of the pharmaceutical companies. The majority of the people that work at the FDA either worked for the companies they regulate in the past, or will work for them after they leave the FDA. Just like most of the branches of our federal government they are corrupt through and through. Could they regulate effectively? Sure! Do they? no. Why don't they regulate "Supplements"? Why do they regulate so many rudimentary anti-inflammatory drugs that have no addictive properties at all? Why can I get enough Tylenol at a gas station to kill 10 people but my asthma inhaler I need a prescription for? Because the FDAs primary role is NOT to keep us safe. It's to keep the drug companies products scarce and drive up their price.

Re:I'm not a doctor

[Razgorov Prikazka]

I am not on any bandwagon. The above was just reasoning in a (I think) logical line. Of course the FDA has it's drawbacks and so does the NHF or any other system like it. Because it is a system. No system is without its errors.
I have some acquaintances that are physicians of some sort and this is the sort of line of thought I usually hear. So I thought that my answer would be sufficiently on-topic to answer the Parent.

Re:I'm not a doctor

[Tharsman]

Given how few drugs are meant to save lives, and most are just to make conditions bearable or alleviate temporary effects (and in most cases just to fix patient negligence that cause things like diabetes) I think more people would die due to lack of drug testing than from lack of the drugs in question.

Re:I'm not a doctor

[mcgrew]

The majority of the people that work at the FDA either worked for the companies they regulate in the past, or will work for them after they leave the FDA

Well, if I were running a drug comapny I would want someone who knows the ins and outs of the bureaucracy, and if I were running a regulatory agency I'd want to hire someone who knows the ins and outs of the industry.

Why don't they regulate "Supplements"?

Because the law doesn't allow them to. That's not the FDA's fault, that's your legislator's fault.

Why do they regulate so many rudimentary anti-inflammatory drugs that have no addictive properties at all?

Because too much aspirin or too much Naproxin Sodium can eat a hole in your intestine wall, and too much acetominaphin (which I don't know how to spell) can ruin your liver. A better question is why they're not regulating addictive drugs like alcohol and tobacco. Of course the reason is because they're regulated by the ATF (which I think should be abolished).

Why can I get enough Tylenol at a gas station to kill 10 people but my asthma inhaler I need a prescription for?

Because the asthma inhaler has steroids, and steroids can do a LOT of things to really fuck you up real good; for instance, steroid eyedrops will give you cataracts (I found this out when I was prescribed them for an eye infection and wound up getting cataract surgery in that eye as a result; it was the eye doctor that told me the steroids caused the cataract).

Get rid of the FDA and you're going to see a hell of a lot more worthless snake oil on the market, which is why the FDA was started in the first place.

Does the tinfoil hat work best shiny side in or shiny side out?

Re:I'm not a doctor

[BattleApple]

Because the asthma inhaler has steroids

I use an albuterol inhaler, and need a prescription to get it.

Re:I'm not a doctor

[Anonymous Coward]

Well, everyone knows supplements are not regulated. Since that's a known fact, you know there's increased risk with supplements. Having the FDA regulate supplements would increase the cost involved in running the FDA. That's not something we need to be doing in this economy.

Re:I'm not a doctor

[ravenshrike]

If they abolish the BATFE, who's going to give guns to the mexican drug cartels?

Re:I'm not a doctor

[mcgrew]

A little googling shows albuterol can be pretty dangerous, too.

Dizziness; headache; nausea; nervousness; sinus inflammation; sore or dry throat; tremor; trouble sleeping; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur when using Albuterol:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; ear pain; fast or irregular heartbeat; new or worsened trouble breathing; pounding in the chest; red, swollen, blistered, or peeling skin; severe headache or dizziness; unusual hoarseness; wheezing.

This is not a complete list of all side effects that may occur.

Re:I'm not a doctor

[BattleApple]

I can see why steroids require a prescription (my grandfather died in his 40's because he was over medicated with cortisone). But the warnings for albuterol sound pretty much like the warnings for any OTC medication, and they're considered rare side effects, only listed to cover their asses.

"Rarely, this medication has caused severe (rarely fatal), sudden worsening of breathing problems/asthma etc...".

http://www.medicinenet.com/albuterol-inhalation_solution/article.htm

The test is good

[Anonymous Coward]

We know it works, now we can put it to more important uses.

Hook up the weiner, he's got his viagra prescription to utilize.

Fact is becoming better than fiction

[jcrb]

Between this, the latest reports of restoring sigh with implantable photo voltaic chips and engineered nano particle drug delivery, medical science fiction is running out of subjects that are still fiction. Kurzweil's Singularity is looking more and more likely every day.

In the words of Glenn Reynolds ...... FASTER, PLEASE!!

Re:Fact is becoming better than fiction

[rrohbeck]

Sigh.

Re:Fact is becoming better than fiction

[FunkDup]

FASTER, PLEASE!!

I'm starting to get the impression that the changes associated with this singularity, while certainly amazing, are not necessarily going to be psychologically comfortable for us flesh bags. I mean, this stuff is only the beginning. Are future software beings going to look pitifully on us because we're traumatized from our world changing underneath us so many times?

Re:Fact is becoming better than fiction

[Anonymous Coward]

I plan to look down upon you people with benevolent indifference and perhaps some subtle pity. I will generally have more important things to do then think about simple humans, such as modeling the particle flow in the first seconds after the big bang in my mind space.

Re:Fact is becoming better than fiction

[mcgrew]

medical science fiction is running out of subjects that are still fiction

Indeed, compared to a modern hospital, Dr. McCoy's sick bay looks downright primitive (I journaled about this a few years ago). Some things are beyond sci-fi today. For example, in Star Trek II, McCoy gives Kirk reading glasses because he's allergic to lens softeners (we still don't have that) but a CrystaLens implant will cure age related presbyopia, as well as myopia, astigatism, and cataracts -- bus they still haven't invented them in the Star Trek 23rd century.

A gall bladder operation used to leave a six inch scar and left you hospitalized for weeks. Now the scar's half an inch or less and you may have to stay hospitalized overnight.

FASTER PLEASE indeed! When I was a kid, medicine was downright primitive. They used ether as an anesthetic, it's a nightmare trip for the patient and incredibly dangerous; it's so flammable that it's used as automotive starting fluid. I had a surgery in 2002 and the anestesiologist said "ok, you're going to sleep now." I replied, "uh, it isn't working." He laughed and said "we're done!" No nightmare trip, no post surgical nausea (ether is sickening).

However, there is some science fiction medicine I hope they don't develop. I was reading a story the other day with a drug that makes your blood deadly to anyone but you. NOT a good innovation!

Re:Fact is becoming better than fiction

[kurzweilfreak]

"Girl look at that body..."

No dexterity in the fingers

[cortex]

Pretty amazing surgery, but watching the videos shows limited restoration of function. The key is getting the transplanted/regenerating nerves to make the proper connections. The surgery is not going to re-wire the incredible number of connections made during development. Neural prostheses currently offer better dexterity and restoration of function than the nerve transplant. However, it is likely only a matter of time (maybe sever decades) before the neural re-wiring problem is solved.

Re:No dexterity in the fingers

[Anonymous Coward]

You should account for re-education. Give him some time dude.

Re:No dexterity in the fingers

[Anonymous Coward]

They can sever nerves, but to sever decades is the real trick

Re:No dexterity in the fingers

[crash123]

You have to remember that this operation probably caused nerve damage too and nerves take a ridiculously long time to heal (about 6mm per week) also the dude hasn't used his hand in four years so he has probably just forgotten how to use it too. He will have a lot of rehab ahead of him i imagine.

Re:No dexterity in the fingers

[Neil Boekend]

Don't forget: the nerves they connected the hand to were not meant to be used for this. They wired an "arm up and down" nerve to a "close and open hand" nerve. The brain can adapt and send the new data, but this takes time. Imagine the weirdness when you want to close your hand and had to lift your arm to send that signal. Now you need to learn you should only use one of the muscles involved in lifting your arm, because otherwise you'll lift your arm.

Re:No dexterity in the fingers

[Ihmhi]

Pretty amazing surgery, but watching the videos shows limited restoration of function.

I know a couple of people personally who would vastly prefer "limited restoration of function" over "no function".

Re:No dexterity in the fingers

[anerki]

It's far too early to already conclude that reqained functionality is minimal or not worth the risk.

The human nerve system could be compared to the central phone systems of a long time ago where you had an operator that would connect you (where your line inserted) to where you wanted to go by just replugging your cable.

The human or animal body does much the same. It will check what the connections are, and over time optimise them or redirect them if their function has changed.

This was proven a long time ago on some type of animal, I forgot which but it was some mammal (sadly, references are missing too), where they swapped the connections of the legs in the nerve system. It only took the dogs a couple of days to naturally adapt and they would no longer notice the difference. The same goes for the eyes btw, the connections in our brain are reversed, it's assumed that very early one babies see everything upside down (like you do in a camera, it's the same effect of lenses causing it (a lens swaps the image)) but the brain just compensates, redirects and you no longer notice it.

If for some medical reason, it swaps (and it has occured), the brain will take a couple of days to compensate and then adjust to the 'new normal'.

Hopefully for the person who underwent the surgery, he'll see an improvement soon ...

Re:No dexterity in the fingers

[Electricity Likes Me]

Conversely the brain's body map is actually incredibly malleable anyway - since it expands and contracts to deal with tools you're using and transitioning to or from. People wince when they scrape their car, because in a very real sense they feel like they hit a part of themselves.

With time (and well, it's definitely a permanent part of him) I suspect he could recover full function to the point of not needing to think about it.

Re:No dexterity in the fingers

[operagost]

I have been told that if you wear glasses that flip your vision, within a few days you'll see the correct way again. The idea of actually trying that myself is a bit intimidating!

Re:No dexterity in the fingers

[mcgrew]

People wince when they scrape their car, because in a very real sense they feel like they hit a part of themselves.

Bullshit. People wince when they scrape their cars because its resale value just dropped. You don't wince when you drop your screwdriver and it was part of your hand ten seconds earlier. You might wince if it breaks and you have to buy a new one. Nobody driving a beater cares if it gets another dent. Anyone whose identity depends on their car should be treated by a mental health professional, because that's just fucking crazy.

Re:No dexterity in the fingers

[Electricity Likes Me]

People wince when they scrape their car, because in a very real sense they feel like they hit a part of themselves.

Bullshit. People wince when they scrape their cars because its resale value just dropped. You don't wince when you drop your screwdriver and it was part of your hand ten seconds earlier. You might wince if it breaks and you have to buy a new one. Nobody driving a beater cares if it gets another dent. Anyone whose identity depends on their car should be treated by a mental health professional, because that's just fucking crazy.

Well gee, you sure showed the body of neuroscience.

Take a computer then, because the same phenomenon applies: the reason you can use a mouse proficiently is because of exactly the same process. For the duration your holding and interacting via mouse, as far as your brain is concerned it's actually an extension of your body - it's why you don't need to plan how you're going to move your hand to get the cursor somewhere.

Your screwdriver example doesn't apply, because like you said - you dropped it. It was disconnected and no longer part of you. But while you're holding it, you use it very much as though it was a limited part of your hand, and neurologically your brain doesn't really care about the difference.

You can map these types of changes with fMRI, they're very fluid and with time can eventually become fixed as well (even to the point of detriment). People who do things with their hands - say, play the piano or golf - at an elite level usually get taken out when they develop "the shakes" - which is a neurological condition that is a direct result of the over-enlargement of the region of the brain dealing with the hands, to the point that it encroaches on neighboring tissue, and basically starts receiving interference.

You may say it's because they know the resale value changed - and yes, part of that would be - but the fact they can drive and have even a passing familiarity with the boundaries and behavior of the vehicle is because neurologically, when you drive your brain reconfigures your body map to the limits of the car. The sense of familiarity you feel behind the wheel is exactly this process.

This is awesome

[Anonymous Coward]

The human body never ceases to amaze in how flexible and adaptable it is. Amazing work by the doctors.

Re:This is awesome

[Anonymous Coward]

No embryonic stem cells were harmed in the making of this operation.

Qaelia sensory mapping

[Anonymous Coward]

"The brain has to be trained to think, 'OK, I used to bend my elbow with this nerve, and now I use it to pinch' [...] it's more of a mental game that patients have to play with themselves."

I love imagining just how this would feel. Does the wiring ever become automatic and abstract in the same way that we normally come to experience motor movements(not thinking about pulling this muscle, relaxing that one, but just that we want to move our leg)? Or will he for the rest of his life feel like he is trying to move a specific forearm muscle group when he scratches his head?

Re:Qaelia sensory mapping

[durrr]

It becomes abstract and automated. Sortof like how your brain can flip your vision if you wear inverting glasses for prolonged timeperiods.

Re:Qaelia sensory mapping

[Anonymous Coward]

Yes it does become automatic and you forget over time the original function of the nerve.

  Because when you play video games you don't think move left finger down, you think strafe left - indeed you don't even think strafe left per se, it's a part of a higher level action.

Re:Qaelia sensory mapping

[Fluffeh]

If anyone was curious like me for a proper article on these upside-down glasses experiments, here is a link though be warned that it is a PDF.

Re:Qaelia sensory mapping

[Anonymous Coward]

If anyone was curious like me for a proper article on these upside-down glasses experiments, here is a link though be warned that it is a PDF.

The paper doesn't state that "(the) brain can flip your vision if you wear inverting glasses for prolonged timeperiods", it just states that the subjects adjusted to the new perception of space throught motor learning.

Gentlemen, we can rebuild him.

[Will Steinhelm]

Gentlemen, we can rebuild him. We have the technology. Better than he was before. Better, stronger, faster.

Re:Gentlemen, we can rebuild him.

[Anonymous Coward]

worse, weaker, slower but at least rebuilt
great surgery imagine it is like a more complicated nerve graft

Re:Gentlemen, we can rebuild him.

[gijoel]

I don't know there would definitely be a downside to having your hand making that whirring and eh-eh-eh-eh noise every time you masturbated.

Re:Gentlemen, we can rebuild him.

[operagost]

Not to mention the disturbing burning smell.

I had these nerve rewirings in 1998 too...

[antdude]

Reposted and updated from http://science.slashdot.org/comments.pl?sid=8937&cid=613380 ...

When I had my cranial surgery (due to my locked jaw -- had to open my jaw -- it was so bad that I couldn't stick my tongue out), the doctors had to break some nerves to fix this (from my neck and right side of my head near the ear area).

After the complex surgery, the right side of my face were unresponsive (i.e. couldn't move and feel). That included my right eye where I couldn't move my eye lids (not even close fully).

After about two months, I went to another surgery to fix these damaged facial nerves. The doctors fixed this by connecting working nerves to the damaged ones. Basically, they were rerouting these signals as if you were rerouting a network.

Some of my broken nerves are currently recovered, but it will take years to recovered almost fully (not 100%).

You can read more old details from http://zimage.com/~ant/antfarm/about/surgery/surgery.html ...

--

5/15/2012: Nope, they never recovered fully. I still can't close my right eye lid fully and can feel a little more, but still can't move fully. The feelings still funky in other areas on my head/face/neck. Heh!

I wonder how much has improved from 1998 if I had that nerve reconstruction in 2010s.

Re:I had these nerve rewirings in 1998 too...

[Anonymous Coward]

You could have been international news.

Re:I had these nerve rewirings in 1998 too...

[antdude]

I know! :( But hey, I am on /. with +5 in both places. That's good enough ;)

Cloning

[theshowmecanuck]

This would be a good candidate for cloning. i.e. clone the nerves. They don't remotely look like body parts so the average person wouldn't be so squeamish about it, and it provides enormous benefit so the public conceivably would back the research. And... it would give scientists the room to figure out how to clone other body parts in immune system agnostic ways for when people would buy into growing a new foot.

Re:Cloning

[Rosco P. Coltrane]

How is cloning gonna help anything? The problem isn't obtaining nerves, it's connecting them.

Think of it like this but at microscopic level, and with no labels on the cables to figure out what should be connected to what.

Re:Cloning

[theshowmecanuck]

Of course obtaining nerves is a problem. To get them you have to take them from somewhere else. They have to disable one part of your body by removing a nerve connection to use it at another point. Granted the ability to walk is more important for most people than being able to say move your arm normally. But why should we have to compromise? I can tell you from experience that having one part of your body, even part of a limb not working right sucks like hell. And cloning removes the problem of rejection. And rejection would be a problem if they tried to use donor nerves (if it's even possible).

Excellent news

[Anonymous Coward]

The prayers were answered! ... Uhh... wait, no.
Science, not others, scores.

I knew a guy

[Anonymous Coward]

I knew a guy who tempted fate and jumped into a swimming hole from a railway bridge. It was only about 20 feet down to the water, and the boulder was only 4 inches below its surface. He has use of part of the muscles in one shoulder (otherwise a quadriplegic). This would really help him. He isn't that old. Problem though: he was a dare devil before his accident. He wouldn't think twice of jumping into a Chevy truck with a 350 V8 engine, and hammer on the gas on an icy winter road, then stomp his foot on the emergency brake and see how many donuts he could do on the icy highway at 80 miles per hour. If he got this surgery, would he go back to his death defying ways, and would he kill himself, or worse, someone else, or worse, both himself and someone else if he gets this procedure?

I'm guessing he sucked on some fetuses...

[luke923]

Seriously, any time I hear of stuff like that, I think it's gotta suck for Christopher Reeve now.

And only then he hugged his wife.

[Impy the Impiuos Imp]

> Paralyzed Man Regains Hand Function After Breakthrough Nerve Rewiring Procedure

And, yes, "that" was the first thing he did.

Mesh network

[digitalsolo]

The adaptability of the nerve network in the human body really does amaze me. I'm glad to see that we're (as in humanity) making some steps toward resolving paralysis. The concept of being trapped in my own body has always been somewhat chilling to me.

Forget the hand and legs doc

[Anonymous Coward]

You know what I want wired back up first!!

Prior art - already done

[Anonymous Coward]

old news

this was already done ages ago -> Jesus heals the paralyzed man

They fixed his hand?

[mr.mctibbs]

He's paralyzed from the waist down. Have a mercy, folks, and get his penis working first.