Three paraplegics go back with wireless implants in the cord

Three paraplegics go back with wireless implants in the cord https://i1.wp.com/www.eresviral.com/wp-content/uploads/2018/11/Tres-parapléjicos-vuelven-a-andar-con-implantes-inalámbricos-en-la-médula.jpg?fit=219%2C146&ssl=1

Three paraplegics go back with wireless implants in the cord







Grégoire Courtine, a renowned neuroscientist at the Federal Polytechnic School of Lausanne (EPFL), has spent years researching how to get people with damaged spinal cord back on track. He has previously demonstrated his advances in monkeys and rats.



Now, in collaboration with neurosurgeon Jocelyne Bloch, of the University Hospital Center of Vaud, has managed to three paraplegic men can walk with the help of crutches or walkers thanks to wireless implants in the cord, which can be activated and deactivated by a device in the form clock that obeys the voice of the user. The results of the research appear today in two studies in the journals Nature and Nature Neuroscience.



As Courtine points out, unlike the findings of two other independent papers, recently published in Nature Medicine and in Nature Reviews Neurology, on a similar concept, "we have shown that neurological function persisted beyond training sessions, even when deactivated the electrical stimulation. "



"Our findings are based on a deep understanding of the underlying mechanisms we obtained during years of research in animal models. So we could imitate in real time how the brain naturally activates the spinal cord, "says the neuroscientist.







David Mzee, who was totally paraplegic after sports accident, takes a few steps. (Photo: EPFL / Jean-Baptiste Mignardot)



For her part, Bloch, who was in charge of surgically placing the implants in the patients, points out that when she saw that the three of them could walk with the help of support systems within a week, she knew that they were on the right track.



Courtine indicates that "the exact moment and location of the electrical stimulation are key so that the patient can produce the desired movement. It is also this temporal coincidence that triggers the growth of new nervous connections. "



To administer electrical stimulation, the team used motor neuron activation maps and models to identify optimal patterns in different muscle groups. The stimulation was produced by a pulse generator controlled in real time by wireless communication, and timed to coordinate it with the expected movement.



A few days after starting the treatment, the patients began to walk on a treadmill and on the floor with the help of smart harnesses (while receiving stimulation). They were able to adjust the elevation of their steps and the length of the stride. Over time, they managed to walk on the tape for an hour.



In subsequent rehabilitation sessions, the three participants were able to walk with their hands free for more than a kilometer with the help of directed stimulation and harnesses.



These long and high intensity sessions were crucial to trigger the plasticity, the intrinsic capacity of the nervous system to reorganize the nerve fibers, which leads to a better motor function. After months of training, patients were able to voluntarily control the muscles of their legs without the need for electrical stimulation and take some steps on their own with their hands free, the authors point out.



In previous studies with more empirical approaches, such as continuous electrical stimulation protocols, it had been shown that some people with paraplegia could walk with the help of support and stimulation systems, but only in short distances and whenever the stimulation was activated. As soon as it was deactivated, the patients returned to their state of paralysis.



"We have achieved an unprecedented level of accuracy," says Bloch. "Directed electrical stimulation should be as accurate as a Swiss watch. In our method, we implanted a series of electrodes on the spinal cord that allow us to target individual muscle groups in the legs. The selected configurations of the electrodes activate specific regions of the marrow, imitating the signals that the brain would emit to give the order to walk, "highlights the neurosurgeon.



The challenge for the patients was to learn to coordinate the intention of their brains to walk with specific stimulation, but that did not take long to happen. "The three participants managed to walk with body weight support after a week, and voluntary muscle control improved greatly within five months of training," says Courtine. "The nervous system responded much better than we expected to treatment," he concludes.



The start-up GTX Medical, co-founded by Grégoire Courtine and Jocelyne Bloch, will use the new findings to develop tailored neurotechnology with the aim of converting this rehabilitation paradigm into a treatment available in hospitals and clinics around the world.



"We are building next-generation neurotechnology that will also be evaluated very soon after the injury, when the recovery potential is high and the neuromuscular system has not yet suffered the atrophy that follows chronic paralysis. Our goal is to develop a widely accessible treatment, "says Courtine. (Source: SINC)

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