Physical therapists and sports trainers primarily use neurostimulation to reduce pain and augment rehabilitation. The CDC keeps a running section on the ScienceDirect website with articles about external and implanted neurostimulators. Medical professionals don’t all agree about the use of neurostimulation, but the treatment appears to be gaining greater acceptance. We wrote in January 2018 about global giant GlaxoSmithKline partnering with NeuroMetrix to use its wearable stimulator for pain control. In the last 14 months, the FDA cleared Medtronic to use neurostimulation for pain management and use of the NSS-2 Bridge wearable to treat opioid withdrawal pain.
More recently, scientists at Ecole Polytechnique Federale De Lausanne (EPFL) and the Lausanne University Hospital (CHUV) in Switzerland revealed potentially breakthrough work with neurostimulation for treating paralysis. In a study published in Nature, the Swiss team showed how three paralyzed patients were able to walk after a few months of training with precisely directed electrical stimulation to their spinal cords. In a short time, they were able to walk without the continuous stimulation.
The breakthrough program is called STImulation Movement Overground (STIMO). The patients in the study had sustained cervical spinal cord injuries many years before. The patients regained sufficient voluntary control of their leg muscles to walk with crutches or a walker on a regular basis, sustained by a protocol of targeted electrical stimulation of the lumbar spine and weight-assisted therapy. The training regimen uses precisely placed electrodes implanted over the spinal cord that target individual muscle groups in the legs. Correct stimulation at the right time was crucial to the treatment’s success. According to EPFL neuroscientist Grégoire Courtine, it is “this spatiotemporal coincidence that triggers the growth of new nerve connections.”
While earlier studies demonstrated paraplegics taking steps for short distances and only when stimulated, the STIMO program training included walking hands-free for more than one kilometer. The relatively long distances set off activity-dependent plasticity: the rearranging nerve fibers. The Swiss group plans to develop tailored neurotechnology to offer at hospitals and clinics. The scientists also want to test STIMO with patients in early recovery after spinal cord injuries when recovery potential is higher than with long-term paraplegics because of their neuromuscular systems will not have atrophied to the same degree. This technique could offer new hope for paralyzed patients.
