Nanotechnology for Spinal Cord Injury

A cure for spinal injuries that leave people paralyzed, currently incurable, is being developed by Researchers at Northwestern University in Chicago. They are looking into using new nanotechnology that could enable them to completely heal cut and severed spinal cords allowing the previously paralyzed to walk again.

Spinal cord injury often leads to permanent paralysis and loss of sensation below the site of the injury due to damaged nerve fibers which can?t regenerate. These nerve fibers (axons) have the capacity to grow but don?t because they are blocked by scar tissue that have developed around the injury. Northwestern University researchers have shown that a new nano-engineered gel inhibits the formation of scar tissue at the injury site and enables the severed spinal cord fibers to regenerate and grow.

The gel is injected as a liquid into the spinal cord and self -assembles into a scaffold that supports the new nerve fibers as they grow up and down the spinal cord, penetrating the site of the injury. When the gel was injected into mice with a spinal cord injury, after six weeks the animals had a greatly enhanced ability to use their hind legs and walk.

However it was stressed that the results were preliminary and there is no magic bullet and it may not necessarily work on humans, but it helps a new technology to develop treatments for spinal injuries.

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Researchers Developing Therapy to Treat Paralysis

A team of researchers at Case Western Reserve University in Cleveland, Ohio are developing a new therapy that will help paralysis victims regain control of their muscles.

Functional Electrical Stimulation uses electric currents to stimulate muscles that no longer receive messages from the brain.

"When someone has a spinal cord injury, it's like they cut an electrical wire," Brian Heidenreich, associate professor of psychology, said. "The neurons that control muscles in the spinal cord are still there, but they don't get any messages from the brain."

Strokes may also damage or limit interaction between the brain and the muscles.

"Strokes wipe out the motor cortex, which controls motor movement in the body," Heidenreich said.

Organizations like the Food and Drug Administration, the State of Ohio and the National Institute of Health provide funding for FES research.

"The majority of the research programs at the Cleveland FES Center focus on spinal cord injury (SCI) and stroke," Mary Buckett, Cleveland FES researcher, said. "SCI programs at the FES Center vary and range from high level tetraplegia to incomplete paraplegia."

The actual treatment is an implanted prosthesis that restores communication between the brain and the muscles.

Researchers can also make the frontal lobe - the part of the brain that controls learning and thought - perform the tasks of the motor cortex with an FES device.

"It is possible to get brain regions to take over functions that weren't theirs originally," Heidenreich said.

Other FES programs focus on illnesses like Multiple Sclerosis and Osteoporosis. The programs are located in countries like Argentina, Canada, Australia, Poland, Japan and Italy.

A majority of the volunteers at the Cleveland center, Buckett said, have already sought traditional therapies. For them, FES treatment is seen as an additional opportunity to regain the ability to stand, apply make-up or write. In MS patients, FES therapy can reduce hand tremors by 50 percent.

The therapy may also restore basic bladder, breathing and hearing functions and eliminate the occurrence of urinary tract infections, loss of bone density and muscular atrophy.

Buckett, a former architect, explained in an FES Center document that her implant allows her to live as she did before she became paralyzed.

"I am less dependent on ? people to take notes in class for me or manipulate books and papers on my shelves and desk," she said.

"It has been amazing to witness individuals regaining function and independence," Buckett said. "To see someone stand from their wheelchair with pride and confidence and shake hands whilebeing introduced is a wonderful thing."

FES therapy still needs to go through additional testing, research, technological advances and FDA approval before researchers submit it for widespread use.

"This study is clearly a step toward making a device _that allows movement by people with paralysis, but it's one in a series that may achieve that goal," Heidenreich said.

By: Joanna Pelletier

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Could a Spinal "Bypass" Reverse Paralysis?

A breakthrough in spinal surgery yesterday offered hope to victims of paralysis.

The technique, which has been tested on rats, involves bypassing damaged tissue in the spine.

This allows signals to travel across injured areas, New Scientist reports.

Dr John Martin and his colleagues at Columbia University in New York have so far tested the procedure only on rodents. They selected a motor nerve branching from the healthy cord above the injury and cut it away from the abdominal muscle to which it is normally attached.

They then stretched the free end across the injured section of spinal cord and used a protein "glue" to fix it.

Two weeks later the team found that the graft had sprouted new extensions which had begun to form connections - or synapses - with the motor nerves in the isolated lower spine.

Zapping the spinal cord above the injury made the lower limbs of the rats twitch - showing motor signals had started once again to pass along the entire length of the spine.

The researchers say removing the nerve from the abdominal muscle did not appear to cause any major side effects and suggest this is because nearby nerves pick up the slack.

Fellow neuroscientist Dr Reggie Edgerton, of California University, said the approach had considerable clinical potential but added that it was too early to tell whether it would work in humans.

Dr Marie Filbin of the City University of New York cautioned that it may not be possible to "reprogramme" a nerve that normally connects to an abdominal muscle to transmit the sophisticated signals needed to produce fine, controlled movements.

But Dr Martin, who presented his study at the New York State Spinal Cord Injury Research Program Symposium, said: "What we want to do is plug in new connections to bypass the damaged region."

He believes that - with a little surgical assistance - spinal cord nerves above an injury could be capable of making such connections with nerves lower down the spine.

He said: "We know the nerves can make new connections to muscle so we asked whether it's possible for them to also connect with spinal cord neurons isolated through injury."

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Doctors Try New Injection To Fight Paralysis

There are currently no effective therapies for spinal cord injuries. But a protein injection may help some patients walk again.

Two years ago, Michelle Robinson was on her way home from work when she was hit by a car.

"All I remember is hearing a loud screeching noise and I remember going, flying up in the air," Michelle said.

The accident left the 42-year-old mother paralyzed. Now she hopes an experimental drug will put her back on her feet.

"It appears that this actually does improve their prognosis," said James Harrop, a neurosurgeon.

Harrop is testing the novel drug called Cethrin to treat spinal cord injuries.

"It's a paste or a jelly that you sort of just spread onto the spinal cord with a little applicator, like a syringe," he said.

Doctors apply the protein during standard decompression surgery to stabilize the spine. The idea is to stop nerve cell death that includes days to weeks after the injury occurs.

"Inside the cell, there?s a nucleus which is controlling sort of this, the auto-regulator of the cell and what it?s doing is it?s telling the cell we don?t want you to function anymore," Harrop said.
Cethrin is designed to interfere with that message by seeping through the spinal cord membrane to cells at the injury site.

"It goes into the cell and it says 'wait a minute'. I don't want you guys going down that path anyways, I want you to stop and I want you to start repairing the cell," Harrop said.

Early trials show the protein therapy is safe. And the results are promising. Michelle says she is both excited and hopeful the new therapy will work for her.

"I say those words because Dr. Harrop told me that he was very hopeful that, you know, maybe one day I would be able to walk again, so I'm very hopeful also."

Doctors caution that Cethrin, also called BA210, is not a magic bullet. But in the study, 31 percent of patients regained some function after being injected with the drug. The study is still enrolling patients. About 253,000 Americans are living with a spinal cord injury. Roughly 11,000 new cases occur every year.

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