Rotterdam researchers' breakthrough could help paraplegics stand with support

Researchers at the Erasmus Medical Center in Rotterdam had a breakthrough that could help paralyzed people be able to stand on their own feet with support. They found that the stimulation of a nerve node in the lower back, the spinal ganglion, elicits muscle responses that allow people with a full spinal cord injury to bear their own weight, the hospital said.

"We placed a device that delivers electrical currents directly to the nerve node (the spinal ganglion, or DRG) in the lower back. This spot has so far been overlooked by spinal cord injury researchers. They focused on stimulating the spinal cord itself and did not look at the nerve node. We did that for the first time," researcher and PhD student Sadaf Soloukey explained.

The nerve nodes form a unique area outside the central nervous systems that also transfers information to and from the rest of the body. With a complete spinal cord injury, instructions from the brain stops at the injury. "By delivering electrical impulses to the spinal ganglion, we induced reflexes in the spinal cord. Because the nerve node is under the spinal cord injury, the electrical signals arrived in the legs. So we actually created a short cut to a muscle movement," Soloukey said. 

The first five participants in this study all have a complete spinal cord injury and have had no leg function for at least four years. With the device that stimulates the DRG, the thigh muscles in all five patients were activated. The muscles contracted, stretching their legs and knees enough to support weight, allowing some of them to stand with support. "Within five days, without any form of rehabilitation or training and after years of complete paralysis. That is a wonderful result," research leader Dr. Sanjay Harhangi said.  "This also felt like a special moment for the patients. Moreover, inserting the device that gives the electric pulses is a relatively simple procedure."

Whether this method can be further developed to actually allow patients to walk again will require more research, Harhangi said. "We still have to find out if we can get their legs to make a precise walking motion. How strong should the currents be and at what frequency, for example? We have seen that it is possible to generate gait patterns. But real walking requires even more, for example stability of the trunk. We want to investigate that further."