Gripping news — Non-invasive zaps to the spinal cord can treat paralysisbut no one knows why The benefits may seem small, but they can make a world of difference, patients say.
Beth Mole – May 21, 2024 10:28 pm UTC Enlarge / Trial participant Sherown Campbell manipulating a Rubik’s Cube. UP-LIFT Trial reader comments 41
With a zap of electricity from well-placed electrodes on the back of the neck, patients with tetraplegia can regain some modest yet potentially “life-changing” functioning of their hands and arms, according to data from a small clinical trial published Monday in Nature Medicine.
The relatively simple stimulation methodwhich requires no surgeryoffers an accessible, more affordable, non-invasive means for those living with paralysis to regain some meaningful function, the researchers behind the trial say. However, the therapy’s further potential remains limited given that scientists have yet to fully understand exactly why it works.
For the trial, 60 patients with tetraplegia underwent the stimulation therapy over at least 24 sessions during a two-month period. At the end, 72 percent (43 patients) saw clinically meaningful improvements in both strength and functional performance. Further, 90 percent (54 patients) saw improvement from at least one strength or functional outcome. There were no serious adverse events reported.
“The most exciting thing for us is that we’re seeing effects that improve quality of life,” Chet Moritz, a co-author of the study and co-director for the Center for Neurotechnology at the University of Washington, said in a press briefing. “And also, we believe that the stimulation may be causing neuroplasticity or, in a sense, healing part of the damage to the spinal cord injury, such that the benefits persist beyond stimulation.” Advertisement Clinical video of a trial participant testing grip
The trial, which took place at 14 clinical sites across the US, Canada, and Europe, was a prospective studynot the gold-standard design of a randomized, double-blind placebo control trial. Moritz and his colleagues explained that there were a number of reasons for this. For one, they weren’t sure if they could use a sham electrical stimulation for a placebo group. Patients can feel the real electrical stimulation, described as an internal “buzz,” and efforts to re-create the feeling, but not the effects of a sham treatment, were uncertain. Also, there were ethical concerns about having people with tetraplegia repeatedly travel to clinical sites and be subjected to potentially uncomfortable treatments with no expected benefit.
Still, the researchers behind the study are confident that the gains they saw were not simply placebo effects. For one thing, all the trial participants spent two months in standard rehabilitation therapy before they underwent the stimulation therapy. And their progress in that first phase of the trial was compared to their progress in the second half, in which they received the therapy. The differences were “very dramatic for many of the measures,” Edelle Field-Fote, a co-author and Director of Spinal Cord Injury Research at Shepherd Center in Georgia, said in the briefing. Page: 1 2 Next → reader comments 41 Beth Mole Beth is Ars Technicas Senior Health Reporter. Beth has a Ph.D. in microbiology from the University of North Carolina at Chapel Hill and attended the Science Communication program at the University of California, Santa Cruz. She specializes in covering infectious diseases, public health, and microbes. Advertisement Promoted Comments 0101010111 This is the single most exciting piece of research in spinal cord injury medicine.
Dr. Mole did a great job of summarizing its benefits and unexpected gains like sweating for thermal regulation. The nerves of the neck (C-spine) are arranged so that each level has a function. C5 for bending your elbow, C6 for wrist extension, C7 for straightening out the elbow, and C8 for grip. Gaining one level is huge because getting back C5 allows one to feed oneself, C6 imparts weak prehension, C7 allows you lift oneself from a bed or a chair so that you can transfer into a wheelchair and avoid pressure ulcers. Each fractional improvement is meaningful because it crosses functional thresholds in peoples lives and can mean needing someone to attend you all day vs. moving around town and having a job. Nothing that we have done in the last 40 years has really changed the recovery profile after spinal cord injury except for this, and similar lines (Harkema et. al), of neuromodulation research. Stem cells and other biologics just haven’t delivered.
It’s so rare to see such an impactful treatment that doesn’t have a real downside. These are sticky electrodes on the skin applied over clear anatomical landmarks. It’s cheap, easy, and effective.
**I’m a physician in this small niche and have lectured with Chet Moritz before. He is an amazing scientist and an accomplished windsurfer. I couldn’t be happier for all the deserving people out there that will benefit from this novel treatment. We doctors get so disenchanted, to put it lightly, when there are novel but stratospherically priced therapeutics like immunotherapy, gene therapies, or even joint replacements. It’s great to see something that can be made for probably less than $200 off Digikey using the published waveform parameters. May 21, 2024 at 11:14 pm Channel Ars Technica ← Previous story Next story → Related Stories Today on Ars
