MONDAY, Feb. 7, 2022 (HealthDay News) — A motorcycle accident left Michel Roccati with complete lower-body paralysis following a devastating spinal cord injury.
It was in 2017.
But now the Italian native is walking again, thanks to groundbreaking Swiss research that restores motor function within a day through carefully targeted electrical stimulation.
“At first I was unable to move my leg muscles, and I don’t feel anything,” Roccati recalled recently.
Now he can stand, walk and climb stairs. In fact, “anything I have in mind to train I can do with stimulation,” Roccati said at a press briefing hosted by natural medicinewho recently published the results.
According to the World Health Organization, each year, between 250,000 and half a million people around the world suffer a seriously disabling spinal cord injury, most often following a fall, violence or, like Roccati, a traffic accident. Compared to people without this injury, they are two to five times more likely to die prematurely.
Roccati is one of three patients enrolled in the Swiss effort, all men between the ages of 29 and 41. Each had suffered a complete spinal cord injury at least one year prior to the start of the study.
“That means they couldn’t move their legs and they had no sensation above the legs,” said study co-author Dr. Jocelyne Bloch, a neurosurgeon and head of the functional neurosurgery unit at the University Hospital of Lausanne in Switzerland.
Speaking at the briefing, Bloch noted that in 2020 the three men underwent surgery at the NeuroRestore in Lausanne to implant a pacemaker in the abdomen and electrodes directly on the spinal cord.
These electrodes are themselves an important innovation, explained study colleague and neuroscientist Grégoire Courtine.
Built to be permanent, they are “precisely positioned to target all regions of the spinal cord relevant to activating core and leg muscles,” said Courtine, of the Ecole polytechnique fédérale de Lausanne.
The electrodes were then paired with new software that facilitated highly personalized mapping of each patient’s spinal cord, Courtine said during the briefing.
The software also provides a simple tablet-based interface that allows patients and physiotherapists to easily set up semi-automated stimulation programs allowing for a variety of movements.
Patients can operate these programs themselves, via a tablet and small remote controls that can communicate wirelessly with the patient’s pacemaker.
For Roccati, all of this meant that after a 10-day post-surgery recovery period, rehabilitation began – and “I was able to walk after a day,” he said. The remote controls are attached to his walker.
“Thanks to this technology, the three patients, immediately after the operation, were able to stand up and walk,” Bloch said during the briefing. Pedaling, swimming and torso movements were also enabled. None reported pain or stimulation-triggered side effects.
Still, Bloch noted that the motor control “wasn’t perfect at the very beginning”. And Courtine stressed that regaining movement after surgery is a process, “not a miracle”. patients initially needing a lot of physical support. Also, “the recovery of sensations is very different from one patient to another,” he added.
“But what it does do is enable immediate training ability,” Courtine noted. And because the technology is small and portable, this training can take place in the real world.
Every day, with the stimulation on, “Michel is able to stand for two hours, and he walks almost 1 kilometer (0.6 mile) in a straight line, without stopping”, in addition to going up and down stairs , said Courtine. “When the stimulation is off, he had some recovery, but to a very limited extent.”
Bloch said the technology would almost certainly work just as well in paralyzed women.
And while future research may expand what’s possible, Bloch recognized a key limitation: “We need at least 6 centimeters of healthy spinal cord below the injury. This is where we implant our electrodes.
Claudia Angeli, director of the Center for Spinal Cord Injury Research at the University of Louisville in Kentucky, agreed that the Swiss team’s work was “encouraging” but said other approaches also had merit.
“This group uses a very specific stimulation signaling method, while alternative efforts attempt to enable motor control via direct stimulation of brain signals,” she said.
Such alternative approaches “showed similar results,” Angeli noted. “There has not been a direct comparison of the two methods, but both show promise for recovery after spinal cord injury.”
Meanwhile, the Swiss team has an ongoing lawsuit in the United States. The researchers noted that the U.S. Food and Drug Administration has approved a “breakthrough devices” designation to expedite the process by which the technology could become commercially available. This designation would also guarantee coverage through the Medicare Coverage of Innovative Technology program if larger clinical trials are successful, the researchers said.
As for Roccati, after nine months of drug treatment in Lausanne, he now lives independently in Italy. “I continued rehabilitation at home, working alone, with all the devices,” he said. “And I see improvements every day.”
There’s more on spinal cord injury and paralysis at Christopher & Dana Reeve Foundation.
SOURCES: Claudia Angeli, PhD, assistant professor, School of Engineering, University of Louisville, and director, Kentucky Spinal Cord Injury Research Center; press briefing, February 2, 2022, and natural medicine, February 2, 2022