Thread: ChinaSCINet Update

  1. #1181
    I hope this is wrong.
    Why would they spend a lot of time, money and resources on a phase three trail if the 6month data of the phase two trail shows no recovery?
    Quote Originally Posted by paolocipolla View Post
    Moe,

    I... don't care about what I think ... you should just ignore my posts.

    I don't understand ... words.

    Paolo

  2. #1182
    Quote Originally Posted by Solan View Post
    I hope this is wrong.
    Why would they spend a lot of time, money and resources on a phase three trail if the 6month data of the phase two trail shows no recovery?
    Any chance Dr. Young could comment on the rationale here? It seems to me, from the comments here and indeed the question at that talk, that there is reason to suspect that some combination of the rehab alone and false classification of complete injuries could be responsible for the walking... Ok maybe not even suspicion, more pure speculation considering none of us have seen the data, but is there sufficient evidence to the contrary i.e. the cell transplant is helping?
    An aside: we've probably all met walking quads/incomplete paras who have little to no sensation below a certain level, for example below the knees. What on earth would it feel like to walk without having a change in sensation below an upper thoracic/lower cervical injury?!?

  3. #1183
    Quote Originally Posted by paolocipolla View Post
    At the spinal cord workshop of today Wise has given un update on the trials at chinaSCINet.
    Videos are available here:

    http://www.ustream.tv/channel/spinal-cord-workshop

    It is interesting that Wise said that the patients didn't improve motor and sensory score, but some of them walk... ???

    Paolo
    This is another disappointment
    Dr. Young, why r u going ahead with the trial in Norway, China, US and India ??

  4. #1184
    This is a big disappointment , but was on the cards , as Wise had said earlier to lower down our expectations. I do not see any real cure of sorts coming in the near future. With this kind of a result I don't think many countries are going to do what Wise is hoping that they will do.

  5. #1185
    lakboy and others,

    As I pointed out in my talk, it is still early and we don't have all our 6 month data yet. The American Spinal Injury Association (ASIA) motor and sensory scores represent voluntary strength of 5 muscle groups in the legs. These scores do not appear to have changed at 6 weeks but some of the patients have shown improvements in their ability to stand and take steps. This does not mean that the patients will not recover voluntary scores in the coming months and years. It is still very early.

    I asked the question how people can recover locomotor capability when they are not showing changes in their motor and sensory scores. Our data suggest that the ASIA motor and sensory scores do not necessarily reflect indirect activation of the central pattern generator. ASIA motor and sensory scores are very important for detecting losses of long spinal tracts. However, they may not reflect recovery of function, which may be through indirect activation.

    If you ask people who are "walking quads" (like Patrick Rummersfeld, who runs marathons and does triathlons) to tap their feet or wiggle their toes, you will find that they are often not able to do so. Patrick has little or no feeling below his knees. Yet, he is able to walk well and run marathons. That is because he is able to activate the central pattern generator even though he may not be able to activate the muscles directly.

    This discrepancy between walking and motor scores may also be because spinal tract growth is (and should be) taking a long time. We see no growth of white matter tracts across the injury site at 6 weeks or even 6 months in some subjects. We are seeing white matter growth at 6 months in 3 of the 5 patients that we have transplanted and obtained good MRI-DTI scans from.

    We don't know whether the axons that appear to be crossing the injury site have connected with neurons below. We also need to confirm these imaging results with careful neurophysiological assessments of the patients. Also, although we saw this in one patient only, white matter not only appears to be able to grow but also to retract, which is not so surprising.

    These are very important phenomena to know and understand as we design our phase III studies. I also wanted my colleagues who are designing and running clinical trials to be aware of these phenomena.

    Wise.

  6. #1186
    Quote Originally Posted by Solan View Post
    I hope this is wrong.
    Why would they spend a lot of time, money and resources on a phase three trail if the 6month data of the phase two trail shows no recovery?
    Solan, I did not present the 6 month data. As I have said many times before, we don't have that data from Kunming yet and will not until the end of November. These are still the 6 week data. Wise.
    Last edited by Wise Young; 11-10-2012 at 11:32 AM.

  7. #1187
    Quote Originally Posted by Buck503 View Post
    They recovered some walking without increase in motor function or sensory?

    Also, regrowing spinal cord tissue might not help functional recovery?

    Maybe I misunderstood what he said.
    Buck503,

    Yes, as I pointed out, some subjects (and I emphasize that this is still very early in the study) appear to be getting some locomotor function back without any change in sensory or motor scores. This may be because some of the regrowing axons may be activating walking behavior through the central pattern generator and they have not yet recovered direct voluntary activation of the spinal cords.

    The MR/DTI images are from subjects in Hong Kong who did not receive intensive locomotor training. Just because there is growth of white matter across in the injury site does not mean that the fibers have reconnected with neurons in the spinal cord that innervate the legs. This may take time. It also suggests that locomotor training is important for recovery of locomotor function.

    Wise.

  8. #1188
    keep up the hard work wise I just like to see posts on this thread to know that someone cares and is trying to help.

  9. #1189
    Quote Originally Posted by fti View Post
    what is strange not the name of dr zhu hui on the website of the hospital and nothing on the internet and read in on a site that Chinese hui zhu retired definitive
    fti,

    Dr. Zhu has retired from the Army and has started a new center at a new hospital in Kunming. People who want to contact her can write to zhuhuichina5@gmail.com.

    Wise.

  10. #1190
    Quote Originally Posted by lunasicc42 View Post
    Paolo, I thought that too, was the jist of it that the rehab regimen improved walking function and ucbmc doesn't really do anything? As to sensory and bbb???
    Lunasicc,

    I would not conclude that the UCBMC "doesn't really do anything" based on the data to date. In Hong Kong, we saw no white matter crossing the injury site in any subject before treatment. In one subject who did not have treatment, we saw no white matter growth across the injury site over a 2 year period. In 3 of 5 subjects who were treated with UCBMC and had reasonable MRI-DTI images, we saw white matter tracts crossing the injury site. In Kunming, some subjects that have been treated with UCBMC show early locomotor improvement though they did not show changes in motor scores in the legs at 6 weeks. We did not do MRI/DTI in the Kunming subjects but all received the intensive locomotor training.

    Long tract regrowth is a very slow and the axons have a long ways to grow. Axons grow very slowly, no faster than hair growth and that is assuming that they know exactly where to go and have no impediments. A mm per day would be very fast. In order to activate muscles directly, the axons must grow all the way to the lumbosacral spinal cord located at T12 and L1 spine, a distance of over 500 mm from the neck to the bottom of the rib cage.

    So, let me give an analogy. We are waiting in Miami Florida for a train to come from Boston. The train tracks have been disrupted in Connecticut (cervical spinal cord injury). No trains have come from Boston for a long time. We hear on the news that an effort has been made to repair the train tracks. After waiting a day, no train appears. The news, however, tells us that some trains have been sighted in Washington DC and we are seeing increased activity in Atlanta and Alabama. Should we be concluding that the repairs of the train track have been unsuccessful?

    Wise.
    Last edited by Wise Young; 11-10-2012 at 12:39 PM.

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