'Hope' for the paralysed?

 
Paralysed rat walking Paralysed rat in harness walking after chemical-electrical stimulation

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Seven years ago I stood on a bridge over the M40 doing a "piece to camera" for a report about spinal repair. The aim was to come up with a metaphor for how researchers at University College London were trying to overcome spinal cord paralysis.

It went something like this: "Imagine your spinal cord as a motorway, the cars travelling up and down are the nerve fibres carrying messages from your brain to all parts of the body. If this gets damaged the cars can't travel. The messages are blocked, the patient is paralysed.

"Normally there is no way of repairing a severed spinal cord. But the team at UCL took nasal stem cells, and implanted them into the area of damage. These formed a bridge, along which the nerve fibres re-grew and re-connected."

Start Quote

This is the World-Cup of neurorehabilitation. Our rats have become athletes when just weeks before they were completely paralysed.”

End Quote Prof Gregoire Courtine EPFL

The research at the Spinal Repair Unit at UCL involved rats, not humans. In my TV report we showed rats unable to climb a metal ladder after one of their front paws had been paralysed to mimic a spinal cord injury. But after an injection of stem cells, the rats were able to move nearly as well as uninjured animals.

"Difficult and complex"

The hope then - and now - is that such animal experiments will translate into similar breakthroughs with patients. Seven years on and the team at UCL led by Professor Geoff Raisman are still working on translating this into a proven therapy for patients. He told me "This is difficult and complex work and we want to ensure we get things right."

So it was with a sense of caution that I approached some Swiss research in the latest edition of the journal Science in which paralysed rats were able to walk again after a combination of electrical-chemical stimulation and rehabilitation training.

The research prompted some newspaper reports talking of "new hope" for paralysed patients. The lead researcher, Professor Gregoire Courtine enthused: "This is the World-Cup of neurorehabilitation. Our rats have become athletes when just weeks before they were completely paralysed."

My colleague James Gallagher has reported on the research and you can read his copy here.

A brief summary of the research is this: the team at the Federal Institute of Technology (EPFL) in Lausanne injected chemicals into the paralysed rats aimed at stimulating neurons that control lower body movement. Shortly after the injection their spinal cords were stimulated with electrodes.

The rats were placed in a harness on a treadmill which gave them the impression of having a working spinal column and they were encouraged to walk towards the end of a platform where a chocolate reward was waiting. Over time the animals learned to walk and even run again.

Prof Courtine, who holds the International Paraplegic Foundation Chair in Spinal Cord Repair at EPFL said: "After a couple of weeks of neurorehabilitation with a combination of a robotic harness and electrical-chemical stimulation, our rats are not only voluntarily initiating a walking gait, but they are soon sprinting, climbing up stairs and avoiding obstacles when stimulated."

The major question is this: What does this mean for humans who are paralysed?

"Ground-breaking"

Prof Courtine said he was optimistic patient trials would begin in "a year or two" at Balgrist University Hospital Spinal Cord Injury Centre in Zurich.

Other scientists gave a mixed response to the findings. Dr Elizabeth Bradbury, Medical Research Council Senior Fellow, King's College London, described the Swiss experiments as "elegant" and "ground-breaking". But she said questions remained before its usefulness in humans could be determined.

She said: "Firstly, will this approach work in contusion/compression type injuries? These injuries involve blunt trauma, bruising and compression of the spinal cord and are the most common form of human spinal cord injury. Very few human spinal cord injuries occur as a result of a direct cut through spinal tissue (as was the injury model in the Courtine study).

"Secondly, will this technique work in chronic (long-term) spinal injuries? It is not yet known whether it is possible to generate extensive neuroplasticity in a system that has been injured for a long time and now contains many more complications such as abundant scar tissue, large holes in the spinal cord and where many spinal nerve cells and long range nerve fibres have died or degenerated."

Start Quote

This is yet another example of research that will lead nowhere.”

End Quote Dr Jan Gawronski Royal National Orthopaedic Hospital

That term "neuroplasticity" is crucial. It refers to the ability of the brain and spinal cord to adapt and recover from moderate injury - something which researchers have been trying to exploits for years.

Prof Raisman of UCL said few people, even doctors, were aware that around half of all patients who become paralysed will walk again no matter what treatment they have. He questioned whether the improvements in the paralysed rats might in part be due to spontaneous recovery - neuroplasticity - rather than the combination of interventions.

Prof Raisman is now conducting trials with paralysed patients in Poland, who are all at least 18 months post-injury which removes any doubt that spontaneous repair may be the cause of any improvement.

False hope

Other scientists are scathing about efforts to repair the spinal cord. Dr Jan Gawronski, consultant in rehabilitation medicine, Royal National Orthopaedic Hospital, said the Courtine study was "yet another example of research that would lead nowhere". He said scientists had been doing rat studies on neuroregeneration for decades and "not one had led to a breakthrough for patients."

He pointed me to a recent article in the journal Spinal Cord, by neurologist Dr L S Illis in which he states: "There is not a single example of experimental work translating into a therapeutic effect. ...It would be difficult to find any other branch of science with over a century of such sterile endeavour."

Supporters of this field of research would counter with the case of Rob Summers, a paralysed American patient who is now able to stand with electrical stimulation of his spinal cord. We reported on his case last year, which appeared in the Lancet journal. He could walk on a treadmill while being supported. But doctors warned that the research was still very much at the early experimental stages.

There are research teams worldwide trying to find ways of curing spinal cord injuries.

But until there are successful trials involving several patients, scientists and journalists need to be careful about giving false hope to patients living with paralysis.

If you want to see a video release of the Swiss research then you should click on the box below. I should warn you that it shows experiments with rats in a harness walking on a platform while their spinal cord is being stimulated.

Footage of rat being retrained to walk using robotic harness (courtesy of Swiss Federal Institute of Technology)

 
Fergus Walsh Article written by Fergus Walsh Fergus Walsh Medical correspondent

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  • rate this
    0

    Comment number 40.

    Folks: being spinally-injured is hard. Life stops being straightforward. You must spend £50k a year on your care - the Government only help out once you have nothing left, surely a scandal in itself - and if you do manage to hold down a job, you cannot save any money otherwise you must spend that too. I'm sorry for the rats, but if there's any hope at all, then long live these heroic scientists.

  • rate this
    0

    Comment number 39.

    @JackRuss, so a 17 yo boy struck down by Leukemia who then contracts a spine-destroying infection, is because of your aversion to animal testing, denied the hope of or opportunity to access a treatment that might allow him to regain a measure of dignity in however long is hos shortened life, as Dean' said? Or one day walk down the aisle, to conceive children naturally, to kick a ball in the park?

  • rate this
    +2

    Comment number 38.

    As a C-5 'incomplete' SCI victim I have a thankful understanding for these lab mice. Sure, it's not nice that they're tested on but it's a much better alternative than testing on humans.

    And remember this there's far more problems than simply walking. I'm sure many would change their minds if they relied on catheters and needed help showering and using the restroom.

    I still have hope!

  • rate this
    -2

    Comment number 37.

    there is just no excuse, for this animal to be experimented on, none at all! PAH!

  • rate this
    0

    Comment number 36.

    A few of these comments that are against animal experimentation have good views on why it's wrong BUT when you think of how much it will help people and how it will affect our lives as a collective, it is so worth it. I'm sorry but people matter more than non sentient animals like rats. Now on the other hand, animals like dolphins that have a sense of consciousness should be left alone altogether

  • rate this
    0

    Comment number 35.

    Have the Swiss got anything to do with God?
    Possibly.

  • rate this
    +1

    Comment number 34.

    To: 32. penguin337

    Where does Beef Pork Lamb Chicken come from?

    Animals that we kill

    Where do leather goods come from?

    Animals that we kill

    Where does the Feathers in your duck down duvet come from?

    Animals that we kill.

    Get real, we use animals all the time to feed and clothe us.

  • rate this
    +2

    Comment number 33.

    Cant belive some people seem to be against this and therefore all the good it could do based on the welfare of a rat.

  • rate this
    -3

    Comment number 32.

    no worse than killing it and eating it, or making shoes or clothing from it's dead skin
    --

    making shoes or clothing from it's dead skin
    We don't do that anymore as far as I am aware, unless the skin is a byproduct of the food industry

    but it is no worse than killing it and eating it
    I would disagree, most carnivores on the planet kill to eat, this is relatively natural

    Live testing is gruesome

  • rate this
    +3

    Comment number 31.

    Perhaps all the "Anti Vivisectionists" would care to volunteer to take the place of the rats?

    Some things can only be done by using live test subjects, or in killing the animal humanely and testing of the tissue etc.

    Yes this is NOT ideal, but it is no worse than killing it and eating it, or making shoes or clothing from it's dead skin.

  • rate this
    +1

    Comment number 30.

    26 jackinthegreen
    "I see no justification for the maiming and torture of another sentient creature."

    Nor do I, but rats barely sentient (if at all) and the workers don't torture them.

  • rate this
    +1

    Comment number 29.

    #25 Diffusa. Rats 'spread plague' and are therefore the enemy? Actually, fleas were the vector, so are the fleas our 'enemy'? What about the actual bacterium, is that the enemy? Who feeds the rats so they can flourish. Oh... that's us. Just because we compete with another species doesn't mean it deserves our hate or contempt. They feel pain as we do. No, I am not anti-vivisection.

  • rate this
    0

    Comment number 28.

    It is amazing how we can put such anger towards people who test on animals, to enhance our standards of living. Yes, they have no choice in the matter, but if you are so against it, then maybe you should stop using most of the marvels of modern medical technology as a lot of it was developed in concentration camps during WWII and is being expanded upon through all the wars we are fighting now.

  • rate this
    0

    Comment number 27.

    20. yottskry
    2 HOURS AGO
    "Its amazing how we think our needs come before the need of other species."

    I'm willing to bet your attitude would change if you found yourself paralysed. It's very easy to act aloof with a situation that doesn't actually involve you.
    --
    Would you condone experimenting on humans to enhance the life of rats?

  • rate this
    -6

    Comment number 26.

    I see no justification for the maiming and torture of another sentient creature.

    The great myth of vivisection is little more than an opportunity for a huge industry to make lots of money.

    "Open your eyes - DON'T believe the lies."

  • rate this
    0

    Comment number 25.

    Rats spread the Black Death which killed millions of humans - they are our ancient enemy and will again be a real threat when a pandemic or other natural disaster lays waste what mankind have built - don't waste your sympathy on them sooner or later you will know what they can do...No sentimentality or anthropomorphism here merely harsh reality.

  • rate this
    +1

    Comment number 24.

    To those who are describe this experiment as cruel, you need to watch the rats behavior more. If you notice that its facial expressions, and body language show very little signs of pain or suffering. Apart from restricted use of its hind limbs it is behaving very normally, and reacting very positively to external stimuli.

    Saying this I'd prefer no experimentation on animals but it is necessary!!

  • rate this
    -2

    Comment number 23.

    22.Jesse Pinkman

    Irony aside, I apologise for my brusque manner. I was just trying to hi-light what others have elucidated on in that being able to make a paralysed rat walk does not mean much for Humans for various reasons.

  • rate this
    -1

    Comment number 22.

    14. Golgotha
    How original, I bow to your superior intellect!
    ////
    You're not bowing deep enough, you can still type.

  • rate this
    -2

    Comment number 21.

    I think Rats are very different to people.

 

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