18 February 2013

Update On Spinal Cord Injury Treatment Through Robotics, Neurorehabilitation, and Electrical-Chemical Stimulation


An update on the research conducted last year on repairing spinal cord injury is set to be delivered at the 2013 Annual Meeting of the American Association for the Advancement of Science (AAAS) in Boston.

In the June 01 issue of Science, Grégoire Courtine, of the École Polytechnique Fédérale de Lausanne (EPFL) published a report on how rats with spinal cord injuries and severe paralysis managed to walk and even run again.

"After a couple of weeks of neurorehabilitation with a combination of a robotic harness and electrical-chemical stimulation, our rats are not only voluntarily initiating a walking gait, but they are soon sprinting, climbing up stairs and avoiding obstacles," explains Courtine, who holds the International Paraplegic Foundation (IRP) Chair in Spinal Cord Repair at EPF

Courtine used a cemical solution that triggers cell responses to specific receptors on the spinal neurons. This chemical, monoamine agonists, replaces neurotransmitters and acts to excite neurons. After the injection, the spinal cord is electrically stimulated with electrodes. The electrical stimulation sends continuous electrical signals through nerve fibers to the chemically excited neurons that control leg movement.

Every year, around 50,000 people suffer spinal cord injuries, most result in paralysis. This study may lead to effective treatments of these injuries and allow patients to walk again and even fully recover from it.

Spinal Cord Injury Treatment

In the lab, rats with severe spinal cord injury are learning to walk—and run—again. Last June in the journal Science, Grégoire Courtine, of the École Polytechnique Fédérale de Lausanne (EPFL), reported that rats in his lab are not only voluntarily initiating a walking gait, but they were sprinting, climbing up stairs, and avoiding obstacles after a couple of weeks of neurorehabilitation with a combination of a robotic harness and electricalchemical stimulation.

Now, at the 2013 Annual Meeting of the American Association for the Advancement of Science (AAAS) in Boston, Courtine describes this research in detail and the next steps towards clinical trials to be done in Switzerland. Courtine holds the International Paraplegic Foundation (IRP) Chair in Spinal Cord Repair at EPFL. At AAAS, in a symposium titled, “Engineering the Nervous System: Solutions to Restore Sight, Hearing, and Mobility,” he outlines the range of neuroprosthetic technologies developed in his lab, which aim to restore voluntary control of locomotion after severe spinal cord injury. He explains how he and his colleagues are interfacing the central nervous system with stretchable spinal electrode arrays controlled with smart stimulation algorithms – combined with novel robotic rehabilitation – and shows videos of completely paralyzed rats voluntarily moving after only weeks of treatment.

Video: Walking Again After Spinal Cord Injury

Courtine expects to begin clinical trials in human patients within the next two years. At AAAS, he presents the 9 million euro European project NeuWalk, an effort dedicated to the transfer of technology from rats over to humans with spinal cord damage through development of effective neuroprosthetic systems for rehabilitation. The first phase of clinical studies will be conducted at the Lausanne University Hospital (CHUV), which has developed extensive expertise in the electrical-chemical stimulation of the human spinal cord. The second phase will take place at the newly planned EPFL Valais Wallis academic cluster in Valais, Switzerland, to be inaugurated in 2015. This health and biotechnology center in Valais will focus on new treatments and rehabilitation for people with physical disabilities. This research program has the potential to develop effective treatment paradigms for rehabilitating individuals with severe spinal cord injury, for whom current rehabilitative treatments do not restore the ability to stand or walk.

RELATED LINKS

Ecole Polytechnique Fédérale de Lausanne
American Association for the Advancement of Science (AAAS)
EPFL at AAAS 2013
NeuWalk
Project Rewalk
Walking Again After Spinal Cord Injury Through Neuroprosthetics and Robotics
Repairing Spinal Cord Injuries Through Schwann Cell Transplantation and Inhibition of Scarring
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