Tuesday, September 01, 2009

New data on Paralysis Could Impact Future Treatment Strategies

Sufficient information on the prevalence of Americans living with paralysis and spinal cord injuries (SCI) has always been hard to come by. Most information cited in educational literature and on many Web sites regarding paralysis and SCI is extremely outdated. This presents numerous hurdles in devising new or evaluating existing policies, programs, and services for people living with these types of disabilities.

In 2004, The Christopher & Dana Reeve Foundation brought together a task force of more than 60 scientists, scholars, health advocates, and experts from the U.S. Centers for Disease Control and Prevention (CDC) and numerous universities, policy centers, and nonprofit health care organizations to identify what was needed to improve the quality of life for people living with paralysis. In order to complete this complex initiative, the Paralysis Task Force first needed to obtain more recent data on the individuals they were trying to assist.

With support from the University of New Mexico?s Center for Development and Disability (CDD) in partnership with the Christopher & Dana Reeve Foundation?s Paralysis Resource Center (PRC), researchers designed and conducted a survey of more than 33,000 households across the country??one of the largest population-based samples of any disability ever conducted. The new data demonstrates that paralysis may be dramatically more widespread than previously thought.

Below are some of the report?s major findings:
  • Approximately 1.9 percent of the U.S. population, or 5,596,000 people reported they were living with some form of paralysis, defined by the study as a central nervous system disorder resulting in difficulty or inability to move the upper or lower extremities. This is about one-third more Americans living with paralysis than previously estimated (4 million).
  • The leading cause of paralysis was stroke (29 percent), followed by spinal cord injury (23 percent) and multiple sclerosis (17 percent).
  • Data indicate that 1,275,000 people in the United States are living with spinal cord injury?more than five times the number of Americans previously estimated in 2007 (255,702).

These findings have major implications for the treatment of spinal cord and paralysis-related diseases?not only for those living with these conditions, but also for their families, caregivers, health care providers, and employers. As the number of people living with paralysis and spinal cord injuries increases, for example, so do the costs associated with treating them. Each year, paralysis and spinal cord injuries cost the health care system billions of dollars. Spinal cord injuries alone cost roughly $40.5 billion annually?a 317 percent increase from costs estimated in 1998 ($9.7 billion),? the report states.

If you have yet to read this important report conducted by the Christopher and Dana Reeve Foundation, you can access the 28-page PDF here.

By NY Disability Examiner Tom Scott

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Friday, April 10, 2009

"Moment by Moment: The Healing Journey of Molly Hale"

"Moment by Moment: The Healing Journey of Molly Hale" is an inspiring documentary film on a woman's journey to heal from a spinal cord injury. It documents Molly's progress to work past a prediction that she would be paralyzed from the shoulders down. Through a variety of healing methods and an outpouring of hands-on-support from her community, she is beginning to learn to walk again and has hope for future progress. It is an intimate, touching film that could help others to visualize a healing path for themselves. It can be viewed online for free.

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Tuesday, December 16, 2008

Help Find A Cure for SCI!

By joining Find A Cure Panel?s exciting online research panel for people with spinal cord injuries, you will be empowered to share your personal experiences in vital research.

What's more, for each survey you complete a $10 donation is made directly to a worthy nonprofit organization in spinal cord injury research and support.

Registering is fast, free and your privacy is completely protected!

Registration Link: Find A Cure Panel

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Friday, November 21, 2008

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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Nose Cells May Heal Spinal Cord Injuries

People paralysed by spinal cord injuries could soon be "repaired" using cells from their own noses, say Otago University researchers.

The Health Ministry's ethics committee has just approved an application by the Spinal Cord Society to open the way for a clinical trial involving 12 patients, which could start next year.

The society's president, Noela Vallis, said there was no shortage of volunteers ready to take part.

"Some have already gone overseas out of a sense of frustration that they can't access it [the experimental treatment] here," Mrs Vallis said.

About 5000 Kiwis are in wheelchairs as a result of accidents - the highest rate of any country in the developed world.

Research director Jim Faed, who heads the the Spinal Cord Society's lab at Otago University, has spent five years developing laboratory methods for growing cells potentially useful for spinal cord injury repair.

His team is focusing on two promising cell types: one is a kind of adult stem cell produced by a patient's own bone marrow.

However, researchers are likely to begin trials using olfactory (scent receptor) cells from the patient's nose, injecting them into damaged spinal cord.

"The olfactory tissue in the nose is unique because it is the only place in the body where there is constant replacement of nerve cells throughout life," Dr Faed said.

"There is growing medical opinion that these cells can help overcome the blocks that prevent nerve cells regenerating after damage to the spinal cord."

The nasal tissue acts like "nurse cells", providing growth factor hormone to nerve cells, enabling them to make "meaningful connections".

Internationally, several research groups have done animal trials using the cells, but there has been only one human trial - in Portugal in 2006. The Otago group is in contact with Portuguese neuropathologist Carlos Lima, who pioneered that trial.

Dr Faed said some participants experienced side-effects, but they were "few and manageable" and none had been fatal.

Positive benefits for patients included return of some muscle function and sensation in parts of the body which previously had no feeling.

Dr Faed said the Dunedin lab hoped to get full approval for the trial before Christmas, and would then begin recruiting patients. The first 12 could start treatment next year.

Mrs Vallis - who founded the society after her late husband was paralysed in an accident - said the group aimed to raise $1 million to fund the trial, in addition to the $300,000 it finds every year to run the lab. "We should be at the forefront of developing this medical treatment, given the number of our citizens in wheelchairs."

Feilding man Iain Scott, a quadriplegic since dislocating his neck while playing rugby 19 years ago, said the possibility of the treatment was "huge" and gave hope to people with spinal cord injuries. "If nothing happens, at least you had a go ... you don't want to die wondering."

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Monday, October 27, 2008

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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Monday, May 05, 2008

Advances Offer Hope for Spinal Cord Injury Patients

Cell transplantation, physical therapy show promise in restoring function

There is no cure for a spinal cord injury, but much headway has been made in clinical research that could lead to one. Other therapies have helped to restore some function in spinal cord injured patients. A look at some efforts?

The latest in cell transplantation

Cell-based therapies hold the potential for replacing cells and restoring function lost to disease or injury. Among those being developed to help treat spinal cord injuries:

Stem cells are building blocks capable of turning into various cells and tissues found in the body. Embryonic stem cells, in particular, are able to transform into any tissue, given the right biochemical instructions, and could be used to replace spinal cord cells lost during injury. However, human embryonic stem cell research is politically controversial, because culling the cells destroys embryos. Still in the research phase, stem cells have helped paralyzed rodents move again in several ways, including helping to regrow destroyed nerve cells in the spinal cord and successfully restoring myelin, a nerve fiber insulation that helps maintain the electrical conduction required to move.

Olfactory tissue, which covers about one-inch of the upper nasal cavity, contains many cells with regenerative potential, including olfactory ensheathing cells (OECs). Several experiments have found that OECs promote nerve regeneration and may restore function when implanted into an injured spinal cord. These OECs produce insulating myelin sheaths around the damaged nerve cells, encouraging regrowth. While research continues, some scientists, including Portugal's Dr. Carlos Lima, have transplanted olfactory tissue into patients with spinal cord injuries. Preliminary results were published in 2006 in the Journal of Spinal Cord Medicine.

Schwann cells: Another type of "ensheathing" cell, Schwann cells may also help stimulate nerve regeneration of an injured spinal cord. According to Dr. Wise Young, founding director of the W.M. Keck Center for Collaborative Neuroscience at Rutgers University, many laboratories have shown that Schwann cells alone will improve function after spinal cord injury in animals and even more so when they are combined with other therapies, such as OECs.

New advances in physical rehabilitation

Functional electrical stimulation: When connections between the brain and spinal cord are diminished by trauma, the ability to control movement can be eroded or lost. Functional electrical stimulation, or FES, systems can act as a substitute for those lost signals. FES systems apply a small electrical current that stimulates muscle contractions via electrodes that are either taped to the skin or surgically embedded. The contractions help maintain muscle mass, initiate movement in hands or legs or even stimulate the bladder or diaphragm. Dr. John McDonald of Baltimore's Kennedy Krieger Institute uses special exercise bicycles hooked up to FES systems to help paralyzed patients pedal, believing the repetitive activity helps restore function and also may stimulate regrowth of the damaged neural connections. McDonald also used FES in working with the late actor Christopher Reeve.

McDonald says: "We're focused on incremental improvements. What we ... say is this: No one can tell you whether you can walk or not walk. All I can say is doing an activity-based program in today's world is your best chance at meeting the cure halfway.''

Treadmill training uses repetitive motion to try to teach the legs how to walk again. A paralyzed person is suspended in a harness above a treadmill, reducing weight the legs have to bear. As the treadmill starts, therapists move the person's legs in a walking pattern. The theory driving the work is that paralysis causes "learned nonuse" of muscles, but the injured nervous system may be capable of recovery when certain conditions are optimized, including the patterned neural activity that accompanies treadmill walking. (Source: The Christopher and Dana ReeveFoundation Paralysis Resource Center.)

Activity-based, exercise or aggressive physical rehabilitation: Based on the same activity-triggering premise, several centers across the nation are using aggressive exercise, or activity-based therapy, to help restore function in some spinal cord injured patients. Results vary, depending on the patient's level of injury and how much time has passed since the injury.

But researchers like Young, of Rutgers, voice encouragement: "Many of the people who are currently not walking, if trained properly, would be able to walk. What is really necessary is more evidence-based medicine to indicate that these things really work and then to show to the insurance companies that this is an effective therapy so that they will cover it. Hundreds of thousands of peoples' lives would be affected.''

Centers include: Project Walk in Carlsbad, Calif.; BeyondTherapy, at the Shepherd Center in Atlanta; The Center for SCIRecovery at the Rehabilitation Institute of Michigan.


Methylprednisolone, a steroid drug, became a standard treatment for acute spinal cord injury in 1990 when a large-scale clinical trial showed significantly better recovery in patients who were given the drug within the first eight hours after their injury. It appears to reduce the damage to nerve cells and decrease inflammation near the injury site by suppressing activities of immune cells. (Source: National Institute of Neurological Disorders and Stroke.)

Other drug-related research now under way includes: Studies to determine whether Riluzole, now used to treat Lou Gehrig's disease, may protect nerve cells and promote motor recovery when administered after spinal cord injury; and a trial involving the drug Cethrin, which has been found in animal studies to lessen post-traumatic neural cell death.

Gene therapy

Gene therapy carries the potential to provide the injured spinal cord with the specific gene products, or proteins, that it needs to promote functional recovery. Gene therapy is not a current treatment for spinal cord injuries but is being studied with animal models of spinal cord injury. The concept is to transfer into the spinal cord a gene encoding a therapeutic protein, such as a growth factor or an axon guidance molecule, or to transplant cells modified to incorporate the gene. When the gene is expressed, the cell makes the desired protein. (Source: "Spinal Cord Injury: Progress, Promise and Priorities,"' a publication of The Institute of Medicine, an arm of The National Academies.)

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Wednesday, April 30, 2008

Decompression Aids Spinal Injury Recovery

Done within 24 hours, the procedure improved neurological outcomes a year later

Surgical decompression of the spinal cord involves the removal of various tissue or bone fragments that are being squeezed and comprising the spinal cord. While commonly done after an injury occurs, the timing of the procedure varies widely.

The study looked at 170 patients with cervical spinal cord injuries, graded as A (most several neurological involvement) to D (least severe), who underwent decompression surgery.

Six months after the surgery, 24 percent of the patients who had the surgery within 24 hours showed two-grade or greater improvement in their condition compared with only 4 percent in the group that had the surgery more than a day later.

"The initial results suggest that decompression within 24 hours of injury may be associated with improved neurological recovery at one-year follow-up. However, further recruitment of patients with long-term follow-up is necessary to validate these promising results," study author Michael Fehlings, head of the Krembil Neuroscience Center at the University Health Network in Toronto, said in a prepared statement.

Fehlings was expected to present the findings in Chicago April 28 at the annual meeting of the American Association of Neurological Surgeons.

Every year, almost 12,000 people in the United States and Canada, mostly young adults, sustain a spinal cord injury. Although surgery, such as decompression, can help, these procedures often do not dramatically improve overall recovery and outcome.

"This is an area of medicine that has not seen tremendous scientific advances, so there remains an urgent need to improve upon current interventions to help restore neurological function in patients with acute (spinal cord injury)," said Fehlings, who is also professor of neurosurgery at the University of Toronto.

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Monday, April 07, 2008

Experimental Russian Stem Cell Treatments Credited for Woman's Progress

Experimental Russian stem cell treatments for spinal injury credited for woman's progress

Notice: The following excerpts are taken from the Grand Rapids Press. A link the the entire article is listed below, and is well worth the time to read.
When Kadi DeHaan took her first steps in December, two years after a car accident forced her into a wheelchair, she did it in typical Kadi style: low-key, nonchalant and with a confident grin.

Apparently, she knew all along she would walk away from her pink and black wheelchair and her customized leg braces, despite a spinal cord injury at chest level and a grim prognosis that she would never walk again.

It happened after two years of intensive therapy and six trips to Russia, where her stem cells were harvested and then injected into her spinal cord to restore nerves.

Kadi's progress is "very much a unique and wonderful thing," said physical therapist Sandy Burns, director of the Center for Spinal Cord Injury Recovery in Rockford, a clinic affiliated with the Detroit Medical Center.

No one can say for sure if nearly two years of experimental treatments or hours upon hours of physical therapy -- a trio of three-hour sessions every week -- led Kadi to where she is today.

Probably both, said Burns, whose clients sometimes head to Russia or Portugal or China for treatments that aren't approved in the U.S. and generally aren't covered by insurance.

The physical therapy is a very important component, "but it's definitely Russia," that put Kadi back on her own two feet, Kadi's mom, Bonnie, insisted. "There are just too many coincidences. Kadi knows that what she's got she got from Russia."

After fundraising dollars ran out more than a year ago, Kadi's parents took out a loan to pay for the trips to Russia. The three-year protocol recommended by Moscow doctors will cost in excess of $150,000.

At the time, Kadi had just a bit of feeling in her feet and could walk only with lots of help from custom-built leg braces and a walker.

Since then, she's given up the braces and is "tons stronger" and "a lot more independent," she said. She's a full-time student at Davenport University who quaffs Mountain Dew and confesses to sending text messages during class.

"I've seen a lot of changes. I've seen motor return, sensory return, everything," Kadi said.

She's so convinced of the gains made at the NeuroVita Clinic that she's planning her seventh trip there in August. Quite a change of attitude after she declared the first trip "the worst three weeks of my life."

Burns, who is quick to say her clinic does not endorse any of the alternative treatments, acknowledged that the stem cell injections do seem to make a difference, at least for Kadi.

"Folks that have gone there have, I think, consistently reported that they are noticing changes. They are feeling more," Burns said.

She tempers her optimism with the reality of what she sees every day: some of her clients will never accomplish half as much as Kadi has. Progress often depends upon the severity of the spinal injury, not just the region of the spine that was damaged.

That's why Burns doesn't make predictions about what her clients will eventually accomplish. But of course, she hopes Kadi continues to make great strides.

The Neurovita Clinic

Where: Moscow, Russia
What: Treats spinal cord injuries, degenerative disorders and some cancers with patient's own stem cells, which are harvested, grown and re-injected. Clinic moved away from use of embryonic stem cells because of compatibility issues.
Insurance: Because treatment is experimental and not performed here, U.S. insurance policies don't cover it.
Website: neurovita.ru/eng_index.html

The NeuroVita clinic was founded by neurologist Andrey S. Bryukhovetskiy in 2002. It's located on the campus of the Russian State Medical University and can accommodate 35 patients.

The clinic dabbled in embryonic stem cell treatments but now uses only autologous material -- that which is obtained from the patient -- because there are no problems with compatibility, not to mention politics and religion, according to the Web site.

About 11 of every 100 patients with spinal cord injuries walk again after the stem cell treatments, Bryukhovetskiy told them.

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Thursday, February 07, 2008

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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Tuesday, January 08, 2008

Scientists Able to Get Mice with Spinal Injuries to Walk

Scientists conducting research have been able to gain fresh insights into how partial mobility is possible despite spinal injuries. The research, conducted on mice with spinal injuries could provide a totally different approach to restoring mobility, even if it is partial, in patients who have suffered similar injuries.

Scientists conducting research have been able to gain fresh insights into how partial mobility is possible despite spinal injuries. The research, conducted on mice with spinal injuries could provide a totally different approach to restoring mobility, even if it is partial, in patients who have suffered similar injuries.

In the study, mice were inflicted with spinal injuries in the laboratory. Over a period of two to two and a half months (eight to 10 weeks), the mice were able to walk again, though not as fluently as they used to before the injuries.

The study involving the mice highlighted the fact that after a spinal cord injury, the brain and the spinal cord had the ability to reorganize their functioning and re-establish the communication network needed at the level of the cell to execute the task of walking.

Scientists said after the mice suffered from the partial spinal cord injuries, the neural networks in the brain and the spinal cord reorganized themselves. The reorganization was done in such a way that though the long and continuous neural highways transmitting impulses between the brain and the center for walking located in the lower regions of the spinal cord were broken, the mice were still able to walk.

Researchers are quite excited about the new findings. As Dr. Michael Sofroniew, neurobiology professor at the University of California Los Angeles? David Geffen School of Medicine and lead researcher put it, ?This is not the end of a story. This is the beginning of a story.?

Dr. Sofroniew said the research team was able to identify a mechanism that aided the functionality recovery from partial spinal cord injuries that no one knew about earlier. He said there was still work to be done, and that scientists now could focus on understanding this mechanism better so they would be able to know how to make better use of it.

Dr. Sofroniew said they could achieve this by undertaking the right approach to rehabilitation therapy and also determining how to stimulate this alternative network. The research is almost revolutionary as so long, scientists were of the opinion that the only way to get a person with a spinal cord injury to walk again was to have the long neural highways grow back and connect the brain to the spinal cord base.

The spinal cord basically passes through the neck of a person, down the back. It transmits messages between the brain and the different parts of the body. Any serious injury to the spinal cord, as in a car accident, can sever the long neural highways, causing the patient to be paralyzed. So far, scientists had not been able to cure paralysis of this kind.

The new research shows that when the damage to the spinal cord causes the neural highways to break down and stop messages transmitted from the brain from reaching the designated parts, it was possible for the messages to find alternative ways to reach the destination.

For instance, if the instruction from the brain was to move the leg, as in the case of walking, it would not go over the neural highway; instead, it would travel over an alternate network consisting of a number of shorter connections to ensure the message from the brain reached the legs.

Dr. Sofroniew said the situation was somewhat akin to a traffic situation. If there is a jam on the freeway, one could get on to interconnected and shorter side roads to circumvent the jam and reach the destination. That was how it was in the case of message transmission in the laboratory mice, he said.

During the research, the team shut down half the neural fibers on either side of the spinal cord without disturbing the center. The center has a series of interconnected neural passages to send and receive information between the top and the bottom of the spinal cord.

In the next step, the researchers blocked the short passages as well, and the paralysis came back, confirming the messages had earlier gone to their destination over these shorter networks, which had been earlier left open.

The next step, researchers say, is to find out how to enable the spinal cord nerve cells to develop and grow around a specific injury site so the brain can work with these cells instead and ensure there is no paralysis.

The team of scientists conducting the research has published its work in the journal Nature Medicine.

by Daisy Sarma

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Saturday, January 05, 2008

Join NSCIA for Free by January 15th to Help People with SCI

Medtronic, a leader in medical technology, has offered to donate $5 for every person who signs up as a member of the National Spinal Cord Injury Association (NSCIA) before January 15th!

Best of all, individual membership in the NSCIA is FREE!

The NSCIA has helped to improve the quality of life for people with spinal cord injuries and diseases since 1948. NSCIA advocates for best practices and public policies that affect people with SCI, and their families and service providers. Their 40 Chapters and Peer Support Groups provide a vital lifeline of information and support to more than 1,000,000 people living with SCI.

Members receive a variety of benefits that are not available to the general public, primary among them our bi-monthly publication, SCI Life, filled with issue-driven articles and news of interest to the SCI community and SCI e-news, our monthly member newsletter.

To learn more about all the benefits available to members, visit the NSCIA at www.spinalcord.org.

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Friday, September 21, 2007

Drug Can Help Patients Heal From Spinal Cord Injuries

According to the Spinal Cord Injury Information Network, there are about 11,000 new spinal cord injuries each year. Car accidents have been responsible for nearly 50 percent of spinal cord injuries since 2000, and falls have been the second most common cause of spinal cord injuries. Currently, about 253,000 Americans are living with a spinal cord injury.

Dr. Michael Fehlings from Toronto Western Hospital is studying a new drug to treat spinal cord injuries soon after they happen. The drug, called Cethrin, is applied during surgery to the injury site in a fibrin glue type of material. Cethrin is a recombinant protein that is made through artificial DNA technology. The protein inhibits Rho, a key pathway that triggers cell death and increases damage after a spinal cord injury.

"You apply [Cethrin] directly to the damaged spinal cord and then the medication penetrates the damaged spinal cord," Fehlings said.

Cethrin is still under study, but early results look promising. Results from a one-year study of the drug in 37 patients were presented in April, 2007 at the annual meeting of the American Association of Neurological Surgeons in Washington, D.C. All patients in the study had "A" grade injuries, which are the most serious. Injuries are graded from A to E, with A being the most serious and E being the least serious.

Patients received Cethrin an average of 53 hours after their injury occurred. After six months, 28 percent of patients improved by one or more grades. Five patients improved to a "C" grade, and two improved to a "D" grade.Typically, there is some recovery that occurs after an injury, but the rates of recovery are quite low, in the range of 5 percent to 10 percent.

"In this trial, fully a third of patients showed significant recovery, and almost 20 percent of the patients showed a major degree of recovery. In my own clinical experience, this type of recovery is very unusual," Fehlings said.

Fehlings says the drug is not a cure for spinal cord injuries, but it could have a major impact on patients' lives.

"They might be able to now grip a jar or to drink, or they might be able to transfer themselves, whereas before they might not have had trunk control. In some patients, it might even mean that they could recover the ability to walk," he said.

At least five institutions in the United States and three in Canada are studying Cethrin's role in spinal cord injuries.

By: Ivanhoe Broadcast News

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Thursday, September 06, 2007

Spinal Cord Implant

A team at University College London (UCL) is developing a spinal canal implant that could improve the quality of life and life expectancy for people with serious spinal cord injury.

Previous research has restored function to this patient group by stimulating muscles through the skin using surface electrodes or implanting electrodes in the muscles or between the spinal cord and the muscles.

UCL has for some time been investigating a different approach by putting the electrodes on the nerve roots, which is where the nerves emerge from the spinal cord but remain within the spinal canal.

'These are relatively fine and fragile fibres within the spinal canal,' said Prof Nick Donaldson of UCL's neuroprosthesis engineering department. 'The complication is that there are many fibres very close together which emerge from the spinal canal and form the major nerves that run down into the legs and also control the bowel and bladder.

'The advantage from a surgical point of view is that they're all available in one location, so you can, in a single procedure, field and place the electrodes together rather than having to fit electrodes and route cables over the legs of the patient.'

FineTech Medical makes an implant called the sacral anterior root stimulator for this site in the body which is just used for neurological functions ? primarily emptying the bladder and bowel.

'That has been very successful and made a big difference to patients who've had it fitted,' said Donaldson, 'but it doesn't do anything for the legs. I ran a research project in the 1990s where we stimulated the roots a bit higher up ? the lumbar roots ? and showed that we could get useful leg function, allowing a paraplegic to propel a recumbent cycle.

'We would like to expand the existing device by giving it more channels so we can add leg function to the existing neurological functions of the implants.'

The surgeon inserting the implant has to connect very small electrodes to individual nerve roots in such a way that the currents which flow between the electrodes just stimulate the target nerve roots, not neighbouring ones. This is achieved using a structure called an 'active electronic book,' because the surgeon can place the roots between the 'pages' of the device, separating them.

'The project, which is mainly technological, addresses how we can increase the number of stimulation channels without having many cables going into the spinal canal, said Donaldson. 'At the moment we have really been working at the limit of what the surgeons think is practical, with 12 channels, each corresponding to a nerve stimulated. The number one might want to stimulate is in the region of 20 to 30, so if we could double or treble the number of channels, we could do more for patients.

'That requires us having some way of putting the electronics right down near the electrodes. So the idea of the active book is that it has semiconductor switches and perhaps amplifiers within the electrode structure, we call the book and relatively few wires going through the dura (the outer membrane of the spinal cord) into the canal.'

This has the advantage of reducing the risk of infection and cerebro-spinal fluid (CSF) leak.

By the end of the project, the team hopes to show the technology can run in saline for long periods. It aims to demonstrate a method of sealing the electronics so the implant will be reliable for years, and carry out mechanical tests to prove its robustness.

The EPSRC-funded project runs from 2008 until 2010 during which time UCL will carry out the design of the electronics. When complete, approval will be sought from the Medicines and Healthcare products Regulatory Agency (MHRA) to undertake trials, which could take up to 10 years

UCL's project partners are the Tyndall Institute, which will develop the integrated circuit sealing, and Freiberg University, which has special knowledge of laser cutting tiny electrodes.

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Friday, August 24, 2007

Stem-cell therapy: Cure or hoax in China?

'Some get miracles'; others are skeptical

The website for Beike Biotechnology bursts with stories that can only be categorized as medical miracles: a paraplegic can move his legs again; a man with muscular dystrophy can carry a cup of water, a stroke victim can speak.

These tales of ailments treated come from all over the world - England, Hungary, Russia, Canada - and back the healing claims of a controversial Chinese treatment that purports to cure the incurable.

"I saw miracles every day I was there," says Leslie Wells, who flew to China in April, 11 years after a swimming pool accident rendered her arms and legs limp. "It can be a crapshoot. Some people get miracles, some people get nothing."

Doctors at Beike - based in Shenzhen, China - are treating a host of nerve disorders with stem-cell therapy, a procedure still under early clinical trials in much of the Western world. In just two years, doctors at Beike have injected stem cells from umbilical cords into the spines of nearly 1,000 patients from outside the country. Roughly 30 of those patients came from Canada, according to a Beike spokeswoman.

Approval for such treatments in Canada is years away, and the medical community here stands firmly opposed to people seeking them in China, citing possible health risks. In a research paper published in Neurorehabilitation and Neural Repair last year, several doctors in Canada and the United States followed up with patients of Hongyun Huang, who has been offering stem-cell treatments in China for several years. Few of the patients had improved since returning from China.

"If it sounds too good to be true, it's too good to be true," says Michael Rudnicki, Canada Research chair in molecular genetics at the University of Ottawa.

But increasing numbers of Canadians are sidestepping domestic regulations and venturing to China in hopes of a cure.

Ms. Wells, of Milton, Ont., first heard about Beike in a news story she read about two Ontario women who had suffered spinal-cord injuries in a car accident and then received the stem-cell treatments in China with some success.

As she flipped through the beaming testimonials on the company's website, it crossed her mind that the whole thing might be a scam. She just wanted a cure to nerve pain so crippling that "no painkiller known to man would help."

Her spine specialists warned her against it.

Eventually, she decided. "I was like, all right, what do I have to lose? Just a little money."

Ms. Wells paid $23,000 for the procedure and travelled to Nanshan Hospital in China, where she received six injections teeming with stem cells into her spinal fluid. Beike says the stem cells repair damaged nerves.

After her second injection, the pain that had made jobs and school seem impossible, was nearly gone.

"On a scale of one to 10, it went from like a nine down to a two. I haven't taken a single painkiller since."

She's not alone in her praise of the injections. With his speech and balance failing, George Arruda, an Ancaster, Ont., landscaper with ataxia, flew to Nanshan for four spine injections and two IV drips.

Ataxia is a progressive disorder that prematurely kills the nerve cells responsible for balance and co-ordination, and is one of the long list of neural conditions that Beike will treat. That list also includes epilepsy, ALS, cerebral palsy, spinal-cord injury and strokes,

Mr. Arruda knew it was an uncertain therapy, but his wife had recently given birth to a daughter. "I just wanted to be a healthy strong dad for her."

Before the trip, he could get around only with the aid of a walker. One night, about midway through his treatment, he was surprised to find himself walking to the bathroom unassisted.

"Immediately, I was about 20 per cent better," he says.

Since returning to Canada in February, he's had a relapse of symptoms. But he says that was probable considering the degenerative nature of ataxia. He's now looking at other stem-cell treatments.

Western medical experts chalk up the positive testimonials to the placebo effect. "We can give people a sugar pill and tell them it will get rid of all their pain and they'll insist that it works," Dr. Rudnicki says, "so I'm highly doubtful of testimonials. If I just spent $30,000 on a procedure, I would want to say it worked too."

Researchers at the University of Alberta are in the midst of studying the proliferating number of companies offering stem-cell cures. So far, they've discovered more than 30 based all over the world.

"The term stem cell has so much currency around the world right now," says Tim Caulfield, Canada Research chair in health law at the University of Alberta and member of a Canadian network of stem-cell researchers. "Even though the scientific community is deeply skeptical, people just associate the term with hope. It's a perfect area for quackery."

Eventually, Dr. Caulfield expects that researchers can use the University of Alberta study to make policy recommendations. "If there is fraud, we want to find it. The people going in for this are often tremendously sick and desperate. We want to ensure they are not being exploited."

Beike is open to the scrutiny. Patients are encouraged to post pictures and blog entries online documenting their time in China. Most depict a pristine hospital with cheery medical staff.

"Most of the doctors who work for us have been trained in Europe or the U.S.," says Kirshner Ross-Vaden, lead medical consultant with Beike's North American operations. "These are people who are leading the entire medical field. We have the nicest hospitals in China. The North American medical establishment is simply behind the times."

Beike says that 86 per cent of their clients show some measure of improvement.

Researchers in Canada say that while clinical trials have begun to look at the possibilities of stem-cell treatments, the therapies won't be available to the public for years - if they actually work.

Until that day comes, researchers here continue to advise against a stem-cell trip to China.

"They are ... putting patients at risk," Dr. Rudnicki says.


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Thursday, June 28, 2007

Clinical Trial Suggests Bone Marrow Stem Cells Are Useful for Spinal Cord Injury

Patients Experienced Increased Mobility After Treatment; Preliminary Results Involving 25 Patients Presented at International Society for Cellular Therapy?s Annual Meeting in Sydney

PrimeCell? Therapeutics LLC announced that it provided research support and pre-clinical studies for a clinical trial to assess the safety, feasibility and efficacy of implanting autologous bone marrow stem cells into spinal cord injury (SCI) patients.

Dr. Luis Geffner presented a preliminary report at the 13th Annual Meeting of the International Society for Cellular Therapy, held here June 24-27. From May 2006 to January 2007, 25 patients with SCI were treated at Luis Vernaza Hospital in Guayaquil, Ecuador. They were treated with autologous bone marrow stem cells ? meaning the cells were extracted from the patients' own bone marrow.

Fifteen patients (60 percent) could stand up, ten patients (40 percent) could walk on the parallels with braces, seven (28 percent) could walk without braces, and four (16 percent) could walk with crutches. Patients demonstrated improvements in sensitivity, motility, bladder sensation, even controlling sphincters, erection and ejaculation. No adverse event was observed.

"These preliminary results, while encouraging, must be interpreted cautiously and prudently, and we must continue work examining the benefits of surgically implanted autologous bone marrow stem cells to patients with spinal cord injuries," said Geffner, director of the stem cell program at the Junta de Beneficencia de Guayaquil. He emphasized that this work was done with the help and support of the Junta de Beneficencia, Benemerita Sociedad de Lucha Contra el Cancer (SOLCA), and with the research support and pre-clinical studies performed by stem cell biologist and senior author Francisco Silva and his team at PrimeCell Therapeutics, based in Irvine, Calif.

The study included in vitro (laboratory tests), pre-clinical (animal) and clinical (human) data.

"There is evidence demonstrating significant improvement in the quality of life of patients receiving the treatment, including spinal cord regeneration and additional clinical improvements following these stem cell transplants,? said Silva, vice president of research and development for PrimeCell Therapeutics. ?More research is needed, of course, but this is very encouraging. Our ultimate goal, as always, is not just research ? but research that will lead to timely viable therapies."

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Wednesday, April 18, 2007

Drug Shows Promise in Spinal Cord Injury Treatment

A drug called Cethrin shows promise in treating people with spinal cord injury (SCI), according to a study by American and Canadian researchers.

Cethrin inhibits Rho, a signaling master switch that, when activated, triggers cell death and increases damage after SCI. Tests in animals with SCI have found that Cethrin inhibits cell death and promotes neural regeneration.

This one-year study looked at the use of Cethrin (a recombinant protein) formulated with a fibrin sealant in 37 patients who had just suffered an SCI that left them with no sensory or motor function below the area of the injury.

All the patients had an "A" grade injury as ranked by the American Spinal Injury Association (ASIA). Grades of injury go from A through E. An "A" is the most serious while "E" is normal.

After the patients had surgical decompression/reconstruction, the researchers started treatment with Cethrin, an average of 53 hours after the injury occurred. The patients received increasing doses of the drug (0.3, 1.0, 3.0 and 6 milligrams) administered extradurally to the injured spinal cord. The patients were assessed at various points over a year.

The study found that at six weeks, 30.6 percent of the patients improved by one or ASIA grades of injury. At six months, 28 percent of patients improved by one or more ASIA grades. Five patients improved to "C" and two improved to "D." One patient died from acute respiratory distress syndrome.

The study, which was funded by BioAxone Therapeutique of Montreal and Boston Life Sciences Inc., was presented Monday at the annual meeting of the American Association of Neurological Surgeons, in Washington, D.C. The findings from this Phase I/II study warrant moving on to a prospective randomized trial of Cethrin, the researchers said.

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