How to Restore Walking After Spinal Cord Injury

A new study by scientists at the .NeuroRestore research center has identified the type of neuron that is activated and remodeled by spinal cord stimulation, allowing patients to stand up, walk and rebuild their muscles – thus improving their quality of life. This discovery, made in  nine patients, marks a fundamental, clinical breakthrough.

In a multi-year research program coordinated by the two directors of  .NeuroRestore – Grégoire Courtine, a neuroscience professor at EPFL, and  Jocelyne Bloch, a neurosurgeon at Lausanne University Hospital (CHUV) – patients who had been paralyzed by a spinal cord injury and who underwent  targeted epidural electrical stimulation of the area that controls leg movement  were able to regain some motor function.

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Paraplegics Walk Again With Electrical Stimulation

Three paraplegics who sustained cervical spinal cord injuries many years ago are now able to walk with the aid of crutches or a walker thanks to new rehabilitation protocols that combine targeted electrical stimulation of the lumbar spinal cord and weight-assisted therapy.

This latest study, called STIMO (STImulation Movement Overground), establishes a new therapeutic framework to improve recovery from spinal cord injury. All patients involved in the study recovered voluntary control of leg muscles that had been paralyzed for many years. Unlike the findings of two independent studies published recently in the United States on a similar concept, neurological function was shown to persist beyond training sessions even when the electrical stimulation was turned off.

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Our findings are based on a deep understanding of the underlying mechanisms which we gained through years of research on animal models. We were thus able to mimic in real time how the brain naturally activates the spinal cord,” says EPFL neuroscientist Grégoire Courtine.

All the patients could walk using body weight support within one week. I knew immediately that we were on the right path,” adds CHUV neurosurgeon Jocelyne Bloch, who surgically placed the implants in the patients.

The exact timing and location of the electrical stimulation are crucial to a patient’s ability to produce an intended movement. It is also this spatiotemporal coincidence that triggers the growth of new nerve connections,” says Courtine.

The STIMO study, led by the Ecole Polytechnique Fédérale de Lausanne (EPFL) and the Lausanne University Hospital (CHUV ) in Switzerland, is published in  Nature and Nature Neuroscience.

Source: https://actu.epfl.ch/