During rehabilitation sessions, the three participants were able to walk hands-free over more than one kilometer with the help of targeted electrical stimulation and an intelligent bodyweight-support system. "They need to be mentally active all the time in order to close the loop with the electrical stimulation that ultimately produces the muscle activity".
The research represents cutting-edge progress in the field of spinal cord injuries, according to Sylvia Gustin, neuroscientist and psychologist at Neuroscience Research Australia (NeuRA) and the University of New South Wales, who was not involved in the study.
"I remember the first time we went outside by the lake here in Switzerland, and one of our participants who was bound to a wheelchair for seven years just walked ... for about 500 meters". 'Unbelievable!' Courtine's postdocs said. "We were thus able to mimic in real time how the brain naturally activates the spinal cord", said Courtine.
Created by a team at École Polytechnique Fédérale de Lausanne (EPFL), the device was part of the work done in a clinical trial, as published in the journal Nature. Because it disrupts the connection between the brain and the spinal cord, injuries can lead to motor and sensory deficits or, sometimes, paralysis.
"Voluntary muscle control improved tremendously within five months of training", said Courtine. They even built personalized model spinal cords to lie in an electricity-conducting salty fluid, allowing the team to work out precisely where each electrode needed to be inserted during surgery. 'It's enhancing the brain's ability to control the legs.
"The thought is that somehow there's a command coming down from the brain telling the lower limbs to move, and somehow the stimulation is enabling that", she says.
For Courtine, Bloch, and their colleagues, the next step is to explore results in people with recent injuries, where "the potential for plasticity is elevated and the neuromuscular system has not yet undergone the atrophy that follows chronic paralysis", they write. After a spinal cord injury many people lose other bodily functions such as sweating, bladder and bowel control, and sexual function.
"The later you start the treatment, the longer it takes to see improvements", Professor Courtine said. Courtine thinks the spine might be regenerating nerve fibers that cross the injury like new lanes being built around a broken highway section.
However, neurostimulation for paralysis is still in its early stages, and scientists don't know exactly how it works to restore movement, says Kristin Zhao, an investigator at the Mayo Clinic and author of one of the September papers. It tapped into "residual connections that are not being used" after a spinal cord injury, the outlet noted. And so the researchers set about understanding how the nervous system responded to movements in every joint in healthy individuals, building up a "map" of what these activation patterns looked like.
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