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Thread: Epidural Stimulation Future Trials and Commercial Planning

  1. #81
    Senior Member kate's Avatar
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    Quote Originally Posted by JamesMcM View Post
    Of course why would it be, damn got a little excited. Incompletes again of course, still a good thing I am more on the biological front anyways.
    What I find most interesting about the epistim stuff is that they don't really understand the mechanism by which some of these results are happening. They thought that Rob being ASIA B meant there were intact pathways that were somehow activated by the little jolt they were delivering to the lower cord. That's why they went out to find people who were both motor and sensory complete for round 2.

    This is what Reggie Edgerton said about that:
    Now even though the individual with a complete injury may not be able to feel all of this sensory information — normally the sensory information goes to the spinal cord and then it goes to the brain. And the brain may modulate what’s going to happen given the sensory information . . . but in this case, we know that the sensory information can go to the spinal cord and tell the spinal cord what to do.

    In other words, it knows whether the individual is trying to stand or trying to step or whatever it’s trying to do. So again, the important point is the importance of the sensory information that’s coming in, and it can actually serve as the control.
    Source

    In other words, it doesn't seem to matter whether a person is consciously experiencing sensation -- things can work even without that, because whatever "sensation" means inside the cord below the injury, it seems to be enough to cause reaction through intact neural networks. The stimulus doesn't need to get up past the injury site.

  2. #82
    Quote Originally Posted by JamesMcM View Post
    Grammy any idea if they're accepting quadriplegics in this trail? And is this the upgraded version of the stimulator?
    Our goal is to demonstrate the effectiveness of epidural stimulation in improving functions such as cardiovascular, sexual and bladder function, as well as the ability to facilitate voluntary movements. The study will also begin to track the impact of epidural stimulation to alleviate the financial burden of SCI on individuals and the healthcare system. Participants are expected to benefit from reduced medication and hospitalization expenses related to treating complications of paralysis. We also hope to reduce the threat of premature death caused by complications like autonomic dysreflexia.

    Study subjects will make an approximate three--‐year commitment to the research after which they will be given the option to keep or remove the stimulator. (They may also opt--‐out atthe conclusion of the first year.) They will have long term follow up after the initial three year commitment. The study subjects must meet the research protocol that is being set up. The sign up form below will go to Harkema. http://louisville.edu/medschool/neur.../harkema/form/

    It's not my understanding yet that they are ready for quads. I understand that they're taking different ages of both men and women with diverse backgrounds. As far as the stimulator goes, they'll still be using the old Medtronic pain 16 electrode array, but they'll try to tweak it a bit.

    It's Reggie Edgerton's group in San Diego that has been working on quad experiments for hands and arms. He's also the one with the company NeuralRecovery Technologies that is working at bringing forth the more sophisticated electrode array of 32 or 34 I believe. We'll hear more about that later in the week.

  3. #83
    Senior Member lynnifer's Avatar
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    Quote Originally Posted by Curt Leatherbee View Post
    I've been interested in this sort of thing since I got injured in 1981 I think it is promising hope for the future.
    I have to disagree with Paolo here. For those of us 25+yrs this could really change our lives for the better, at least for the last third of it. Sure I hope that regenerative therapies continue, but for those of us older - far too late for that.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  4. #84
    Senior Member lynnifer's Avatar
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    Quote Originally Posted by GRAMMY View Post
    To fund it, we have to raise $15 million, and we already have $5 million of that.
    This is where I'm disappointed with the Rick Hansen Foundation - they probably have that in reserve easily - or some of their staffers could take a pay freeze. (my bitter sarcasm)
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  5. #85
    Senior Member lynnifer's Avatar
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    Quote Originally Posted by kate View Post
    Oh, believe me, it's a question I'm very interested in too. My understanding is that everything works sexually, and that this is also the case for at least one of the other 3 guys.
    I'd be very interested in results on women! Especially as I think I'm entering peri-menopause.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  6. #86
    Quote Originally Posted by kate View Post
    What I find most interesting about the epistim stuff is that they don't really understand the mechanism by which some of these results are happening. They thought that Rob being ASIA B meant there were intact pathways that were somehow activated by the little jolt they were delivering to the lower cord. That's why they went out to find people who were both motor and sensory complete for round 2.

    This is what Reggie Edgerton said about that:
    Source

    In other words, it doesn't seem to matter whether a person is consciously experiencing sensation -- things can work even without that, because whatever "sensation" means inside the cord below the injury, it seems to be enough to cause reaction through intact neural networks. The stimulus doesn't need to get up past the injury site.
    That's fine and dandy, but sensation is crucial I I think all of us want to feel things, warm, cold, textures, different terrains etc allows us to connect better and fully interact with the world around us. Also returned of sexual function is almost entirely based on sensation in my opinion.

  7. #87
    Quote Originally Posted by lynnifer View Post
    I have to disagree with Paolo here. For those of us 25+yrs this could really change our lives for the better, at least for the last third of it. Sure I hope that regenerative therapies continue, but for those of us older - far too late for that.
    It is positive to have desagrements sometimes, it induce us to dig deeper into things.

    Paolo
    In God we trust; all others bring data. - Edwards Deming

  8. #88
    Quote Originally Posted by kate View Post
    Oh, believe me, it's a question I'm very interested in too. My understanding is that everything works sexually, and that this is also the case for at least one of the other 3 guys.

    eta: I also got to talk with one of the subjects in the StemCells Inc trial that's been going on in Zurich. He says that they're working hard over there to get human epidural trials running. I think the principal investigator would be Gregoire Courtine, who (like Susan Harkema) trained with Reggie Edgerton.

    This is from an article about Courtine's work. It's rats, but it's really good.



    My friend who's been traveling to Zurich says they're pretty sure that what they have will be an order of magnitude better than what was done in Louisville -- which should not surprise anybody, as that was just a very crude first iteration.
    source
    I have been to Zurich a while ago and more recently in Lausanne to visit Courtine's lab. I support Stem Cell Inc. trial and Courtine's planned trial as there will be usefull lessons to learn from both even in case of modest or no recovery at all, but I am afraid some people are expecting way too much from these trials..or maybe I have missed something big.

    I also wonder.. if it is so good why investors are not covering the full cost? And why isn't the NIH &/or the DOD funding the trial?

    Paolo
    In God we trust; all others bring data. - Edwards Deming

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  10. #90
    Senior Member lynnifer's Avatar
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    Twitter convo with Fehlings.
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    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

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