According to the National Spinal Cord Injury Statistical Center (NSCISC), approximately 17,000 new spinal cord injury (SCI) cases are recorded each year in the United States and figures estimate there may be as many as 347,000 people living with the consequences of SCI. New research conducted at the BioMag laboratory in Finland might reveal a new way to help patients begin taking back control of their lives.
The majority of spinal injuries (68.5%) are caused by trauma from falls or vehicle crashes. These injuries lead, in the vast majority of cases, to some degree of physical impairment and loss of motor skills. In fact, the NSCISC say, less than 1% of people experience "complete neurological recovery" by the time they are discharged from hospital. In most cases, patients suffer some form of paraplegia or quadriplegia — in 1 in 5 cases, the quadriplegia is total.
The new study — led by Dr. Anastasia Shulga, a specialist in neurology at Helsinki University Hospital — involved two patients with spinal cord injuries. Each received a form of treatment that combined transcranial magnetic stimulation (TMS) with simultaneous peripheral nerve stimulation (PNS). TMS uses an electromagnetic coil placed near the head to stimulate nerves cells in particular regions of the brain — a procedure sometimes used to treat depression. PNS is another non-invasive technique which, according to Touch Neurology the stimulated nerve delivers a "pleasant sensation described as tingling or warmth."
For the study, these treatments were given repeatedly for almost six months. The Finnish team says this is the first time long-term stimulation treatment of this type has been used in an attempt to rehabilitate patients with paralysis caused by spinal cord injuries.
Both patients who participated in the study had spinal cord injuries caused by trauma. One patient was paraplegic — paralyzed from the knees down — while the other was quadriplegic, with some voluntary movement of the hands but no capacity to grasp. Both patients had been injured for more than two years, had received conventional rehabilitation treatments throughout their recovery and continued to do so during the stimulation treatment.
After approximately six months of the stimulation treatment, the team says, the paraplegic patient could bend both ankles, and the quadriplegic could grasp an object. "We observed strengthened neural connections and partial restoration of movement to muscles which the patients were previously entirely unable to use," explains Shulga.
Crucially, the researchers say, the movement they restored in the study participants was still there a month after the stimulation treatment had ended. One of the patients is now participating in a further study in which stimulation is given more extensively and for an even longer period. The team hopes their tentative new study will lead to bigger things, offering new hope to those with SCI.
As Shulga's colleague, Dr. Jyrki Mäkelä, points out, the rehabilitation of patients with chronic spinal cord injuries is highly challenging and new treatment methods are sorely needed. "This is a case study with two patients only but we think the results are promising," he says, "Further study is needed to confirm whether long-term paired associative stimulation can be used in rehabilitation after spinal cord injury by itself and, possibly, in combination with other therapeutic strategies."