Non-Invasive Spinal Cord Stimulation Gets Paralyzed Legs Moving Again

schwit1 writes: A new technique called transcutaneous stimulation has allowed five men with complete motor paralysis regain the ability to move their legs voluntarily and produce step-like movements. The treatment requires no surgery and adds to prior work to help paralyzed people gain voluntary movement through electrical stimulation (one completed in 2011, the other in 2014). Gizmag reports: "The new treatment uses a technique called transcutaneous electrical nerve stimulation, which involves strategically placing electrodes on the skin of the lower back. While receiving stimulation, the men's legs were supported by braces that hung from the ceiling. At first their legs only moved involuntarily, if at all. But they soon found they could voluntarily extend the distance their legs moved during stimulation. They doubled their range of voluntary motion after four treatment sessions."

Comments

Looks promising

[The Real Dr John]

They have more work to do but this looks quite impressive considering. The patients had slight movement before the treatment, so there were functioning fiber connections, but the ability was minimal. After treatment, there was much greater control. An excellent start on getting this to work with some patients.

Re:Looks promising

[dinfinity]

The patients had slight movement before the treatment, so there were functioning fiber connections, but the ability was minimal

I'm not seeing that anywhere in TFAs. In fact, the term "complete motor paralysis" is mentioned several times. Where did you get that from?

Re:Looks promising

[The Real Dr John]

The video linked to at the bottom of the article showed very slight movement when their legs were tethered to keep them suspended. It was very minimal, and would not be usable for any actual movement. But it indicate that some nerve fibers must still have been connected.

Re:Looks promising

[dinfinity]

I hadn't looked at the video yet, and you are right.

It does seem like information significant enough that it should be included in the text of such an article. Thanks for including it via the comments, +1 Informative.

Re:Looks promising

[sumdumass]

Are you sure that isn't what they were considering in the article summery "At first their legs only moved involuntarily, if at all. But they soon found they could voluntarily extend the distance their legs moved during stimulation."

I guess when the device is first connected, there is random movement. The patient then quickly builds the ability to control and extends this movement. But I'm under the understanding it is due to the process not the patients themselves.

Re:Looks promising

[dinfinity]

I thought that might have been the case as well, but it says 'Voluntary oscillation' in pretty big letters in the video right before the movement is shown.

Re:Looks promising

[rtb61]

Keep in mind their legs still have a connection to their spinal cord and hence limited reflex actions are still in place. That bundle of nerves in the spinal cord, seeds specific kinds of signals from specific locations, so forget some connections being able to be used for other thing. So like when people suffer spinal damage and lose strength. They loose strength because they are only communicating with some of the muscles fibres in some muscle clusters and they are doing all the work whilst the rest do nothing. They gain strength over time not so much because of nerve cell regrowth but because muscles fibres doing nothing shrink away and muscle fibres doing all the work, a huge amount of work are stimulated to grow, this of course takes quite some time.

Re:Looks promising

[CaptQuark]

Transcutaneous electrical nerve stimulation (TENS) units are not new. I have been using one for 10 years to control lower back pain (with mixed results). What is interesting in this study is using a TENS unit with patients with complete motor paralysis to help rebuild/retrain nerve connections allowing them more voluntary control of their lower extremities.

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Re:Looks promising

[JimSadler]

This may be better than it sounds at first. Maybe a learning process can result in which the damaged nerve can improve the ability to communicate with the brain and tissues required for controlled movement. And if all else is of little value it might provide a good way to exercise the lower body to maintain strength and circulation in the tissues. So maybe what we have is to be considered on a scale with good at the bottom point and fabulous at the top point of the scale. I do wonder if some stem cell nerve tissue sort of thing could not be added in parallel with the existing nerve to enhance the neural pathway or why it is so difficult to do such things.

Re:Looks promising

[sysrammer]

My wife is a candidate for SCS right now, or some type of spinal fusion. She wants to avoid the fusion, of course, but is not sure that SCS is worth the trouble. One Dr. made a comment that doing SCS first can make it more difficult to do a fusion later if it doesn't work. We're following up on that.

When you say "mixed results", is it a case of sometimes it works, sometimes it doesn't? Is it predictable as to when it might work and when not?

thx, sr

Re:Looks promising

[Jane Q. Public]

I was going to the same thing. I have a medical TENS unit that is probably 30 years old.

The electrodes have improved. Not much else.

Re:Looks promising

[CaptQuark]

Mixed results for me means some days the TENS unit will help me feel less of the pain in my back and some days it just feels like electricity zapping me through the electrodes. I can vary the frequency and duration of the pulses and sometimes this helps too. It does seem to help during long drives if I use it intermittently.

I have also tried it on plane flights with limited success, perhaps because I can't stretch as well between applications. I haven't had any problems going through airport security with my unit but I have heard of others that have been questioned by TSA about theirs.

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Re:Looks promising

[sysrammer]

Ok, thanks for your reply.

Re:Transplant?

[Anonymous Coward]

Yes! It was delicious!

Re: Transplant?

[Anonymous Coward]

The article states that the treatment required no surgery I would say no.

Re: Transplant?

[GrantRobertson]

An injection is not normally considered surgery. Stem cells are often merely injected into the target site.

Just saying.

Great except for one thing

[p51d007]

What about someone who has a spinal cord injury?

I've always wondered...

[Anonymous Coward]

If the spinal cord was broken/damaged, what's stopping us from attempting to 'bypass' the break and send the signals down the rest of the cord?

I mean, there would be a slight lag between moving your toes and your toes actually moving when converting the signals, but surely this is better than nothing?

Limited Usefulness

[spineboy]

Unfortunately, these types of devices will always be of limited usefulness for most pre-existing spinal cord patients. Why? - because after only a few months, most muscles have had permanent wasting, and joints have begun to contract, often permanent as well. Bones have undergone significant disuse osteopenia. Unless the patient has Christopher Reeve type resources, then the day to day intensive PT to mobilize limbs does not occur.

Even in young healthy patients, even having a cast on for 2 months results in permanent muscle loss.

Br J Sports Med. 2006 Jun; 40(6): 552–553.
doi: 10.1136/bjsm.2005.020743
PMCID: PMC2465116
Calf muscle wasting after tibial shaft fracture
M Khalid, A Brannigan, and T Burke

Re:Looks promising-Paradigm shift

[Anonymous Coward]

Sub: spinal cord stimulation-
It is a welcome trend and paradigm shift in practice. Add Bio-Energy Aura .