Thursday, May 31, 2012

If You Were a Rat, You'd be Walking

Scientists in Switzerland have restored full movement to rats paralyzed by spinal cord injuries in a study that spurs hope that the techniques may hold promise for someday treating people with similar injuries. 

Gregoire Courtine and his team at Ecole Polytechnique Federale de Lausanne saw rats with severe paralysis walking and running again after a couple of weeks following a combination of electrical and chemical stimulation of the spinal cord together with robotic support.

"Our rats are not only voluntarily initiating a walking gait, but they are soon sprinting, climbing up stairs and avoiding obstacles," said Courtine, whose results from the five-year study will be published in the journal Science on Friday.

Courtine is quick to point out that it remains unclear if a similar technique could help people with spinal cord damage but he adds the technique does hint at new ways of treating paralysis.
Other scientists agree.

"This is ground-breaking research and offers great hope for the future of restoring function to spinal injured patients," said Elizabeth Bradbury, a Medical Research Council senior fellow at King's College London.
But Bradbury notes that very few human spinal cord injuries are the result of a direct cut through the cord, which is what the rats had. Human injuries are most often the result of bruising or compression and it is unclear if the technique could be translated across to this type of injury.

Handout / Reuters
A combination of electrial and chemical stimulation were used to stimulate the spinal cords of rats with spinal cord injuries and severe paralysis for a study that will be published in the journal Science.

It is also unclear if this kind of electro-chemical "kick-start" could help a spinal cord that has been damaged for a long time, with complications like scar tissue, holes and where a large number of nerve cells and fibres have died or degenerated.

Nevertheless, Courtine's work does demonstrate a way of encouraging and increasing the innate ability of the spinal cord to repair itself, a quality known as neuroplasticity.

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Sunday, April 1, 2012

Paralyzed Bride Can Have Sex!

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Thank You Canada

The Rick Hansen Institute (RHI) and Rick Hansen Foundation (RHF) today thanked the Harper government for partnering in their vision of an accessible and inclusive society and a cure for paralysis after spinal cord injury (SCI).

Today's Federal Budget announcement will support essential advancements in research for a cure for paralysis after spinal cord injury, and make a positive difference by promoting the translation of promising research discoveries and best practices into real, practical benefits for the more than 86,000 Canadians with spinal cord-related injuries and illnesses.

"The Government of Canada has been a critical partner in my 25 year journey towards a healthier and more inclusive world, and we are extremely grateful for their continued support," said Rick Hansen. "This renewed federal investment will allow us to further advance in our collective goal of achieving a cure for paralysis after spinal cord injury and achieve better medical care and outcomes as we assist SCI patients in becoming more active members of the community. While much has been accomplished, I truly believe our best work is in front of us."

The Rick Hansen Institute and the Rick Hansen Foundation are committed to advancing clinical research studies in such priority areas as reduction of paralysis and secondary complications; the implementation of validated best practice guidelines in SCI care nationally and build capacities for hospitals to adopt these standards; and the expansion of the pan-Canadian SCI clinical research network to enhance collaboration between Canadian and international SCI experts.

"Together we are solidifying Canada's position as a global leader and a world-class SCI centre of excellence," added Hansen. "The path we are taking is reducing hospital visits, readmissions from secondary complications, and the financial burden that comes with the injury, as we work towards a world without paralysis after SCI. We are grateful for not having to take the path alone".

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Sunday, March 25, 2012

MS Drug Reduces Spinal Cord Injury

A drug found to slow some of the physical problems and reduce the number of flareups of multiple sclerosis (MS) could also show promise for treating spinal cord injuries, according to a new Japanese study.

Researchers from the Jichi Medical University School of Medicine and the Universisty of Tokyo's Graduate School of Medicine found that FTY720, also known as Gilenya, helped mice with spinal cord injuries (SCIs) recover some motor function when they were given the drug immediately after the injuries.

FTY720 acts in a number of ways, the study authors wrote. The drug, provided by its manufacturer, Novartis, for this study, suppresses the immune system, which reduces inflammation that occurs after injuries. Inflammatory effects, they explained, can worsen the damage done by SCIs. The drug also helped the mice's damaged tissue regenerate, among other effects.

"The main biological activity responsible for these actions is believed to be immunological, but our data suggest that nonimmunological role(s) of FTY720 are also important in the treatment of SCI," they wrote.

The drug still needs to be evaluated in larger animals before determining whether it is effective in treating SCIs, but still has promise, the authors added.

Experts not involved with the study, however, are a bit more skeptical. Many interventions work in mice, so determining the utility of Gilenya for SCIs in humans is a long way off, if it happens at all.

"Another issue is that in this study, the drug was given immediately after the SCI, and rarely do we have the opportunity to give a drug immediately after this type of injury in humans," said W. Dalton Dietrich, professor and scientific director of the Miami Project to Cure Paralysis at the University of Miami's Miller School of Medicine. "One big question is if the drug delivery is delayed, will it work?

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Saturday, March 10, 2012

Spinal Cord Injury Cure May Come In A Fortune Cookie

Doctor looks to China for spinal injury 'cure'

One of the world's leading researchers into spinal cord injuries says China could hold the key to a cure that he has been searching for since he met late actor Christopher Reeve in the 1990s.

US-based Doctor Wise Young first used the word "cure" in relation to his work after a conversation with Reeve, the "Superman" hero who became quadriplegic in an equestrian accident in 1995.

Reeve contacted him looking for help and the two became close friends. The actor died of heart failure in 2004 at the age of 52, having devoted his life to raising awareness about spinal cord injuries and stem-cell research.

But it was a star of a different sort, Chinese gymnast Sang Lan, who set Young on the path he believes has brought a cure closer than ever, thanks to ground-breaking clinical trials of stem-cell therapy he is conducting in China.

"Everybody assumed that I'm doing this in China because I wanted to escape George W. Bush, but that's not the case at all," Young told AFP in an interview, recalling the former US president's 2001 decision to effectively stop Federal funding of embryonic stem cell research.

"I started the clinical trials in 2005 here in Hong Kong ... mainly because of a promise that I made to a young woman. Her name is Sang Lan."

Sang crushed her spine during a routine warm-up exercise at the Goodwill Games in New York in 1998. She met Young as she underwent treatment and rehabilitation in the United States over the next 12 months.

"Her parents came to me and asked whether or not there would ever be a cure for her, and I said we're working very hard on it," recalled Young, who was by then one of the leading US experts on spinal cord injuries.

"When she went back to China after doing her rehabilitation in New York she cried and asked how would therapies go from the United States to China.

"In those days China was still relatively poor and backward so she didn't think that any therapy would be coming from China. So I started in 1999 to talk to all the spinal cord doctors in China."

He said the result was China Spinal Cord Injury Net, the world's largest clinical trial network for spinal cord therapies. Established in Hong Kong in 2005, it is about to expand into Europe, India and the United States.

"We're testing umbilical cord blood-cell transplants into the spinal cord combined with lithium treatments," said Young, professor in neuroscience at Rutgers University, New Jersey.

At about 20 centres in China, Hong Kong and Taiwan, stem cells are injected into patients' damaged spines to help regenerate nerves, while lithium is used to promote the growth of the nerve fibres.

Each component of the combination therapy needs to be tested separately before they are brought together in the third and final phase, due to take place in the coming years if all goes well.

The results so far have been promising, although it's "still too early" to draw conclusions about recovery of movement, Young said.

"What we can comfortably say right now is that the procedure seems to be quite safe. Nobody has lost any function," he added.

"We don't expect people to be jumping out of bed and running marathons after this. Regeneration is a slow process."

The trials also involve intensive walking exercises for some of the severely injured participants at the Army General Hospital in Kunming, southwestern China.

In two sessions of three hours each, six days a week, the patients "sculpt" their nerve fibres into shape, Young said. He likened it to running a marathon every day. By comparison, Reeve did about two hours of exercise daily.

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Sunday, February 26, 2012

Quick Surgery Lessons Injury

Speedy surgery lessens chance of paralysis in cervical spinal cord injuries

Neurosurgeon Dr. Michael Fehlings was asleep at his High Park home one night two years ago when his pager went off. A patient with a serious spinal cord injury was en route to Toronto Western Hospital and Fehlings was beckoned to perform emergency surgery.

Time was of the essence, as a study Fehlings was working on then would later show. The study, published online Thursday in the medical journal PLoS ONE, reveals that patients who get surgery within 24 hours of a spinal cord injury have a 20 per cent improvement in their outcomes. Indeed, one in five could walk away from paralysis.

In this case, it had been 11 hours since Anastacia Espena had suffered a serious fall. The 47-year-old nanny fell while taking out the garbage at the Brampton home where she worked, striking her head on the ground. She tried getting up but couldn’t move her arms or legs. The fall had caused a compression in one of her cervical vertebrae.

Espena lay on the ground for 45 minutes, until a neighbour came to the rescue. She was taken to a local hospital and later transferred to the Krembil Neuroscience Centre at Toronto Western where Fehlings is medical director. He happened to be on call that night.

Despite her serious injury, Espena considers herself fortunate. The last thing she remembers before the anesthesia took effect was praying, “Please God, let me walk again.”

Three days after the surgery, feeling began to return to the left side of her body. With ongoing physiotherapy at Toronto Rehab, she continues to make progress. She has gone from relying solely on a motorized wheelchair to a walker. She is now learning to walk with a cane and even without any assistive devices.

The study found that patients are twice as likely to have major neurological recoveries when operated on within 24 hours of injury. Recovery is measured by the internationally recognized American Spinal Injury Assessment Scale. Scores range from letters A to E. Those with an A have no motor or sensory function below the level of injury and those with an E have normal function.

A major improvement is defined by a jump of two or more grades. Espena moved from an A to a D.

“What this means is that some patients are potentially able to walk away from an injury and others are able to regain a lot more independence,” said Fehlings.

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Monday, January 2, 2012

16 Year Old Hockey Player Paralyzed

Well-wishers crowded into Jack Jablonski's hospital room and lit up his Facebook and CaringBridge pages all weekend as the high school sophomore and his family awaited a prognosis on a paralyzing injury he suffered during a hockey game on Friday.

"It's a parent's worst nightmare," his father, Mike Jablonski of Minneapolis, said on Sunday in the pediatric intensive care unit at Hennepin County Medical Center. "He dropped and didn't move. Right then and there I knew that my son, that there was something seriously wrong."

Known as "Jabby" to his friends, the 16-year-old honors student, hockey forward and varsity tennis player at Benilde-St. Margaret's scored the first goal of what would be a victory for the junior varsity Red Knights against Wayzata during the Holiday Hockey Classic tournament at the St. Louis Park Recreation Center.

Jack's team was up by one goal 5 minutes and 48 seconds into the second period when he made a dash for the puck near the end boards with two Wayzata players in hot pursuit, said Chris McGowan, the Red Knights' JV coach.

McGowan said two players rammed Jablonski from behind, smashing him into the boards, and he collapsed motionless to the ice.

Jack is in critical condition with two fractured bones in his lower neck. He's unable to move his legs and has only slight movement in his hands and fingers, McGowan said.

"He is a first-class kid. Definitely one of my favorite players in the program," he said. "It's team-first with him for everything. He's what I call a very high-end hockey player, too. And he's got an incredible hockey future ahead of him as well, assuming this all works out."

Doctors suspect that Jack suffered a bruised spinal cord and won't speculate about his recovery until the swelling reduces, his parents said. Once that happens, surgeons expect to fuse the two broken vertebrae, they added.

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