The Big Idea: Reeve Foundation's Ambitious New Campaign to Cure Paralysis

    15/02/2015

    Thebigidea

    When Christopher Reeve appeared in the 2000 Superbowl advert to rise up miraculously from his wheelchair and walk toward a gasping audience, he was probably dreaming about a day like today. The Christopher and Dana Reeve Foundation (or Reeve Foundation) launched a new campaign at the end of last year called The Big Idea in which they plan to raise $15 million funding for clinical trials to test epidural electrical stimulation on 36 paralyzed spinal cord injury patients. This trial will be based on a series studies that started in Louisville Kentucky under Susan Harkema and thanks to the electrical medical devices invented by Reggie Edgerton's team at Neurorecovery Technologies Inc. The innovative new treatment has already brought life changing improvements for four patients, as has been reported in the news. Thousands of people have already lined up for the procedure on the victory over paralysis registry.

    More about Susan Harkema:HarkemaMore about Reggie Edgerton:Edgerton

    More about Neurorecovery Technologies Inc:Neuroinc

    For some time now the data from epidural electrical stimulation has been making headwinds in the neuro regeneration community. Essentially, electrode arrays are implanted over the dura of the lower spinal cord (T12-S1 region) and activated to send continuous electrical currents at alternating frequencies to stimulate the lumbar spinal cord. Electrical currents stimulate the Central Pattern Generator (CPG) which, with sensory feedback from muscles of the lower extremities of the body, becomes reactivated after injury. However, reinnervating sensory feedback from damaged muscles to a lesioned spinal cord is difficult. One way to stimulate sensory nerves is to place patients through rigorous locomotor training activities with physiotherapists. Another way is to locally administer drugs to serve as receptor agonists that induce axon regeneration. It is through a combination of these approaches that the CPG can be reactivated. The CPG provides centralized command for many of our most basic rhythmic movements, including walking, climbing, breathing and swimming. By stimulating the CPG successfully in animals with severed connections from the brain, it shows that movement of certain muscles in our bodies are not dependent on the brain or on supraspinal propriosensory neurons, but on rhythmic sensory feedback from the muscles themselves.

    A simplified diagram explaining epidural electrical stimulation from the NIH website:EES

    According to the study reported in the journal Brain, the four subjects who have undergone epidural stimulation have seen a dramatic recovery in voluntary movement of legs, knees and ankles and body weight support. However, apart from the loss of voluntary movement, a variety of disorders usually afflict spinal injury patients, including loss of bowel and bladder control, loss of sexual function and autonomic dysreflexia. The study promises to improve function in all of these systems by restoring electrical innervation. Whether this is the case remains to be seen. There are also many regulatory hurdles this study must undergo with the FDA before it becomes approved for early stages of clinical trials.

    What is for certain is that epidural stimulation and locomotor rehabilitation has already proven successful in functional recovery of spinalized rats. A recent TED talk by Gregoire Courtine, a former postdoc of Reggie Edgerton who now runs his own lab in Switzerland, expounded on the dramatic improvements he found when using this technology on rats undergoing treadmill rehabilitation. Although I believe TED talks have gained a cult-like status with their slick presentations and charismatic speakers at times exaggerating the truth, there is merit in seeing this talk, especially for those working in the field: