New research is suggesting that treatment for spinal cord injuries could now seek to eliminate the need for invasive and high-risk surgery.
The treatment, called transcutaneous stimulation, acts to deliver an electrical current to the spine through electrodes placed on the outside of the lower back.
A recent trial saw five paralysed men utilise the treatment which lead to a steplike movement occurring in all patients. The electrodes were administered whilst each patient had their legs suspended in braces hung from the ceiling. This enabled the electrodes to work by taking advantage of the lack of resistance from gravity.
“These encouraging results provide continued evidence that spinal cord injury may no longer mean a lifelong sentence of paralysis, and support the need for more research,” said Dr. Roderic Pettigrew, director of the National Institute of Biomedical Imaging and Bioengineering.
Whilst the study is an extension of an earlier trial that focussed on inserting electrodes under the skin at the base of the spine, this trial hopes to implement the same ideas without the need for surgery.
“The potential to offer a life-changing therapy to patients without requiring surgery would be a major advance; it could greatly expand the number of individuals who might benefit from spinal stimulation. It’s a wonderful example of the power that comes from combining advances in basic biological research with technological innovation,” said Pettigrew.
The men who took part in the study had all been paralysed for at least two years. As part of the trial, they all underwent 45-minute transcutaneous stimulation sessions every week for 18 weeks. Whilst being instructed to either try to move their legs or remain still, the men also received extra conditioning, where their legs were moved for them in a steplike pattern.
In combination with this therapy, the participants were also given the drug buspirone – which acts like serotonin and has been shown to effectively promote movement in mice with spinal cord injuries.
At the beginning of the trial, movement only occurred if the stimulation was strong enough to encourage involuntary movements in the patients. After four weeks of both therapy and physical training, the range of motion doubled while receiving the treatment.
When the results were being compared against electrical signals between the leg muscles and the brain, the stimulation was seen to be evidence that communication was improving.
“It’s as if we’ve reawakened some networks so that once the individuals learned how to use those networks, they become less dependent and even independent of the stimulation,” said the study’s leader, V. Reggie Edgerton.
Findings from the study were published July 30 in the Journal of Neurotrauma.