Thread: ChinaSCINet Update

  1. #1311
    Dr.Young,

    I apologize if this seems like a silly question, but you have no idea how much I value your opinion and advice. My husband was just recently injured in September of 2012 and has an incomplete SCI at the C5/C level. He is making great gains in rehab, and is actually able to move most of his muscles voluntarily on his left side...all the way down to his toes. My question is, I am pregnant with our first child and even before his SCI we made our decision to bank the umbilical cord...just as a type of insurance. Well since his accident, I have no doubt what so ever in this decision. I know that umbilical cord cells are a long way away from being used in the US...especially since they're still currently being researched, but could you please recommend a company to use? Is there more a benefit to a SCI if the umblical cord cells come from your own child?

  2. #1312
    Shan, watch this if you haven't yet seen- http://www.cordbank.co.nz/cordbank-n...ry-cord-blood/

    Here's more info- http://www.parentsguidecordblood.org/

    Check out Stemcyte- https://www.stemcyte.com/
    Last edited by Jim; 12-06-2012 at 02:23 PM.

  3. #1313
    Senior Member lunasicc42's Avatar
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    http://clinicaltrials.gov/ct2/show/N...injury&rank=25

    If I am right and this is the correct trial: one end date is sometime this month and another end date says march 2013... Wise, is one of those the correct dates for results to be told. Possibly sometime this month?
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  4. #1314
    The 6 month data will be made public this month.

  5. #1315
    Senior Member lunasicc42's Avatar
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    Quote Originally Posted by Jim View Post
    The 6 month data will be made public this month.

    Thanks man
    "That's not smog! It's SMUG!! " - randy marsh, southpark

    "what???? , you don't 'all' wear a poop sac?.... DAMNIT BONNIE, YOU LIED TO ME ABOUT THE POOP SAC!!!! "


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  6. #1316
    Quote Originally Posted by Han Solo View Post
    I don't understand the whole walking without it being voluntary. I'm curious what good is moving if u can't control it? I need to read up more cause I just checked in and saw this but it seems kinda pointless. If I can't wake up, roll out of bed, walk down the steps eat then walk out to my car and drive then what's the excitement about? Like I said I just caught what was being said and haven't taken time to read previous posts or reports but if that is that's all to it then the hell with that b.s., its a waste of time and money.
    Han Solo,

    I did not say that the person cannot control the walking. I said that the motor scores did not change, indicating that the person was not able to exert sufficient control of individual muscles to change motor scores. A motor score represents the strength of a muscle. A person may not be able to wiggle a toe or move the foot up and down better in response to command. However, that person may be able to start the walking, stop it, and even change the rate and direction of walking.

    Many people recover walking after spinal cord injury but cannot control individual muscles of their legs well and many have poor sensations in their feet and legs. For example, Patrick Rummersfield recovered walking and is running in marathons but has little feeling in his feet below the knees and has difficulty tapping his feet or wriggling his toes. Such situations happen if your brain can activate the central pattern generator (CPG) in your spinal cord that tells your legs to walk but your brain cannot activate individual muscles in your legs.

    The CPG can be activated by non-specific stimuli. For example, noxious stimuli can activate the CPG. Walking can also be activated by injecting serotonin (a neurotransmitter) into the cerebral spinal fluid around the spinal cord. If some descending nerve fibers from the brain has reached the central pattern generator and can spritz some serotonin onto the CPG, this will start walking even though the person cannot control the individual muscles of the leg.

    I understand that you may not have time to read all the posts in this topic but please do consider the following before you conclude that this clinical trial is a waste of time and money. These are very early results, between 6-12 weeks after transplantation of umbilical cord blood cells. It takes many months and possibly years for axons to grow long distances. Axons grow no faster (and probably slower) than hair grows. For axons to reach the motoneurons that control the individual muscles of the leg, they must grow from the injury site (which may be in the neck in the case of cervical spinal cord injury) to the lumbosacral spinal cord located in the spinal cord just below the ribs.

    In the Hong Kong study, where we imaged white matter (the spinal tracts), we did not see growth of the spinal tracts until at least 6 months or longer after transplantation. It is little unfair, don't you think, to expect people with "complete" spinal cord injury to walk only a few months after receiving a therapy to stimulate regeneration of the spinal cord. If the people had recovered function within weeks or a few months after transplantation, it is unlikely to be regeneration but may be from sprouting of surviving axons.

    In fact, I am not sure that one can or should declare the treatment does not work based on 6-month motor and walking scores. Even six months may too early to tell whether the treatment worked or not. Finally, even if the treatment does not work, I suggest that it was not a waste of time and money to have tried it in people. While I can understand your disappointment that people are not walking shortly after treatment, it is important to have tried it.

    Wise.
    Last edited by Wise Young; 12-06-2012 at 07:45 PM.

  7. #1317
    [QUOTE=paolocipolla;1621548]
    Quote Originally Posted by swh2007 View Post

    Yes I don't really intend to badger even if it looks like that...

    In my post #1281 I was specifically asking about a situation of "no voluntary movements of the legs" and I got an answer that in my personal opinion was once more confusing, so I got pissed off. I think my reaction was appropriate as I consider necessary and usefull to get pissed off in life sometimes...

    Paolo
    Paolo,

    I disagree. It is neither necessary nor useful to throw a tantrum and question somebody's intentions or motivations simply because you do not understand something. Such behavior is detrimental to communication. You had questioned me when I said that people are showing improved locomotor scores even though they are not showing changes in motor or sensory scores. That is a legitimate concern and I tried my best to explain it to you. Apparently my explanation was confusing to you. So, let me try again.

    Would you not agree with the following statement? If a person has no direct connections to the motoneurons controlling muscles of the legs but has some connections to the central pattern generator that connects to the motoneurons, that person can initiate walking and stop walking but cannot activate movement of individual leg muscles. If you don't agree with the statement, don't read any further and we should discuss why you don't agree with it. If you do agree with the statement, then please continue reading.

    There are many muscles in our body over which we exert limited voluntary control. I had earlier mentioned that we exert limited voluntary control over heart, intestines, and bladder. For example, we can initiate micturition and even stop micturition, although stopping flow mid-stream is not easy. Likewise, when we have a full bladder, it is very difficult to stop the reflex. We can inhibit it for several minutes but it is intensely uncomfortable. If I asked a person to tighten the internal sphincter of their bladder or contract their detrusor muscle, I doubt that they would be able to do it on command. This is because while we have nerve fibers going to Onuf's nucleus which controls the muscles of the bladder, we don't have nerve fibers going to the motoneurons that innervate the bladder muscles.

    Since walking is a motor program in the lumbar spinal cord, it is possible that a person (with training) can initiate walking by activating the CPG without being able to control each individual muscle of the legs. Most people with incomplete spinal cord injuries have both direct and indirect control of their leg muscles. However, in the case of somebody who has a "complete" spinal cord injury and is regrowing some axons that may be reaching the spinal cord below the injury site, it is possible that one early sign of recovery is for the person to be able to initiate stepping in the legs without being able to control individual muscles of the legs on command. In fact, you would expect that this would be one of the early signs of recovery in such situations.

    Wise.
    Last edited by Wise Young; 12-06-2012 at 08:51 PM.

  8. #1318
    Senior Member lunasicc42's Avatar
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    wise, I am mostly worried about b/b/b, update your opinion on that.

    I may be wrong, but my understanding is that you can and have retrained general walking through strict physical training, but is b/b/b affected?
    "That's not smog! It's SMUG!! " - randy marsh, southpark

    "what???? , you don't 'all' wear a poop sac?.... DAMNIT BONNIE, YOU LIED TO ME ABOUT THE POOP SAC!!!! "


    2010 SCINet Clinical Trial Support Squad Member
    Please join me and donate a dollar a day at http://justadollarplease.org and copy and paste this message to the bottom of your signature

  9. #1319
    Quote Originally Posted by Shan103 View Post
    Dr.Young,

    I apologize if this seems like a silly question, but you have no idea how much I value your opinion and advice. My husband was just recently injured in September of 2012 and has an incomplete SCI at the C5/C level. He is making great gains in rehab, and is actually able to move most of his muscles voluntarily on his left side...all the way down to his toes. My question is, I am pregnant with our first child and even before his SCI we made our decision to bank the umbilical cord...just as a type of insurance. Well since his accident, I have no doubt what so ever in this decision. I know that umbilical cord cells are a long way away from being used in the US...especially since they're still currently being researched, but could you please recommend a company to use? Is there more a benefit to a SCI if the umblical cord cells come from your own child?
    Shan103,

    What you ask is not such a silly question. Many people have asked me this question. I cannot advise you to bank your child's umbilical cord blood with any specific company. However, consider the following:

    1. We hope to initiate clinical trials of umbilical cord blood mononuclear cell transplants in the United States, Europe, India, and China in 2013. If our trials indicate that the treatment restores function, the treatment may be approved for clinical use as early as 2014 or 2015. So, it is not as far off as you might think.

    2. Even if the clinical trial shows that umbilical cord blood is not beneficial for spinal cord injury, the cord blood may someday be useful for your child. Umbilical cord blood is being used to treat many conditions, including leukemia, aplastic anemia, acquired immune deficiency syndromes, and other hematological disorders.

    3. Research on umbilical cord blood indicate that it contains many pluripotent stem cells that may be useful for many conditions, including spinal cord injury. Even if our current trial, mononuclear cells without selecting out any specific stem cells, turn out to be not so effective, some specific stem cells in umbilical cord blood would be more effective.

    So, it is getting more and more worthwhile storing your babies umbilical cord blood. The company that is donating all the umbilical cord blood for our clinical trials in Stemcyte, Inc. They are the best public cord blood bank and they do collect private units for families as well. I think that their prices are competitive.

    Wise.

  10. #1320
    Quote Originally Posted by Lyerly View Post
    Isn't standing not a contraction or a different kind? It's not like I use to flex my leg muscles when I was rising from bed or a chair. Your fingers can remain fairly straight without you doing anything.
    Lyerly,

    Yes, standing involves muscles. Your quadriceps (the front muscles of your thighs) contract to keep your knee joint extended. When you are walking and your knee joint is extended, it is called the stance phase. When your quadriceps muscles are weak, your knees would buckle. Standing is not passive, like your fingers remaining straight without doing anything. It requires muscle activity but not necessarily voluntary control. In fact, some animals (like horses and cows) stand while sleeping.

    Spasticity in your legs can cause your legs to flex or extend. If you have a pressure sore on your heels (or other causes of irritation or pain on your feet), spasticity tends to be cause flexion of your legs. Otherwise, most people with spinal cord injury have spasticity of the extensor muscles of the legs, i.e. the quadriceps and the gastrocnemius (the muscle in the back of your lower leg, which extends your foot).

    When walking, people go into alternating flexion and extension of the legs. This rhythmic motion is automatic and goes on without our brains controlling the individual muscles. In fact, I have often wondered how much their brains control walking when people are sleep-walking. Walking is almost reflexic and does not require direct control by the brain. Many animals start walking shortly after birth. For example, baby horses are up on their legs and tottering around minutes after birth.

    Wise.

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