Angeli
CA et al in their article published in Brain
report on four patients with complete paralysis who regained motor movements after
epidural stimulation. Their first
patient who recovered after 7 months of therapy had motor complete and sensory
incomplete spinal cord injury. Three
more patients benefited immediately after treatment though two of them had both
sensory and motor complete lesions, an unexpected result. The authors from the University of
Louisville, KY, UCLA and Pavlov Institute in Russia, demonstrated that neuromodulation of the
sub-threshold motor state of the spinal circuitry, enables patients with
complete paralysis to regain voluntary control of their paralyzed muscles.
The four men who participated in the study had been
diagnosed with clinically motor complete paralysis for more than two
years. The stimulators used in this
trial were made by Medtronic. The electrodes were implanted in the epidural
space at a site below that of the injury.
The patients were able to execute intentional
movements of the legs in response to a verbal and/or auditory commands within a
few days of the initiation of the treatment and improved further over a period
of a few months.
Though the treatment does not allow a paraplegic to
walk, the therapy makes it possible for the person to stand without help. Remarkably,
epidural stimulation also improved control of the bowel, bladder and even sexual
function.
This new therapy can dramatically affect
recovery of voluntary movement in individuals with complete paralysis even
years after injury.
Angeli CA, Edgerton VR, Gerasimenko YP,
Harkema SJ: Altering spinal cord
excitability enables voluntary movements after chronic complete paralysis in
humans. Brain 2014 April 8. (Epub ahead of
print)
PMID: 24713270 [PubMed - as supplied by publisher]
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