Completely paralyzed people walk again after penetrating nerve stimulation

Using a combination of electrical stimulation and intense physical therapy, nPeople with chronic spinal injuries regained their ability to walk.

All suffer severe or complete paralysis as a result of spinal cord damage. Incredibly, the volunteers all saw improvements immediately, and continued to show improvements five months later.

A recent study by researchers from the Swiss research group NeuroRestore identified the exact nerve groups stimulated by treatment, using mice as a starting point.

The neurons that regulate walking are found in the part of the spinal cord that runs through our lower back. Spinal cord injuries can interrupt the chain of signals from the brain, preventing us from walking even when these specific lumbar neurons are still intact.

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Unable to receive commands, these “walking” neurons become effectively nonfunctional, which can lead to permanent paralysis of the legs.

Previous research has shown that electrical stimulation of the spinal cord can reverse this paralysis, but how this occurred was not clear. So neuroscientist Claudia Katt of the Swiss Federal Institute of Technology in Lausanne (EPFL) and her colleagues tested a technique called epidural electrical stimulation in nine individuals, as well as in an animal model.

The spinal cord was stimulated with a surgically implanted neurotransmitter. Meanwhile, the patients also underwent an extensive neurological rehabilitation process that included a robotic support system that assists them as they move in multiple directions.

Patients underwent five months of stimulation and rehabilitation, four to five times per week. Amazingly, all the volunteers were then able to take steps with the help of walkers.

To the researchers’ surprise, the recovered patients showed a decrease in neural activity in the lumbar spinal cord while walking. The team believes this is due to the activity being fine-tuned to a particular subset of neurons essential for walking.

“When you think about it, it shouldn’t come as a surprise,” Curtin told Dyani Lewis at temper nature“Because in the brain, when you learn a task, that’s exactly what you see – there are fewer and fewer active neurons” as you get better at it.

So Kath and his team modeled the process in mice and used a combination of RNA sequencing and spatial transcription — a technique that allows scientists to measure and map gene activity in specific tissues — to understand which cells are doing what.

They identified one group of previously unknown neurons that can progress to take over after injury, located within the medial lamina of the lumbar spinal cord.

This tissue is made up of cells called SC .Vsx2 :: Hoxa10 Neurons do not appear to be necessary for walking in healthy animals, but they do appear to be necessary for recovery after spinal injury, because their destruction prevented mice from recovering. However, their recruitment depends on the activity.

SCVsx2 :: Hoxa10 Neurons are “uniquely positioned” to convert information from the brainstem into executive commands. In their paper, Kath and colleagues explain, it is then transmitted to the neurons responsible for producing gait.

This is only one component of a very complex chain of message and receive cells, so there is still a lot to investigate.

But “these experiments confirmed that the participation of SCVsx2 :: Hoxa10 The researchers concluded that neurons are a prerequisite for recovery from walking after paralysis.

In time, this new understanding may lead to more treatment options, and may provide a better quality of life for people with all kinds of other spinal cord injuries as well.

Their research was published in temper nature.

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