A study is being conducted at the Swiss Federal Institute of Technology in Lausanne, Switzerland (EPFL) that will provide paralyzed individuals with spinal implants. According to the study which was published on Wednesday by Nature, many participants with lower body paralysis were able to walk after their experiment (albeit with crutches and a walker).
For the majority of the study participants, taking steps is slow and difficult and most still ride wheelchairs to get around. However, a surprising result was that even with the stimulator turned off, most of the participants could take a handful of steps with crutches and move joints that had been immobile before. It shows that through the use of electrical stimulation and training, the spinal cord can have control over paralyzed muscles, even a decade after an injury.
The study is led by associate professor at EPFL, Gregoire Courtine, and is the third small study in the past month to show similar results. They have prompted questions as to whether we should implement these spinal stimulation devices into common medical practice. However, many experts say that medical professionals should exercise caution. Reggie Edgerton, a professor of biology at USC in Los Angeles and the co-author on one of the three recent studies, said:
“If we rush too fast, there’s going to be mistakes and that could set back everything. At the same time, I know that patients are waiting, and keep waiting.”
According to the World Health Organization, hundreds of thousands of people are involved in traumatic incidents that cause irreversible damage to their spinal cord. In the USA alone, over 1.3 million citizens have paralysis due to spinal cord injuries. The study conducted by the EPFL offers a glimmer of hope that these people may eventually be able to move their paralyzed muscles and regain a sense of physical autonomy, better blood pressure control, and boosted stamina. But at the moment, there is no official clinical treatment outside of these experimental trials that offer long term benefits for paralyzed persons.
One participant in the study, Kelly Thomas, can now move with the help of a walker and is now working on getting rid of it altogether. In addition, the surgical implants made huge differences for her health in other ways:
“I wasn’t able to contract all my torso muscles prior to having this implant, and now if need to cough, or need to clear my throat, I can,” she says. “It puts my mind at ease.”
In addition, according to a second study conducted about a month ago some participants with complete lower body paralysis can now step across the ground with limited assistance.
Of course, the experimental treatment hasn’t always gone as planned. Two participants in a study in Louisville didn’t have dramatic gains like Thomas, and not one participant has returned to their pre-injury health levels.
Nonetheless, the three studies at different centers have shown positive results through the use of three different approaches. The studies at the Louisville and Mayo Clinic used substantially simpler methods, by merely sending electric stimulation to the spinal cord.
Courtine’s team in Switzerland conducted a more high-tech experiment. They use a device normally used for deep brain stimulation, the Medtronic Activa RC, to send timed pulses of electricity into the participant’s spinal cords. The theory is that the pulsed stimulation mirrors neural signals and the precise timing of the stimulation could help regain plasticity in the injured nervous system.
“We scienced the shit out of it,” Courtine says. “The way we stimulate the spinal cord is with the precision of a Swiss watch — where we stimulate, when we stimulate.”
At the moment, Courtine says the main goal is to improve the technology. The team has released a start-up called GTX medical to continue developing their stimulation tech. The Swiss Federal Institute of Technology (EPFL) owns the patents, and provides GTX medical with exclusive licensing. The startup’s objective is to fully optimize the electrode array and neurostimulator, as well as a voice activated user interface.
However, funding for these projects tends to be difficult and there is no guarantee that these will reach clinical trials any time. The methods for spinal cord transplants will never be foolproof because every injury is different. What may work in one paralyzed person might not work in another. In addition, each participant’s physical training influences the extent of their recovery.
Despite these concerns, many prominent electrical stimulation firms such as Medtronic, Boston Scientific, and Abbot are following these projects closely. However, the company with closest ties to the tech, Medtronic, has little so say as of yet about future plans.
Spokesperson for the company Sara Thatcher said:
“We’ve got a lot to learn related to what type of product this indication really needs and the clinical pathway associated with getting this therapy to market.”