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Thread: SUMMARY: DR. REGGIE EDGERTON, The Spinal Cord Injury Project Summer Open House

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    SUMMARY: DR. REGGIE EDGERTON, The Spinal Cord Injury Project Summer Open House

    SUMMARY: DR. REGGIE EDGERTON
    The Spinal Cord Injury Project
    Summer Open House
    Thursday, 20 July 2017


    This is a synopsis of Dr. Edgerton?s presentation to the W. M. Keck Center Summer Open House. Additional details on his research are available on his website. With appreciation to the students who took notes during Dr. Edgerton?s presentation at the Summer Open House.

    At the invitation of the W. M. Keck Center for Collaborative Neuroscience and the Spinal Cord Injury Project, Dr. Reggie Edgerton gave two presentations at Rutgers University. The first was a scientific presentation for faculty and students co-sponsored by the Department of Cell Biology and Neuroscience entitled: Mechanisms of spinal neuromodulation and plasticity post paralysis.
    Dr. Edgerton?s second talk: Spinal Cord Stimulation: What We?ve Learned ? What?s Next! was given to the Summer Open House hosted by the W. M. Keck Center for Collaborative Neuroscience.

    Dr. Edgerton began this talk by saying he was going to present facts and it was up to each person in the audience to make their own decision about hope. He then stated that ?we are going to have to reassess our thinking about how the spinal cord works, and how the brain interactively works with the spinal cord. The brain has to learn to work with the spinal cord because they both have new circuitry.?

    There are several potential approaches being studied:
    Agonists
    Pharmacology
    indwelling electrodes
    epidural electrodes (on top of the dura)
    transcutaneous electrodes.

    All use common mechanisms, show potential, and are in their infancy.

    Regardless of the type, neuromodulation is different from FES: in FES the device is turned on and movement results; in neuromodulation, when the device is turned on, the person decides whether to move or not.
    He discussed his research on neuromodulation:

    ● Neuromodulation is the activation of spinal networks through electrodes placed either epidurally or transcutaneously.
    ● Types of neuromodulation include:
    eEmc (O)
    pcEmc
    eEmc (N)
    sEmc
    fEMC

    ● Using neuromodulation to regain some of lost function potentially could improve functions such as, but not limited to, sensory, sexual, temperature control, etc. This potentially also could lower health cost.

    ● The theory behind his work is that after injury the neural circuit baseline potential drops below the effective threshold, hence, no movement occurs. Through neuromodulation, the baseline potential can be artificially raised so that it reaches the motor threshold.

    ● Neuromodulation was done on five patients, and they were trained for 18 weeks:
    Prior to training, the patients only can move a little (voluntary oscillation) but with stimulation there is a significant increase in movement. After 18 weeks of training, the patients exhibited notable signs of improvement, as they could now move their legs in a visible kicking/walking motion unaided.

    ● Another experiment also was done, in which patients were trained to move their hands. After further training, they gained greater strength in their hands.

    ● The process builds on the amazing redundancy in the spinal cord and involves training, learning, and retention.
    This provides evidence that residual function post-injury can be enhanced by training, which over time can lead to the regaining of voluntary and autonomic function.
    Voluntary movement from residual function post-injury can be improved through training.

    ● The spinal cord can ?learn?. A study was done on rats, where their paw trajectories were observed walking on a treadmill.

    ● Untrained rats had unsteady and unpredictable trajectories, while trained rats were able to keep significantly more stable trajectories (similar to a ballistic arc).

    QUESTIONS

    When you did double injury instantaneously, why was recovery much less as compared to recovery gained after doing the injury one after the other?

    If you cut two sections of the injury area at the same time, you do not allow for regeneration or reorganization of the tissue. On the contrary, if you cut two injured sections one after the other, the first section will start regeneration of tissue. This is the reason for better recovery when doing the injuries one after the other.

    Which device is better in helping with the movement after injury?

    Transcutaneous stimulation probably is more effective than epidural stimulation because, as the experiment results show, more of the injured patients stand. As a side note, they are yet to do testing stimulations to observe and analyze the patients? will to move their legs even before they move them.

    While bringing the RMP (Resting Membrane Potential) of neurons back to normal, did you see any other positive or negative side effects?

    Yes, in general there are both acute effects on the autonomous nervous system (ANS) and chronic effects on blood pressure, bladder, etc. These two effects are relatively common responses. It also appears that specific parts of the spinal cord can be modulated and stimulated. So we need to use the stimulation model carefully to achieve results.

    What are some of the barriers that you have come across in combining therapies?

    The most important barrier is in how much neuromodulation can be obtained and gauged. The first thing that happens in your body is not movement, but preparation of the brain for carrying out movement.

    For the diagram of the circuit, if you hamper a part or whole of the circuit, does the brain adjust to compensate?

    The exact mechanism is unknown because the order of information flow has not yet been determined. Nevertheless, the brain and spinal cord neurons function repeatedly in a certain way. Hence, a specific pattern gets reinforced and spinal cord learning occurs.

    Did you notice if muscle atrophy and joint dissociation effect the ability to stand?

    Good data has not yet been obtained. We are waiting for MRI scans. However we have observed that locomotor training retains motor mass.

  2. #2
    Senior Member Tim C.'s Avatar
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    "....it was up to each person in the audience to make their own decision about hope"
    Not unlike a typical, made-for-TV Bigfoot/Yeti documentary: 'Here are our observations; you draw your own conclusions"


    "Hope is a dangerous thing"

  3. #3
    Isn't hope why all of us come to the forum and read about what is happening?

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