Introduction

Epidural electrical stimulation update

Epidural electrical stimulation update

[pullquote align=”right”]”One day I realized I could sweat again, and to regulate my temperature, feel hot and cold. I could also feel light touch. I regained control of my bladder, bowel and sexual function and my circulation improved. I’m not 100 percent but the changes really impact my quality of life.” Rob Summers[/pullquote]

Published in the April 2014 edition of the prestigious journal Brain, is a paper detailing the exciting results seen by the first four spinal cord injured volunteers to be implanted with epidural electrical stimulators by researchers at the University of Louisville, Kentucky. The small electrical arrays are installed against the spinal cord below the level of injury. The stimulation seems to make the cord more responsive to any instructions coming from the brain through any surviving pathways.

All four men are now able to flex toes, ankles and knees! To have physical function restored several years after the spinal cord injury is hugely encouraging. 

There were other benefits, too. As Andrew Meas, one of the four volunteers explains, “Before the stim I could sense when my bladder was full, but if I waited too long to empty it, I would get a pounding headache, a sign of autonomic dysreflexia (AD), and a painful reminder that, untreated, this could lead to stroke. Now, I can hold my bladder longer and have no AD symptoms. Bowel function has improved a little bit. As far as sexual function goes, that has improved greatly — everything is possible now, and there is no AD.”

Intriguingly two of the volunteers were considered “complete” ASIA A with no motor or sensory sparing below their injuries. But even they have been able to move their legs with the stimulator turned on.

More extraordinary news comes from volunteer Andrew Meas. The first time he was able to move his legs “it made me feel like a normal person again,” he said. After months of rehab post-implant, “I can pick up both my legs without the stimulator on, and can also stand without it. My record is 27 minutes, and I’m still progressing.”

 

This ground breaking work by Prof Reggie Edgerton, Prof Susan Harkema and colleagues was first reported three years ago when the first of the volunteers, Rob Summers was given a stimulator. The “RestoreAdvanced” stimulators being used are made by Medtronic for pain control and are fairly basic 16 node arrays.

NeuroRecovery Technologies, a start up which includes Prof Reggie Edgerton as a Director and Chief Research Scientist, is further developing the spinal-cord stimulator technology on a commercial basis. Nick Terrafranca, CEO of the company is quoted as saying. “All of these patients have been implanted for some time. Many more patients have been evaluated and treated since these initial four.” He added,  “We’ve been treating patients not just with an implantable approach but also with an external stimulator. The external stimulator, I believe, is going to be a game-changer in the field of neuromodulation. We’ve been getting remarkable results for spinal cord injury patients.”