Posts from ‘Latest Research’
An Ohio company, Synapse Biomedical, created a novel device designed to stimulate natural breathing processes in patients suffering from decreased and degenerating respiration due to upper spinal cord injuries. Dr. Michael DiMaio of the University of Texas Southwestern Medical Center told EurekAlert that, “Patients who have high-level spinal-cord injuries are unable to breathe efficiently because the nerve signals no longer function.” The U.S. Food and Drug Administration approved the NeuRx device for medical use in 2008.
The device, called the NeuRx diaphragm pacing system, seeks to make many improvements upon older respiratory aid models. Older models consisted of electrodes inserted directly on the phrenic nerve by way of incisions through the neck and chest. The phrenic nerve sends impulses from the brain to the diaphragm by way of the spinal cord, causing the large muscle to expand and contract properly, making the lungs inhale and exhale in a relatively natural fashion.
Other common treatments for spinal cord injury-based respiratory dysfunctions included the use of external mechanical ventilators that work by way of a tube inserted through the front of the throat, which has potential to interfere with speech.
The NeuRx device creators hope to revolutionize the respiratory-aid process with their new device, which works through 4 electrodes implanted into the diaphragm by way of incisions through the front of the lower abdomen. Dr. DiMaio also said of the NeuRx, “[It] has some advantages over traditional ventilators,” … “Patients have more mobility because they don’t have an external ventilator to carry around, and the surgery to implant the device is less invasive than previous treatments.”
The earlier nerve-stimulating electrodes had potential to scar and/or fatigue the phrenic nerve, whereas the NeuRx device works directly on the diaphragm with more diffuse electrical stimulus. The NeuRx also aids spinal cord injury patients to retain their natural speech, since the device does not involve incisions or tubes in the throat.
Other reported benefits of the NeuRx are: decreased incidence of infection, more natural breathing patterns, more mobility, less chance of scarring after surgery, and less chance of infection due to weakened respiratory ability.
Surgeons at the University of Texas Southwestern Medical Center are ready and equipped to begin implanting the device into eligible patients. The hospital is one of 25 total hospitals in the U.S. who are ready to implant the NeuRx in spinal cord injury and other respiratory-impaired patients. Hopefully the NeuRx diaphragm pacing system will provide relief and benefit to spinal cord injury patients in the near future.
References:
Morales, Katherine. (November 25, 2009). “New device implanted by surgeons help paralyzed patients breathe easier.” Retrieved December 9, 2009 from the EurekAlert website: http://www.eurekalert.org/pub_releases/2009-11/usmc-ndi112509.php
The BBC recently reported on a 22-year-old man who died from multiple abscesses in his brain related to complications arising from his recent tongue piercing. The journal Archives of Neurology issued a report on the death of the young Israeli man and encouraged consumers to be aware of the dangers involved with such a piercing. A Dental Health Site article published on February 10 of this year gives a list of seven common oral hazards associated with tongue piercings.
Of the seven risks mentioned on the site, infection and death, blood loss and nerve damage, and Hepatitis or HIV infection are among the more serious dangers associated with oral piercing. Another health website, YgoY, reported on the possibly fatal dangers of tongue piercing back in December of 2007. In addition to mentioning the possibility of serious brain infection, the YgoY article also noted the potential for heart valve damage, blood poisoning, and speech impediments.
The BBC article discussed the more common dangers of tongue piercing, including oral infections, chipped teeth, recession of gum lines, and problems with uncontrolled bleeding. Professional piercers pointed out that using proper procedures and maintaining hygienic after-care protocols rarely lead to any complications, much less death from brain abscesses and infections.
Tongue piercing remains both widely popular and controversial. The BBC article named Mel B of the Spice Girls and Princess Anna’s daughter Zara Phillips among the celebrities with tongue piercings.
The scientific advisor to the British Dental Association, professor Damien Walmsley, told the BBC News, “Piercing of oral sites also carries with it a risk of infection. The clear message is that oral piercing is ill advised and should be avoided.” The Dental Health Site article also recommended caution and advised avoidance of tongue piercing altogether.
While the death of the Israeli man from brain abscesses due to complications with his tongue piercing is a rare case, the severity of it may make many consumers more cautious about getting an oral piercing. For many, the risk of brain damage and death may be enough to scare them away from the cosmetic procedure, while for others, the piercing will still be worth the risk.
(pic from wikimedia.org/wikipedia/commons)
A double-blind study release on August 5, 2009 in the New England Journal of Medicine showed that vertebroplasty a procedure that involves the injection of medical cement into the spines of patients who have spinal fractures proved only equally effective as simulated vertebroplasty with no spinal cement injection. One group of patients received the actual vertebroplasty procedure, and the control group received a mock procedure including everything but the cement injections into their spines.
The study’s leader, Dr. David Kallmes, said that while vertebroplasty has been long accepted and utilized as a treatment option for many years, there has been no data or research to verify its effectiveness. The findings of the study conducted by a team of researchers at the Mayo Clinic in Rochester, MN showed that relief of pain and improvement in dysfunctions related to the pain proceeded similarly in both the group of patients who received the vertebroplasty and the control group who did not. The progress of the patients involved in the study will continue to be monitored over the course of one year, after which the comprehensive results of the study will be published.
The study was partially motivated by doctors’ concerns that the cement injections into patients’ spines could potentially increase the risk of future spinal cord injuries. Dr. Kallmes was careful to add that vertebroplasty does actually work. However, scientists and doctors may be able to achieve similar results without the potentially dangerous cement injections.
Kallmes was quoted in a EurekAlert article speculating that the improvements recorded in the control group could be the result of, “…local anesthesia, sedation, patient expectations, or other factors.” He also advised patients to seek professional advice before deciding on treatment options. Many other studies related to treatment for spinal fractures are currently underway at the Mayo Clinic. They will be reported on as the studies and their findings are published.
Many other institutions were involved in the vertebroplasty study, including: the University of Washington, Seattle; Nuffield Orthopaedic Centre NHS Trust, Oxford, UK; St. George Hospital, University of New South Wales, Sydney, Australia; Gartnavel General Hospital, Glasgow, UK; Department of Social Medicine, Bristol, UK; Nottingham University Hospital NHS Trust, UK; and Western General Hospital, University of Edinburgh, UK.
The huge amount of global attention dedicated to improving conditions for spinal cord injury patients is encouraging. Their dedication is producing constant improvements in the quality of care and effectiveness of treatments around the world.
(pic from spineuniverse)
A study published in the September issue of Archives of Surgery on data from the National Trauma Databank held implications that may inspire further research into possible healing functions of alcohol in the bloodstream of traumatic brain injury patients. The study compared and analyzed data from a database of 72,294 people. The researchers were only able to utilize 53% (38,000 people) of the data because the other 47% of patients were not tested for alcohol at the time of their injuries.
The data showed a 9.7% death rate for brain injury victims with no alcohol in their blood compared to a 7.7% death rate for brain injury patients with alcohol in their systems. The study also showed a higher incidence of complications for patients with alcohol in their blood, but less severe and faster healing injuries than those with none.
The study was conducted by a team of researchers at Cedars-Sinai Medical Center in Los Angeles. The study’s main author, Dr. Ali Salim, reported that other smaller human studies showed that alcohol has a diminishing effect on the body’s production of catecholamines, which produce adrenaline in the body. The scientists speculated that using ethanol in small doses may prove effective at reducing the severity of traumatic brain injuries.
Other scientists warn against jumping to conclusions just yet, and think that it it too soon to judge whether or not alcohol will prove to be a safe and effective part of a brain injury treatment plan. Dr, Homer C. N. Tien of the University of Toronto, Dr. M. Sean Grady from the University of Pennsylvania, and even Dr. Ali Salim, the study’s author all cautioned against assuming too much from the results of the study prematurely. They made the point that the study was on administrative, and not clinical, data.
The three doctors all suggested that further research and clinical studies would be necessary before considering the use of alcohol as a part of a treatment plan for traumatic brain injury patients. It is encouraging that studies such as this one are conducted, and that scientists at medical centers and universities around the globe continue to seek better and more effective treatments for traumatic brain injury.
(pic from drugs.ie)
Hundreds of thousands of CT scans are conducted every year on children who have hit their heads. The CT scans have been traditionally used to determine whether or not the children have incurred more serious brain injuries. A recently published study as well as recent discoveries of several more effective methods of diagnosing brain injuries may prove a vast number of CT scans to be unnecessary.
Previous studies mentioned in earlier blog posts on this site explored the use of monitoring NSE protein levels in the blood and DTI scans as possible diagnostic tools that reveal subtle data undetectable by the high radiation CT scans. Monitoring NSE protein levels in the blood enabled doctors to uncover subtle forms of brain damage in long-time boxers, while DTI scans revealed brain damage undetectable by CT scans in military personnel exposed to non-impact explosive blasts.
The recent CT scan research a vast study including over 42,000 children less than 19 years old evaluated the effectiveness of CT scans in detecting traumatic brain injury. The children had all bumped their heads or had accidents involving head impacts. About 15,000 of the sample group received CT scans, but less than a thousand of them actually detected signs of traumatic brain injury.
The results of the study were published online in the September issue of The Lancet. The authors of the study included six signs to use when determining whether or not a traumatic brain injury may be suspected and tested for traumatic brain injury using a CT scan. The New York Times article on the study reported the indicators as signs of a fractured skull, altered mental states, loss of consciousness, vomiting, headaches, and out-of-character behavior.
The principal investigator of the study, Dr. Nathan Kupperman, urged doctors to search for one or more of the six indicators of traumatic brain injury before blindly prescribing thousands more of unnecessary CT scans.
(pic from dbtechno.com)
Anthony Russell, a professor at the University of Calgary, and his colleague, Tim Higham from Clemson University in South Carolina, observed movement in gecko tails after they were severed and were inspired to explore possible ramifications and applications to humans paralyzed by complete spinal cord injuries. The professors noted that there is a great similarity between the neural cells in gecko tails and neural cells in human tailbones. Complete spinal cord injuries refer to injuries in which the spinal cord has been completely severed.
Russell noted in the article that the severed gecko tails moved somehow without physical connection or communication from the brain. He was quoted as saying, “Something in the tail is saying to the tail, ‘Lets use this muscle to move a lot, then take a break, then move again.’ ”
He speculated that the movement in the tail arises as a response to environmental stimuli such as temperature or pressure, which elicit a response in the muscles without prompting from the brain. Humans also reportedly experience movements in their paralyzed limbs after spinal cord injuries.
Other studies released last week reported that rats with severed spinal cords were able to walk on treadmills and support their own weight after a combination treatment of drugs administered below the spinal cord injury, locomotor training, and electrical stimulation.
The movement in severed gecko tails could hold further secrets behind how movement can occur without direct communication from the brain. These studies move scientists and doctors ever closer to a cure for paralysis. The basic implication of the rats studies and gecko observations is the hypothesis that movement is not completely dependent on messages from the brain.
The two professors, Russell and Higham, hope to inspire and collaborate with doctors and scientists on potential research into spinal cord injury applications of their knowledge and observations.
Integration between observations of various professors and scientists with research data and knowledge gathered by surgeons and researchers holds a potential key toward medical advances far beyond the prospects and possibilities presented in singular isolated studies. Integrated thinking across disciplines may lead to more holistic approaches to research and disease prevention, and give realistic hope to those currently suffering from irreversible paralysis.
(pic from herper.com/)
Neuralstem Incorporated recently received Food and Drug Administration approval for a Phase 1 trial to treat Lou Gehrig’s disease (ALS) with their proprietary neural stem cells injected directly into the human spinal cord. They are the first business to conduct a stem cell treatment study for ALS patients.
ALS currently has no cure and no effective treatment options. Neuralstem hopes to develop both a powerful treatment and a potential cure for ALS with their research. World renowned doctors from the University of Michigan Health System ALS Clinic, the Emory Neuromuscular Lab, and the Emory ALS Center have been contracted to conduct the study.
ALS is a neurodegenerative disease that kills its victims by way of the degeneration and death of motor neurons, which control muscle movement, in the human spinal cord. Thirty thousand people in the United States currently suffer from ALS. Dr. Eva Feldman, the proposed director of Neuralstem’s clinical trial, reported in the article that previous stem cell studies on animals with ALS showed promising results.
In the animal studies, the spinal cord stem cells made connections with muscle-controlling neurons and protected other potentially endangered motor neurons. Feldman warned against premature celebration of animal trial results before human trials demonstrate the effectiveness of the treatment in human subjects.
The Neuralstem trial consists of treating ALS patients with injections of Neuralstem’s patented spinal cord stem cells into their spinal cords. 12 patients will receive the treatment and will be monitored and examined over the following 2 years to determine the results of the treatment. Eva Feldman will most likely conduct the study at Emory University with colleagues from the University of Michigan Health System and the Emory ALS Center.
Neuralstem is the first company in the world to produce commercial quantities of viable neural stem cells for use in the human brain and spinal cord. Rats injected with Neuralstem’s spinal cord stem cells lived longer than rats in a control group not injected with the stem cells. It remains unclear whether or not the stem cell treatment will translate to human subjects, but the results of the animal studies show great promise.
In addition to developing treatments for ALS, Neuralstem plans to direct its stem cell research toward finding treatments and/or cures for Ischemic Spastic Paraplegia, Traumatic Spinal Cord Injury, and Huntington’s disease.
Scientists at the David Geffen School of Medicine at UCLA and researchers from the University of Zurich in Switzerland have discovered stunning information on how nerves in the spinal cord, even in cases of paralysis, can be stimulated to elicit a walking response, without communication between the brain and the nerves. The researchers used a combination of treatments to enable rats with severed spinal nerves to bear the full weight of their bodies and run for up to 30 minutes.
The treatment consisted of drugs known as serotonergic agonists, electrical stimulation applied to nerves below the spinal cord injury, and rehabilitation on a slow moving treadmill. When the nerves were activated with electrical currents, it activated evolutionarily primitive nerve connections in the spinal cord to elicit movement in the rats’ limbs without information from the brain.
At first, the rats were only able to move their back legs for a small amount of time. Over a week, the rats could run and walk without support. After a few weeks, the rats were able to fully support their own weight and run forward, backward, and sideways for up to 30 minutes. However, the rats remained dependent on the mix of drugs and electrical stimulation to make their legs work.
Researchers from the University of Zurich also reported that they are developing a series of electrodes for insertion along the spinal cord. They expect to begin human trials in about four years.
Previously, scientists have been able to generate movement in the legs of paralyzed human subjects in the past. Until the most recent study, published in the most recent online edition of Nature Neuroscience, they had never been able to elicit continuous walking and full weight bearing in the paralyzed rats.
The Christopher and Dana Reeve Foundation and many other contributors funded the study. Scientists and support foundations hope to inspire further research leading to a cure for paralysis for patients with severe spinal cord injuries. One of the most remarkable implications of the study is that, “nerve fibers do not need to regrow in order for a paralyzed patient to walk again.”
Combined with neuroprosthetic devices, which may allow a communication bridge from the brain across the injured spinal cord, the data from the current study has brought scientists one step closer to finding a cure for paralysis.
(pic from cdn-write.demandstudios.com)
Patients suffering from loss of consciousness due to traumatic brain injuries and other forms of brain damage may find promise in the results of a new study by scientists at the Hebrew University of Jerusalem. A team of scientists from the University discovered an area of the brain that controls and monitors what they have called the brain’s “alert status.”
The scientists made the discovery while studying the mechanisms by which surgical anesthesia works to suppress conscious awareness and painful stimuli in the brain. It was formerly believed that the changes to the brain under anesthesia which also include a shift to a sleep-like brainwave state, slowed brain metabolism, a sharp decrease in muscle tone, and suppression of behavioral functions were caused by general neuronal suppression due to the drugs used, or lack of oxygen and nutrients.
The new report shows a dramatically different mechanism at work in the brain. A part of the brain called the mesopontine tegmentum contains a small group of neurons near the base of the brain. The neuron group exerts full control of the activity of the cerebral cortex and the spinal cord. The neural structure can also remove pain sensations, lead to a collapse of body posture, and even coma-like loss of consciousness.
The current study was focused on rats and involved injecting the neuron group in the mesopontine tegmentum, referred to by the scientists as the “center of consciousness,” with a tiny dose of anesthetic drugs. The drugs had a massive suppressive effect on cerebral activity in the rats’ brains.
The results, if they prove to translate to the structure of the human brain, promise a wide range of new developments in the treatment and possible cure of patients suffering from coma and other losses of consciousness. The scientists also hope to discover and understand more clearly how consciousness arises out of what they referred to as a “biological machine,” the human brain.
The researchers also speculate that it may be possible to introduce an electrical charge to the center of consciousness in order to draw a patient out of a coma. They also hope to develop more effective treatments for oversleeping and insomnia from analysis and further study.
Peter Wildetrotter, President and CEO of the Christopher and Dana Reeve Foundation, sent a letter to brainandspinalcord.org to show his appreciation and to share with our readers some of the recent breakthroughs in spinal cord injury and brain injury research. The Reeve Foundation funds projects dedicated to finding a cure for paralysis.
The letter brings up many important discoveries and advances, including a recent experiment on rats with severed spinal cords. The rats were able to walk again after a complex, three-part treatment. The rats had completely severed spinal cords. They were given a dose of the drug quipazine, electrical stimulation below the spinal cord injury site, and then locomotor training.
Surprisingly, the rats were able to walk on treadmills while fully supporting their own weight. Previous to this experiment, it was widely believed that movement was impossible below the site of severed spinal cord. Wildetrotter added that the physical movements of the rats was nearly identical to their walking motions before their spinal cord injury.
Even more importantly, the study proves that movement is still possible even when the line of communication between the brain and spinal cord is severed. In order to make such advanced studies possible, many forces must harmonize and collaborate with one another. New research often must confront dated and obsolete ways of thinking, and it is the determination and hard work of countless scientists, universities and medical facilities, public and private funding sources like the Reeve Foundation, and sites such as this one that are necessary to make the formerly impossible possible.
It is not only the scientists and foundations that make a difference, it is every individual who donates time, energy, and money toward paralysis research. Wildetrotter wrote of the recent paralysis breakthrough, “Every time you and other Reeve Foundation supporters donated your hard earned money, contacted your Congressperson or Senator to fund paralysis research, participated in a Team Reeve event, attended a comedy night or other event, you helped make this happen.”
He also expressed gratitude for the public and private support that make possible the Reeve Foundation’s International Research Consortium, as well as the NeuroRecovery network, where spinal cord injury survivors receive locomotor training.
Wildetrotter concluded his letter with a promise to continue the Reeve Foundation’s noble efforts toward a cure for paralysis and expressed enthusiasm that, “Science is fulfilling Christopher’s vision.”
You can donate to the cause by visiting the Reeve Foundation’s website: www.christopherreeve.org/
