A new pilot study on a new treatment mechanism for paralyzed spinal cord injury patients completed by researchers at Duke University and published in Scientific Reports showed an amazing result. Two paralyzed patients were able to walk 4,500 steps, assisted only by a walker, after taking part in the new treatment method.
About the Walk Again Project
A group of neuroengineers established the Walk Again Project about 10 years ago to help patients who have spinal cord injuries regain mobility. Previously, surgery was used as a potential remedy for people inflicted with spinal cord injuries. This is an effective treatment method because surgeons can implant electrodes directly in the brain that can measure the actions of smaller subsets of neurons responsible for controlling movement. Then, a computer = can analyze data and read signaling details in order to control movement in muscles. However, the group recognized the risks of surgery as a treatment mechanism, with its potential to cause an infection or pain or have the immune system reject it. It is also an expensive route that many spinal cord injury patients could not afford.
Rather than implanting the electrodes through invasive surgery, the research team tested the ability to embed them inside a head cap. This innovative technique combined an EEG-based brain-machine interface with other established approaches for neuro rehabilitation, such as visual and touch feedback and movement training.
The protocol begins by using EEG and records and controls virtual avatars while the patient wears a tactile shirt that provides sensory feedback, which teaches damaged nerves to send messages regarding motor functions to healthy nerves to be able to carry out the action. Patients wore cap with eight electrodes to measure movement and stimulate muscles, along with a tactile shirt that gave them a sense of spatial recognition of their body in space and stimulated their forearms. Patients were instructed to imagine moving their legs in a stepping motion. This generated brain activity that the EEG device picked up and was able to translate. Due to this connection, patients did not require verbal instructions or did not need to look at their bodies when completing the training and moving their legs in response to muscle stimulation.
The treatment was comprised of three phases. The first phase involved activating paralyzed legal muscles and attempting to wake them. The next phase involved zapping them to encourage smooth movements. The final phase involved connecting the brain and the zapping into walking motions.
Findings of the Study
The combination therapy was found to rehabilitate broken nerves and permit patients to walk again by using their own bodies. The technology was found to help paralyzed patients walk again without the need for surgery. By implementing multiple techniques at the same time, researchers were able to achieve impressive neuro rehabilitation results.
In 2018, the team showed that EEG-based interfaces could assist mobility in 28 to 38 months when it was combined with other effective methods involving visual and touch feedback and movement training. Seven paralyzed patients received the treatment and showed promising results. Some of these test patients had been paralyzed for decades. Following the treatment regimen, the patients felt sensations in their legs and spatial recognition of their lower limbs. They were better able to control their legs. Some patients reported feeling normal sensations of pain after years of no sensation.
The study continued by focusing on two patients who were part of the original test group. The team trained the patients and further examined their recovery. The first patient was a middle-aged man who had been paralyzed for more than four years at the start of the study. The other patient was 32 years old and had been paralyzed for a decade. Both patients could only extend their knees at the beginning of the study.
In 11 months of using the new treatment regimen, both patients demonstrated significant improvements. Their leg muscles grew. This helped support weight and movements. They also overcame natural atrophy. Without requiring further encouragement from electrical zaps, the first patient walked 10 meters unsupported. The second patient could walk faster than before the training but did require assistance. Both patients experienced cardio health improvements and a reduction in their resting heart rate. The combination therapy was found to have boosted neural plasticity, which allowed them to regain access to muscles that they had not used since the injury.
Researchers also found that patients’ nervous systems were reactivated, which resulted in restoring other neurological recovery in patients, as well as bladder, bowel and sexual control.
Researchers theorized that after the spinal cord injury, the patients likely had spinal cord fibers that survived but that had not been activated for years following the injury. The combination therapy was found to stimulate these again in order to restore movement.
Researchers concluded the future for neuro rehabilitation is to integrate all known tools in order to form a single platform that avoids surgery and is not invasive to patients.
Future of the New Method
The combination therapy is non-invasive unlike surgery. Additionally, it is less expensive and easy for patients to use at home. Although the treatment is not yet available for at-home use, researchers believe that the technology can be implemented into a kit that patients can use at home everyday.
The new study shows that paralysis following a spinal cord injury does not have to be indefinite and gives hope to patients with this condition that movement will be possible again.
