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Thread: Paralysed patients regain voluntary movement with spinal stimulation

  1. #131
    Quote Originally Posted by Curt Leatherbee View Post
    All I know is how many things over the years have crashed and burned never to be heard about again after sounding so good initially? Omentum Transportation comes to mind, OEG cell transplants and a whole host of other things. I have the right to be skeptical and I think many others are at this point after all of many of us have seen who have been close to SCI research for decade upon decade.

    I am twice your age and more than likely have been injured at least 20 years longer than you. I have very closely followed all SCI research from the time I was injured in 1981, 5 years before you were even born.
    I don't have an SCI. I work as an exercise trainer for people with CNS injuries and disorders.
    You absolutely have the right to be skeptical, we all do. And we all should be skeptical rather than just believe everything we hear, lest people falsely get their hopes up. BUT, skepticism is different than ignoring ignoring data...and you still didn't answer my questions.
    1. Did you read the entire paper?
    2. Do you understand that the TMS test confirms how motor complete the subjects were?
    These are simple "yes" or "no" questions.

  2. #132
    @Tomsonite, would you be so kind as to give a brief explanation of what these two acronyms mean? TMS and EMG in relation to the paper or in general? Many people aren't really familiar with some of this and what it's capabilities are..

  3. #133
    Super Moderator Sue Pendleton's Avatar
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    Quote Originally Posted by GRAMMY View Post
    @Tomsonite, would you be so kind as to give a brief explanation of what these two acronyms mean? TMS and EMG in relation to the paper or in general? Many people aren't really familiar with some of this and what it's capabilities are..
    And how EMG has improved over at least the last 20 years I've been injured. Now if I just didn't feel nauseous after that test that would be a great improvement.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  4. #134
    Oh yes I read all that, but who knows, machines will be machines and humans will be humans. Maybe there were calibration problems, maybe something else was amiss, who knows. What it's going to take is time and more people involved and hopefully this thing is as good as it seems to be according to papers that were written. I do have the feeling though this is not going to help everyone who is SCI, only a certain percentage of people. Those who it does work can hopefully advance through more technological changes to make their gained movement more functional.

    Here's a interview, fascinating stuff http://www.sciencefriday.com/playlis...y/segment/9397
    Last edited by Curt Leatherbee; 04-22-2014 at 01:48 AM.
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  5. #135
    Hey guys, I'm glad to see the amount of discussion since I posted this thread.

    In regards to the skepticism - I understand somewhat how you feel Curt, but of course I'll never fully understand as I've only been injured a year. I can imagine you've heard good news before, again and again - only to be disappointed (understatement of course) as I had my first similar experience with the delay of Phase III UCB trial, which as I interpreted, it was supposed to begin August last year but didn't due to regulations, preparation and funding.

    What we can do is wait and see how it works out on the next 8 participants, especially with the revised 27 electrode architecture.

    I am also beggining to think that completes weren't quite as complete. And as a complete I'm anxious in that regard as it depends on the extent of our injuries. Guess we've got to start somewhere as it may be very useful for incompletes.

    And sorry to get off topic, does anyone know anything about the Phase III UCB trial? Last I heard was that Mr Wise Young was sorting out funding. I am waaay more positive to the UCB treatment than the implants. But in respect, both these treatments could be used together!

    Hey GRAMMY, are you behind the spinal research and advocacy site? (Sorry I'm new) I've learnt so much from your site, especially your posts and threads here, and absolutely appreciate it. Would it be OK if I update my original post with links to your site and threads here? It would help the newbies here. I'll also link some more articles and videos if allowed.

    Regards,
    TM

  6. #136
    Quote Originally Posted by tomsonite View Post
    How can you be so sure there isn't ANY sensation at all? Just because it wasn't reported in the paper or has only been reported anecdotally doesn't mean none of them got any sensory return.

    I posted earlier in the thread about how in the paper, the two ASIA B's had a decrease in the delay of the response of their somatosensory evoked potentials (and yes, I know there were no more details or numbers presented, and I am critical of that, and yes I realize this does not confirm any sensory return.)
    The fact that all subjects had no EMG activity in the legs before transplantation, even on the treadmill after multiple bouts of training, yet instantly got EMG activity on the treadmill after implantation, shows that at least the spinal cord was able to receive and process sensory input. The paper also talks in the discussion section about how two of the subjects (the two ASIA As) were able to modulate their EMG responses on the treadmill depending on how much effort they contributed, suggesting some kind of connection between input from the brain and afferent input from the periphery.

    Again, I realize no sensory return was formally reported, and I realize everything I just said does NOT confirm any sensory return. However, I think it is at least enough evidence that you can't conclude with certainty there was no sensory return.
    I never said that I conclude with certainty. I said "With the information that has been made public". Asia A's have NO sensation. Until the lab proves that their device restores any sensation, the assumption is that the patients still have no sensation. The burden of proof is on them. The scientists don't even claim to have restored any sensation. So with info that I know right now, there is absolutely no claims or evidence of ANY sensation, I would not get one of those devices implanted in my body; nor do I have any hope that this device will ever restore any sensation for me (although ever so slightly possible that it could).

  7. #137
    Quote Originally Posted by taymas View Post
    Hey GRAMMY, are you behind the spinal research and advocacy site? (Sorry I'm new) I've learnt so much from your site, especially your posts and threads here, and absolutely appreciate it. Would it be OK if I update my original post with links to your site and threads here? It would help the newbies here. I'll also link some more articles and videos if allowed.
    Regards,
    TM
    Thank you taymas. I do update the community via the Spinal Cord Injury Research and Advocacy blog site. If you wish you can also receive new blog posts via email when I put them up by clicking on the right side "follow" button or you can follow along on Twitter. The blog posts automatically appear on the U2FP/Working2Walk Facebook page as well. U2FP stands for Unite 2 Fight Paralysis and Working 2 Walk is the name of an annual spinal cord injury conference the organization hosts each year. You're welcomed to link to any posts on the blog. I'm glad you're able to get value from the blog.
    Last edited by GRAMMY; 04-22-2014 at 01:37 PM.

  8. #138
    Quote Originally Posted by GRAMMY View Post
    @Tomsonite, would you be so kind as to give a brief explanation of what these two acronyms mean? TMS and EMG in relation to the paper or in general? Many people aren't really familiar with some of this and what it's capabilities are..
    I didn't give an explanation initially because I didn't want to do any unnecessary writing if Curt already knew all about TMS and EMG.
    TMS = Transcranial Magnetic Stimulation. It is a non-invasive way of activating neurons in the brain and sending electric currents down those neurons using electromagnetic fields. TMS can be used so precisely that by placing the magnetic wand over a certain part of the brain, people can be made to involuntarily perform very specific movements or move specific muscles. Rather than you voluntarily deciding to move a muscle, someone flips a switch in the magnetic controller, an electromagnetic field is created, and a movement is generated in your body, because one specific neuron/neurons that control specific muscles was turned on for you.
    EMG = Electromyography. EMG can be use to record and analyze the electric activity of muscles in the body. There are two ways to do EMG. One is with surface electrodes which are sticky little pads that you put on the skin over a specific muscle you want to measure the electrical activity of. Some muscles, however, are not right under the skin, or are too thin or small to be measured by surface electrodes. In this case, intramuscular EMG is used, where a minuscule electrode is actually injected into the target muscle. One you have an electrode in/on a muscle, you are then able to measure the amplitude of the electric current going to that muscle. The more electricity that the nervous system pumps into a muscle, the stronger the muscle fibers contract. Surface EMG does have some reliability issues, but if done properly, surface EMG can tell you reliably if a muscle is working or not.

    Therefore, these are two very useful tools in assessing how complete someone's SCI is. There are people with SCIs who demonstrate no voluntary control of a muscle, yet when they are given TMS, those muscles contract. If you use TMS to stimulate neurons in the brain, as long as there is a connection to the target muscle, some activity should be able to be picked up with an EMG. If, on the other hand, TMS is used to stimulate the brain to try to elicit a certain movement, and literally nothing shows up on the EMG, then the connection is lost. I.e. if TMS produces no visible muscle contraction or EMG activity in the target muscle, you have the most complete SCI possible, which according to the data presented, is what these four subjects had.

    Quote Originally Posted by Sue Pendleton View Post
    And how EMG has improved over at least the last 20 years I've been injured. Now if I just didn't feel nauseous after that test that would be a great improvement.
    I couldn't comment on EMG 20 years ago...are you sure it was an EMG test that made you nauseous? EMG doesn't actually do anything to your body, it just measures activity within it.

    Quote Originally Posted by Curt Leatherbee View Post
    Oh yes I read all that, but who knows, machines will be machines and humans will be humans. Maybe there were calibration problems, maybe something else was amiss, who knows. What it's going to take is time and more people involved and hopefully this thing is as good as it seems to be according to papers that were written. I do have the feeling though this is not going to help everyone who is SCI, only a certain percentage of people. Those who it does work can hopefully advance through more technological changes to make their gained movement more functional.

    Here's a interview, fascinating stuff http://www.sciencefriday.com/playlis...y/segment/9397
    Yes, we need more research on more subjects before we can conclude anything. But any experienced scientist can take care of calibration problems with EMG and/or TMS and get reliable readings properly from the equipment. Frankly, I trust this team of researcher's abilities to do TMS and EMG. They presented data showing that TMS produced no muscle activity at all in the four subjects. This means one of two things:
    1. The subjects had the most motor-complete spinal cord injuries that can possibly be shown with current instrumentation, or
    2. The researchers are liars and knowingly and purposefully gave false data.

    I believe number 1.

    Quote Originally Posted by taymas View Post
    ...

    I am also beggining to think that completes weren't quite as complete. And as a complete I'm anxious in that regard as it depends on the extent of our injuries. Guess we've got to start somewhere as it may be very useful for incompletes.

    ...
    See my above post to Curt. These guys were as motor complete as you can get, unless you believe the investigators are liars. The researchers chose the most complete subjects possible to make sure they could reliably investigate if epidural stim produced activity in a human spinal cord. You can't fool TMS + EMG.

    Quote Originally Posted by Nowhere Man View Post
    I never said that I conclude with certainty. I said "With the information that has been made public". Asia A's have NO sensation. Until the lab proves that their device restores any sensation, the assumption is that the patients still have no sensation. The burden of proof is on them. The scientists don't even claim to have restored any sensation. So with info that I know right now, there is absolutely no claims or evidence of ANY sensation, I would not get one of those devices implanted in my body; nor do I have any hope that this device will ever restore any sensation for me (although ever so slightly possible that it could).
    The burden of proof isn't really on anybody right now, since sensation was never reported on or investigated, as the researchers never sought to increase sensation in the first place. From day 1 these studies were always about seeing if epidural stim can produce activity in an injured spinal cord for the sake of locomotion. I believe that what I said to you in my original post to you IS evidence for sensory function return. We're just going to have to wait and see in further investigations if there is indeed sensory return or not.

  9. #139
    Quote Originally Posted by tomsonite View Post
    TMS = Transcranial Magnetic Stimulation. It is a non-invasive way of activating neurons in the brain and sending electric currents down those neurons using electromagnetic fields. TMS can be used so precisely that by placing the magnetic wand over a certain part of the brain, people can be made to involuntarily perform very specific movements or move specific muscles. Rather than you voluntarily deciding to move a muscle, someone flips a switch in the magnetic controller, an electromagnetic field is created, and a movement is generated in your body, because one specific neuron/neurons that control specific muscles was turned on for you.
    EMG = Electromyography. EMG can be use to record and analyze the electric activity of muscles in the body. There are two ways to do EMG. One is with surface electrodes which are sticky little pads that you put on the skin over a specific muscle you want to measure the electrical activity of. Some muscles, however, are not right under the skin, or are too thin or small to be measured by surface electrodes. In this case, intramuscular EMG is used, where a minuscule electrode is actually injected into the target muscle. One you have an electrode in/on a muscle, you are then able to measure the amplitude of the electric current going to that muscle. The more electricity that the nervous system pumps into a muscle, the stronger the muscle fibers contract. Surface EMG does have some reliability issues, but if done properly, surface EMG can tell you reliably if a muscle is working or not.

    Therefore, these are two very useful tools in assessing how complete someone's SCI is. There are people with SCIs who demonstrate no voluntary control of a muscle, yet when they are given TMS, those muscles contract. If you use TMS to stimulate neurons in the brain, as long as there is a connection to the target muscle, some activity should be able to be picked up with an EMG. If, on the other hand, TMS is used to stimulate the brain to try to elicit a certain movement, and literally nothing shows up on the EMG, then the connection is lost. I.e. if TMS produces no visible muscle contraction or EMG activity in the target muscle, you have the most complete SCI possible, which according to the data presented, is what these four subjects had.
    Thank you so much for giving us such a detailed explanation of the acronyms. That's very helpful.

  10. #140
    Senior Member mcferguson's Avatar
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    thanks, tomsonite.
    T5/6, ASIA A, injured 30 Nov 08
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