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Start over a walk after the paralysis caused by the spinal cord injury seems to be possible thanks to the electrical stimulation: this is what emerges from a new study conducted by the Federal Polytechnic School of Lausanne, Switzerland, published in the journal Nature. In particular, the researchers followed nine patients with spinal paralysiswhich, subjected to a program that provided for the electrical stimulation of the spinal cord area deputy to the control of the legs and physiotherapy, after five months they have regained the ability to walk independently. To investigate the neurological mechanism behind this phenomenon, the scientists replicated the conditions of the study in laboratory animals, identifying a class of neuronsactivated during electrical stimulation, which would play a key role in motor rehabilitation. According to the authors, this discovery marks one fundamental clinical breakthrough for the treatment of spinal paralysis.
Start walking again
The spinal cord is the structure of the central nervous system that it aims to put the brain in communication with the rest of the organism: thanks to the spinal nerves, which form real nerve connection circuitsin fact, the brain sends electrical signals that allow you to control the different parts of the body to get up, move, walk. However, trauma caused by an event such as a car accident or bad fall can result in one injury that destroys nerve connections present in the spinal cord, disrupting communication with the brain and leading to a permanent paralysis in the affected area. When injuries affect the lower spinal cord, the area responsible for motor control in the legs, the result is often the loss of the ability to walk and the damage to other functions where motor neurons come into play, such as bowel and bladder function or sexual activity.
Sometimes, however, the lesion may be incomplete and some spinal tracts may remain intact: in these cases, we try to restore nerve connections lost through electrical stimulation. The latter is a rehabilitation technique which, thanks to thesurgical implantation of a bundle of electrodes in the lower spinal cord, in combination with physiotherapy, aims at re-establish the electrical signal that has been damaged with the wound spinal, potentially restoring limb movement and motor activities impaired by spinal injury. In fact, that’s what the authors of the study wanted to show: the researchers submitted nine patients with spinal paralysis to a five month program which provided for the electrical stimulation spinal cord, exercise and rehabilitation. At the end of the study period, all nine patients have regained the ability to walk.
Find the responsible mechanism
This is a result that, in a lower number of patients, the researchers had already obtained a few months ago (we had told it here), even if the mechanism with which the electrical stimulation could act it remained mostly a mystery. To shed some light on the matter, the scientists studied the activity of spinal cord cells of patients while walking, both before and after treatment, found that they, after electrical stimulation, showed a particular reorganization: probably, the researchers hypothesized, there is a specific class of neurons which is activated only to recover motor function.
At this point the research group studied the mechanism in laboratory mice with spinal injuries, identifying a class of neurons that you activated only after stimulation electric of the spinal cord and which took on an increasingly important role as spinal tissue reorganized nerve connections and animals reacquired their motor functions. Not only: by deactivating these neurons, the mice that had started walking stopped immediately, while this did not happen in the healthy mice. All of this led the researchers to conclude that these neurons are the key players behind the effectiveness of spinal electrical stimulation therapies.
“It is essential that we understand the specific role that each neuronal subpopulation plays as a complex activity such as walking“says Jocelyne Bloch, senior author of the study.”Our new study, in which nine clinical trial patients were able to regain some degree of motor function thanks to our implants, offers valuable information on the reorganization process of spinal cord neurons “. According to the authors, this paves the way for development more targeted treatments for patients with paralysis. “We can now aim to manipulate these neurons to regenerate the spinal cord”, Concludes the researcher.
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