• New Hope for Paralysis Recovery by Dr Jack Lewis

    As 2014 draws to a close my thoughts have recently turned to pondering the greatest neuroscience discoveries of the year. For me I’ve been struck by several developments in an area of biomedical science that during most of my lifetime has been considered beyond the powers of medical therapy to provide a decent remedy.

     

    christopherreeveEver since Christopher Reeve (the actor who played Superman in the much loved films of the late 70’s and 80’s) became paralysed from the neck down during an equestrian accident in 1995, the plight of people who suffer traumatic spinal damage has seemed utterly futile; despite the huge amounts of money various benefactors have ploughed into research. However this year we have seen huge leaps in scientific advancement enabling previously wheelchair-bound people to stand up and take some small but important steps forward under their own volition.

     

    A paralysed person kicked off the 2014 World Cup in Brazil during the opening ceremony using an EEG-controlled robotic exoskeleton. But given that the person in question had to be carried onto the pitch on a golf buggy, as opposed to rising up out of their wheelchair as promised, that feat should only really be considered a drop in the ocean compared to the much more remarkable progress in paralysis rehabilitation we’ve seen over the course of 2014.

     

    DrJackNewsroundAt the beginning of the year I was invited to make an appearance on “Newsround” – the Children’s BBC channel’s daily news show – to explain a totally unexpected and extraordinary breakthrough in rehabilitation research with paralysed army veterans in the USA. A chip was surgically inserted into their spinal cord, below the sites of damage, to apply weak currents of electricity in an effort to reinvigorate the involuntary spinal reflexes that enable us to maintain our balance whilst standing (no input from the brain necessary).

    This unexpected development occurred when, after a few weeks of further intensive rehabilitation exercises, several people regained voluntary movement of their legs for the first time in 2-4 years. Can you imagine how good that must have felt for the people in question? As someone who personally spent three weeks of 2014 with an almost completely paralysed arm after complication during routine surgery, it brings tears to my eyes to think how amazing it must have been to have control over legs that had previously seemed utterly useless for so many long months. It seems that the current injected by the chip had unexpectedly boosted signal strength across the area of damaged spinal cord sufficiently for the electrical messages (action potentials) to get all the way down to the leg muscles.

     

    Geoff RaismanIn 2004 whilst I was doing my PhD at University College London, I attended a talk by Prof Geoff Raisman, now chair of Neural Regeneration at the Institute of Neurology in Queen Square. He presented brand new data that he was clearly extremely excited about in which he showed data that clearly depicted new neuronal growth across the site of a spinal lesion. I cannot remember whether the experiment involved rodents or non-human primates but he made it clear that it would be many years before this pioneering research could ever be used to help paralysed humans. Today, in 2014, this dream is a reality.

     

    OlfactoryCellsInjectedDarek Fidyka was paralysed from the chest down for several years after a knife attack that severed his spinal cord. The 8mm gap that prevented messages sent from his brain to reach the muscles of his leg, penis and bladder were bridged using stem cells extracted from his brain. Mr Fidyka first underwent surgery to remove one of his two olfactory bulbs – the antennae like structures that extend forwards from the brain’s limbic system, running above each nasal cavity and extending smell receptors across the skull and into the nasal epithelium. Because the olfactory receptors come into contact with so many volatile compounds (just think of how potent the gases are that get into your nostrils when you’re downwind of a bonfire) a fair amount of damage happens to these brain cells and so they must be constantly replenished. This means that the olfactory bulbs / neurons of the nasal epithelium are a great source of stem cells.

     

    Darek Fidyka walks with the aid of leg-braces and a walking frameOnce sufficient numbers of Olfactory Ensheathing Cells (OECs) had been cultured and several million of them injected into the gap in his spinal cord a period of intensive rehabilitation exercises got underway. 6 hours per day 5 days per week. A few no-doubt-frustrating weeks later he graduated from walking with the assistance of parallel bars in the rehabilitation gym, to walking with a frame outside the hospital in Wroclaw, Poland where the surgery took place. Perhaps as important he regained some bladder control and sexual function. An incredible achievement for Mr Fidyka, but an absolutely triumph for Prof Raisman and the hundreds of people that have contributed to the groundwork that led to this unbelievable feat of brilliance.

     

    This story was covered in episode 10 of the podcast Geek Chic’s Weird Science – co-presented by yours truly and the gorgeous Lliana Bird – which you can subscribe to on iTunes, absolutely free of charge, by clicking here.

     

    For daily news on the latest advances in neuroscience research you can follow me on Twitter by clicking here.

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