a future with no sporting events for paralysed
people. A future in which there is no need, as all the would-be competitors
will have been cured.
scenario, laughable just a few decades ago, is no longer far-fetched, experts
by bit, important progress is being made in understanding and tackling aspects
believe the time is fast approaching when the major secondary problems from
paralysis – bowel, bladder and sexual
complications, declining muscle tone and bone density – will be treatable,
probably through a combination of drugs, cell replacement, physical training
and electronic aids.
tentative but encouraging signs are emerging in the quest for the ultimate
goal: restoring function to paralysed
is an enormously complicated, but we do believe solvable, problem," said
Susan Howley, vice-president of research at the New Jersey-based Christopher
and Dana Reeve Foundation for paralysis.
of the best and brightest people at work in the neurosciences are thinking
cord injury repair, and working on it. There is tremendous hope," she
full or partial, happens when a message from the brain gets lost on its way to
the muscles, blocked by illness or damage to the spinal highway.
recently as 20 years ago, researchers focused not on a cure, but simply on
making the person comfortable.
was a belief that you are born with a certain number of neurons and when they
die, they die, the dogma was that you cannot repair the damage," said Mark
Bacon, research director at Spinal Research, a UK charity.
thinking has been swept away, although the available options remain unchanged:
the only licensed treatment is physical rehabilitation, which is useful but
the lab, though, extraordinary experiments are taking place.
include cell replacement and regeneration, spinal scar-tissue removal, electric
muscle stimulation and brain-computer connections.
are in clinical trials – the long process of vetting a new drug or medical
technique for safety and efficacy.
Embryonic stem cells
promising but controversial innovation involves replacing or reinvigorating
dead or damaged central nervous system cells using embryonic stem cells.
are hopeful of a breakthrough," said Martin McGlynn, president of
Newark-based StemCells Inc, which is implanting stem cells directly into the
spines of paralysed trial patients.
[T]his therapy has the potential to provide a long-lasting benefit with the
potential to also significantly reduce the overall health care burden."
promising, observers like Howley point out that stem cell research, like most
other therapies, is in its infancy.
need to better understand which are the best cells to be transplanted and which
kind of stem cell should be optimally used; how well do the transplanted cells
actually integrate into the central nervous system and become functioning; and
how to contend with the scar at the lesion site," she said.
last three years have also seen exciting developments in electrical spinal
work bypasses attempts to link the brain to muscles, instead using electrodes
to jolt the relatively autonomous nerve networks of the lower spine directly.
experiments have shown paralysed people stand on their own two feet and regain
limited movement, though apparently no feeling.
individuals regained varying degrees of bladder control and sexual function –
"a patient population for whom it was always believed that nothing could
be done", Howley noted.
the most thrilling work, though expensive and invasive, is in brain-computer
interfaces – using electrodes to read the intent of the brain to make a
movement and relaying that message to muscles to enact it.
brain-machine interface is a promising field, but we are taking the first,
faltering steps," said Nathanael Jarrasse, a robot specialist at the
French National Centre for Scientific Research (CNRS).
A combination of treatments
many as 500 000 people per year suffer spinal cord injuries – one of the main
causes of paralysis, according to the World Health Organisation (WHO).
are the chances of a cure?
obvious there isn't going to be a single magic bullet," said Howley.
way we have to think about fixing spinal cord injury is picking the low-hanging
fruit first, as we continue to work towards fixing the more difficult,
believe the answer will be a combination of treatments.
would likely administer a "neuroprotectant" drug as soon as possible
after injury to reduce the death of precious nerve cells, said Bacon.
could be followed by a drug to encourage the rerouting of broken
nerve connections. Next could be cell replacement therapy to reverse
whatever damage could not be stopped.
the patient may be helped with electrical stimulation to restore some automatic
functions and computer-brain interfaces to wield a still useless limb.
are at the beginning of the journey in the same way cancer was 20 or 30 years
ago, where we have the prospects of treatments that will improve the outcome,
and with time we will refine those," said Bacon.
paralysis with a gel
stem cell trial halted
can a fractured spine cause paralysis?
(Picture: Summer paralympics from Shutterstock)