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Thread: Fourth International Symposium on Spinal Cord Regeneration and Repair in Brescia, Italy (Mar 25-27, 2002)

  1. #1

    Fourth International Symposium on Spinal Cord Regeneration and Repair in Brescia, Italy (Mar 25-27, 2002)

    Well, the meeting just finished and I am posting a short report. It was a small meeting with about 100 scientists and clinicians attending. Hosted by Professor Giorgio Brunelli, who recently has been doing bridging of peripheral nerves above the injury site to muscles below the injury site, the meeting covered a wide range of clinical topics relevant to spinal cord injury, including bladder care, surgical approaches to the spinal cord, functional electrical stimulation, and stem cells.

    I don't have very much time (since I am connecting at Malpenza airport in Milano). Three general impressions:

    1. Stem Cells. They are really quite serious about stem cells in Italy (not the embryonic variety but amniotic fluid stem cell). One speaker announced that the University of Brescia is starting an amniotic stem cell bank as a service, "just in case your son may need it". They are cognizant of the issues and many of the researchers spoke about isolating and using stem cells. However, in my opinion, the work in Italy does not seem to be significantly further ahead than in the United States.

    2. FES. In terms of functional electrical stimulation, they are very strong. Person after person got up and described large series of cases where they have been using FES to exercise people. There were a number of studies of Parastep, arm, and legs, as well as various prostheses for foot drop, walking, treadmill. Volker Dietz spoke about his work with the Lokomat. There is no question that FES has become a routine and significant part of rehabilitation in Europe. They also have a number of consortia that have banded together to share technology and do clinical trials of various FES approaches.

    3. Atrophy of muscles. One researcher got up and really blew me away with data indicating that intense electrical stimulation can restore muscle that have been denervated. These muscles are not only denervated but have atrophied to the point that they are mostly fat and fibrous tissues. They have been doing this in people who have cauda equina, conus, and lower lumbosacral cord lesions where the motoneurons were damaged. The stimulation, however, has to be extremely intense, much (100x) higher than the current limits of stimulators that are used clinically. It also took a long time. In one case, it took 3 years to rebuild the quadriceps muscles of a person. However, the speaker suggested that it will work on atrophied muscles even 25 years after injury. Another speaker showed that he was able to reverse diaphragm atrophy in rats that had one phrenic nerve cut for over a year (like a lifetime in human). This is welcome news indeed because it suggests that even the most severely atrophied muscles can be brought back. Unfortunately, the electrical currents are very high and one has to be extremely careful not to damage the muscles with such high currents (up to 3.0 joules of electrical energy given several hours per day).

    There was a wide range of pessimism and optimism although I think that the clinical establishment in Europe is a little bit more conservative than the U.S. Some doctors were saying that they didn't expect a "cure" within their lifetimes while others were saying that it is already occurring.

    Wise.

  2. #2
    Senior Member DA's Avatar
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    thanks for the update dr young. you are the coolest.

  3. #3
    Dr. Young,
    Thank you for the report from the symposium and your honestly reporting the feelings of some of the doctors "cure" opinions. Let me guess, the ones who don't expect a cure in thier lifetimes are the ones making a living with FES, therapy, etc; while the ones stating the cure is already occuring were the scientific researchers ? WE KNOW THE CURE IS OCURRING NOW, JUST GOT TO START PUTTING THE PIECES OF THE PUZZLE IN PLACE AND START CLINICAL TRIALS ASAP> Thanks again, you are the best.

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    muscle stimulation

    Dr.Young,what do you think about these new
    muscle stimulators for the abdomen such as
    AB Force et.al.?

    Mario

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    Senior Member DA's Avatar
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    Some doctors were saying that they didn't expect a "cure" within their lifetimes while others were saying that it is already occurring.

    BTW, which group do you agree with dr young?

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    Super Moderator Sue Pendleton's Avatar
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    Is Dietz's Lokomat the robotic treadmill that reduces the labor costs needed to rehab a person using it? Buon Viaggio!

  7. #7
    The findings on atrophy are HUGE!

    This was one aspect of paralysis which I feared would restrict the extent of recovery for those with long-term SCI.

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    Senior Member glomae's Avatar
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    thanking dr young

    i for one want to say i think you are great if we had a few more dr youngs we'd be a lot closer to a CURE.

  9. #9

    Your wonderful

    Dr. Young,

    Just wanted to say thank you. I don't know if you realize it but your words have literally puled me back from the brink of giving up many times.

    Deb

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    Senior Member rdf's Avatar
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    Thanks for all you have done for us, Dr. Young. The news on atrophy is great to hear. Please hurry home Wise, there is a state department terrorist warning to americans traveling in Italy, mainly in Milan, Florence, and a few other places. Hurry home, I hope you're already here.

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