November 20, 2018

A Potential Breakthrough for Paralyzed Patients

“David Mzee’s left leg has been paralyzed ever since he bounced off a trampoline and broke his neck in 2010. So when he woke up in the middle of the night last year and realized he was moving his left toe, he couldn’t believe it. “I didn’t know if it was real,” he says. He kept wiggling the toe, resting it, and then wiggling it again. “I think I was awake for an hour after that, just to see if it keeps on moving.”

It kept moving. Mzee’s toe wiggle was the result of months of physical training and a device that delivers pulses of electrical stimulation to Mzee’s spinal cord. Now, after participating in a study at the Swiss Federal Institute of Technology in Lausanne, Switzerland (EPFL), he and Gert-Jan Oskam, another man with partial lower body paralysis, can walk across the ground with crutches. A third participant, Sebastian Tobler, came to the study with an extreme case of lower body paralysis — and by the end, he could walk across the ground with a walker, according to a study published Wednesday in the journal Nature.

For all of the study participants, stepping is still slow and difficult; they continue to use wheelchairs to get around (and, for Mzee, to play competitive wheelchair rugby.) But the surprising thing is that even with the spinal stimulation turned off, both Mzee and Oskam can now take a handful of steps with crutches, and move joints that they couldn’t move before — like Mzee’s left toe. It shows that with electrical stimulation and training, the spinal cord can regain control over paralyzed muscles even years after an injury.

The study, led by Grégoire Courtine, an associate professor at EPFL, is the third small study in just over a month to show similar results. And it raises the question of whether it’s time for these spinal stimulation devices to move beyond the lab and into the clinic. “If we rush too fast, there’s going to be mistakes and that could set back everything,” says Reggie Edgerton, a professor of integrative biology and physiology at the University of California, Los Angeles. Edgerton, who was a co-author on one of the three recent studies, encourages caution, tempered by the urgency felt by many in the medical community: “At the same time I know that patients are waiting, and keep waiting.””

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