Spinal Cord Injury Breakthrough

[Wise Young]

I had commented on this for several reporters but let me share my views here. This is a very interesting study that suggests that increasing the excitability of the spinal cord by injecting cocktails of neurotransmitters and electrical stimulation will accelerate locomotor recovery in rats during the weeks that follow spinal cord injury. Please note that this is during the subacute phase after injury (during the days and weeks that follow the injury). It provides an evidence base for treatments to increase excitability of people's spinal cords after injury to facilitate locomotor recovery. The study was well-done. The authors not only looked at walking but also at changes in activity of the spinal cord. They tried the technique on nearly 100 rats and the results were consistent and impressive.

The study was flawed in two respects. First, they used a very unusual spinal cord injury model, i.e. a double hemisection. They first did an over-hemisection on the left side. This cut the spinal about 2/3 of the spinal cord including all of the left side and dorsal column on both sides, including the dorsal corticospinal tract. Then they did a right hemisection several segments lower, which should eliminate all long tracts connecting the brain and the lower spinal cord. However, there may be sprouting of spinal tracts from the right side to the left side. This is a complicated spinal cord injury model and it is hard to tell based on the data presented whether the treatment they used would have worked on a more common contusion model of spinal cord injury. As the authors pointed out in the paper, they do not know whether this would work in a severely contused spinal cord.

Second, they did not investigate different neurotransmitter mixtures, different temporal windows, and combinations of neurotransmitters and stimulation. So, in the end, we don't really know which of the parameters are necessary and sufficient to facilitate walking recovery, just that this complex mixture of neurotransmitters and stimulation did it. A lot of work will be needed to optimize this therapy for clinical trial. Please note that this is relevant to recovery after acute spinal cord injury and not in people who have chronic spinal cord injury.

Nevertheless, this is an interesting and important study that suggests that the state of excitability of the spinal cord plays a role in recovery of motor function. This will open up a new field of research and I think that this is very important.

Wise.

[Wise Young]

I am merging all the different threads on this topic. Wise.

[MarkB701]

Thanks for that response Dr Wise.
I read the article on a newspaper in the UK:
And all the comments were about the well-being of the rats lol.

....gotta love the general public and their sensibilities....

"Nigel, Newport And you sir, sound like a typical professional whingeing disability campaigner. So get in your wheelchair and push off. - I PREFER ANIMALS, because some humans are lower life forms, 1/6/2012 13:20 -------Whilst you sound a nasty piece of humanity. Thank goodness we do not have Gulags as I feel you would be a very able guard helping to contain the people you clearly hate. Sheesh what have we come too that people put rats before people."

Read more: http://www.dailymail.co.uk/sciencete...#ixzz1wZ0a6hXI

[Cripply]

This study is an example of the new platform I was suggesting, i.e., bridge the gap somehow, while regeneration therapies, which are decades away, are developed.
The model I suggested a few weeks ago lacked the issue of how to provide neurotransmitters, it seems that hurdle might not be very important. Here they just supplied the neurotransmitter cocktail and hope for the best.
In this model, the distance between healthy axons endings was very short, much shorther than in a typical contused cord. And they created partial injuries and several "anchors" to facilitate sprouting.
The good news is that scientists are beginning to think out of the box.

[Barrington314mx]

what makes you think this will come before regeneration therapies? isnt this still behind those types of therapies, given that the regeneration therapies have hit human testing and "bridging the gap" is still in the animal testing?

[Cripply]

Originally Posted by Barrington314mx

what makes you think this will come before regeneration therapies? isnt this still behind those types of therapies, given that the regeneration therapies have hit human testing and "bridging the gap" is still in the animal testing?

Very little is known about the science of regeneration, how to get stem cells to differentiate the way you want, how to support the milieu, etc etc,, whereas the science and technology for other approaches is far more advanced.

[paolocipolla]

Originally Posted by Wise Young

I had commented on this for several reporters but let me share my views here. This is a very interesting study that suggests that increasing the excitability of the spinal cord by injecting cocktails of neurotransmitters and electrical stimulation will accelerate locomotor recovery in rats during the weeks that follow spinal cord injury. Please note that this is during the subacute phase after injury (during the days and weeks that follow the injury). It provides an evidence base for treatments to increase excitability of people's spinal cords after injury to facilitate locomotor recovery. The study was well-done. The authors not only looked at walking but also at changes in activity of the spinal cord. They tried the technique on nearly 100 rats and the results were consistent and impressive.

The study was flawed in two respects. First, they used a very unusual spinal cord injury model, i.e. a double hemisection. They first did an over-hemisection on the left side. This cut the spinal about 2/3 of the spinal cord including all of the left side and dorsal column on both sides, including the dorsal corticospinal tract. Then they did a right hemisection several segments lower, which should eliminate all long tracts connecting the brain and the lower spinal cord. However, there may be sprouting of spinal tracts from the right side to the left side. This is a complicated spinal cord injury model and it is hard to tell based on the data presented whether the treatment they used would have worked on a more common contusion model of spinal cord injury. As the authors pointed out in the paper, they do not know whether this would work in a severely contused spinal cord.

Second, they did not investigate different neurotransmitter mixtures, different temporal windows, and combinations of neurotransmitters and stimulation. So, in the end, we don't really know which of the parameters are necessary and sufficient to facilitate walking recovery, just that this complex mixture of neurotransmitters and stimulation did it. A lot of work will be needed to optimize this therapy for clinical trial. Please note that this is relevant to recovery after acute spinal cord injury and not in people who have chronic spinal cord injury.

Nevertheless, this is an interesting and important study that suggests that the state of excitability of the spinal cord plays a role in recovery of motor function. This will open up a new field of research and I think that this is very important.

Wise.

Wise,

last year in Brescia they presented this line of reserch. I think you had left already when they presented it. The audience was rether excited I would say. I am disappointed that this line of research gets so much money and so much attention. I don't think that it is totally useless, but not something people sould get exited about..

Paolo

[manouli]

Originally Posted by Wise Young

I am merging all the different threads on this topic. Wise.

Thank you very much Dr. Young.

[PeteShick]

[Tim C.]

It appears that we continue to make vast inroads in guaranteeing the future survival of the rat species, in perpetuity. Hail to King Rat.