Five men who were completely paralyzed from the waist down have been able to move their legs thanks to a new noninvasive procedure.
The new technique, details of which are reported in the Journal of Neurotrauma, is believed to represent the first time patients have regained voluntary leg movement without the need for invasive treatments such as surgery.
Instead, scientists utilized electrical stimulation therapy and physical rehabilitation exercises to treat patients.
Senior author Prof. V. Reggie Edgerton hopes these findings will enable scientists to look at spinal cord injuries “in a new way,” offering hope to millions of people with paralysis.
Roderick Pettigrew, director of the National Institute of Biomedical Imaging and Bioengineering at the National Institutes of Health (NIH), echoed this view and believes spinal cord injuries may no longer be “a life sentence of paralysis.” He says:
“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,” he adds.
This is not the first time Prof. Edgerton has investigated how paralysis can be alleviated. Last year, he and his research team investigated paralysis in four men.
Each was paralyzed from the waist down for years but were able to move from their hips to their toes following epidural electrical stimulation of their spinal cords.
Stimulation was elicited by a device called an epidural stimulator, which needed to be surgically implanted into the patient’s spinal cord.
Encouraged by these results, Prof. Edgerton and colleagues pressed on and earlier this year, researchers demonstrated involuntarily stepping movements could be induced in uninjured patients without the need for surgery.
It was this reaction that served as the catalyst for the researchers to see if the same noninvasive method could be applied to patients suffering from paralysis.
In the most recent study, five men – each completely paralyzed from the waist down for more than 2 years – underwent a 45-minute training session per week for 18 weeks.
Electrodes were placed on a patient’s skin on their lower back, which administered a unique pattern of electrical currents. This caused no discomfort to the patients and no surgery was required.
At the beginning of the study, the patient’s legs only moved when the stimulation induced was strong enough to generate involuntary step-like movements. As the study went on, the men attempted to move their legs further while receiving stimulation and the range of movement significantly increased.
For the final 4 weeks, patients were given a twice-daily dose of buspirone – a drug that has ben shown to mimic the actions of serotonin. Buspirone has also been reported to induce locomotion in mice with spinal cord issues.
By the end of the study, the men were able to move their legs with no stimulation at all, but still with the addition of buspirone. The range of movements displayed were also, on average, the same as when the patients were receiving stimulation.
The video below shows one of the men moving their legs following the procedure:
“The fact that they regained voluntary control so quickly must mean that they had neural connections that were dormant, which we reawakened.”
Prof. Edgerton hopes this development may pave the way for new treatments for patients suffering from paralysis, especially those who have repeatedly had surgery and do not wish to do so again. Also, the treatment is estimated to be one-tenth the cost of an implanted stimulator.
Almost 6 million Americans have some form of paralysis, including nearly 1.3 million with spinal cord injuries.
A further follow-up study by Prof. Edgerton and his team has already begun. Using the same patients, he hopes to see if the men can be trained again with the noninvasive spinal stimulation therapy to bear their weight fully. This is a feat that has already been achieved by four men with surgery implanted stimulators.
Although it is likely to be years before the treatment is widely available, Prof. Edgerton hopes this can be a landmark discovery in the innovation of treatments toward paralysis.
“Many people thought just a few years ago we might be able to achieve these results in perhaps one out of 100 subjects, but now we have nine of nine,” he says. “I think it’s a big deal, and when the subjects see their legs moving for the first time after paralysis, they say it’s a big deal.”