Health

Can brain and nerve stimulation restore movement?


spinal cord injury

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In 1999, when Jason Carmel, MD, Ph.D., was a sophomore medical student at Columbia, his identical twin brother suffered a spinal cord injury that left him paralyzed from the chest down. and limited use of hands.

Jason Carmel’s life also changed that day. His brother’s injury eventually led Carmel to become a neurologist and a neurologist, with the goal of developing new treatments to restore movement to people who were paralyzed.

Now, a nerve arouse therapy that Carmel is developing at Columbia is showing promise in animal studies and could eventually allow people with the disease spinal cord injury to regain function of their arm.

“Stimulation techniques target neural connections damaged by trauma, allowing them to take over some of the lost functions,” said Carmel, a neuroscientist at Columbia and NewYork-Presbyterian Universities. “.

In recent years, several well-known studies on electrical stimulation of the spinal cord have allowed some people with complete paralysis to begin to stand up and walk again.

Carmel’s approach is different because it targets the arms and hands and because it combines the brain and spinal cord stimulationwith Electrical stimulation of the brain followed by stimulation of the spinal cord. “When two signals converge at the level of the spinal cord, within about 10 milliseconds of each other, we get the strongest effect,” he said, “and the combination seems to allow the remaining connections to be made. in the controlling spinal cord.”

In his latest study, Carmel tested his technique – called spinal cord coherence plasticity (SCAP) – on mice with moderate spinal cord injury. Ten days after injury, mice were randomly selected to receive 30 min of SCAP for 10 days or sham stimulation. At the end of the study period, the mice that had SCAP targeted their arms significantly better processed food than those in the study group. control groupand have almost normal reflexes.






Credit: Columbia University Irving Medical Center

“The improvements in both function and physiology persisted as long as they were measured, up to 50 days,” says Carmel.

The findings, recently published in the journal Brain, suggesting that SCAP causes synapses (connections between neurons) or the neurons themselves to undergo lasting change. “Paired signals essentially mimic the normal sensory-motor integration that needs to come together to perform skilled movement,” says Carmel.

From mouse to human

If the same technique works for people with spinal cord injuries, patients could regain something else they lost in the trauma: independence. Much of the research on spinal cord stimulation has focused on walking, but “if you ask people with cervical spinal cord injuries, which are the majority, what kind of movement they would like to regain, they’ll say function.” hand and arm capabilities,” Carmel said. “The function of the hands and arms allows people to be more independent, like moving from bed to a wheelchair or dressing and eating themselves.”

Carmel is currently testing SCAP on spinal cord wound patients at Columbia, Cornell, and the VA Bronx Healthcare System in a clinical trial funded by the National Institute of Neurological Disorders and Stroke. Stimulation will be performed during clinically indicated or noninvasive surgery, using magnetic stimulation to the brain and skin stimulation at the front and back of the neck. Both techniques are routinely performed in clinical settings and are known to be safe.

In the trial, the researchers hope to learn more about how SCAP works and how the timing and intensity of the signals affect motor responses in the fingers and hands. This will lay the groundwork for future trials to test the technique’s ability to significantly improve hand and arm function.

Looking further, the researchers think this approach could be used to improve movement and sensation in patients with lower hemiplegia.

Meanwhile, Jason Carmel’s twin brother is working, married, and raising twins of his own. “He has a full life, but I hope we can do more rehabilitation for him and others with similar injuries,” Carmel said.

More information:
Ajay Pal et al., Coherent plasticity of the spinal cord improves sensorimotor function of the forelimbs after cervical trauma, Brain (2022). DOI: 10.1093/brain/awac235

Journal information:
Brain


quote: Spinal cord injury: Can brain and nerve stimulation restore movement? (2023, 20 Jan) get January 21, 2023 from https://medicalxpress.com/news/2023-01-spinal-cord-injury-brain-nerve.html

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