Patients paralysed from the neck down are regaining movement in their hands and feet for the first time after taking part in a ground-breaking Glasgow trial.
Early results from the first UK study of its kind are being hailed as the most significant breakthrough in the treatment of spinal injuries for more than 15 years.
NHS Greater Glasgow and Clyde was chosen to test a small device on a small number of tetraplegic patients aged between 25 and 40. It is similar to a TENS (transcutaneous electrical nerve stimulation) machine which uses a mild electrical current to relieve pain and is commonly used by women during labour.
Trauma to the spinal cord usually results in damage to a section of it which interrupts the messages between the brain and the body that create movement. In the patients the team worked with the messages were “completely interrupted”.
Above and below the site of the injury the spinal cord is usually healthy and the goal is to re-establish connection between the two.
The Up-LIFT device aims to improve the connections between these healthy areas using electrodes that are placed on the skin to activate the nerves below the level of the injury.
The results on patients were “significant”.
A former rugby player who suffered a devastating spinal injury 20 years ago was able to move his toes and hold a mobile phone in his hands for the first time.
Dr Mariel Purcell, a consultant in spinal injuries, who is leading the study, said: “Fifteen years ago we were all excited about the potential of stem cells but stem cells never demonstrated any improvement like this.
“We tested it on four patients and were very excited about what we saw. Patients demonstrated quite significant improvements in their condition.
“Two of them responded fantastically to it and two had an average response.
“There seems to be sort of way of getting the two parts of the healthy spinal chord talking to each other again but using this almost as a bridge.
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“When someone is paralysed, it’s not just their arms and legs that they can’t move, they have problems with their breathing, they have problems with their blood pressure, with their bladder function - everything below where the damage to the spinal chord is affected.
“Even temperature control and this treatment seems to result in improvement in a lot of those areas - not just in the arms and legs - and that improvement seems to be sustained after the treatment stops."
She recalled how a consultant ran in to her room after it became apparent one trial participant had experienced a significant improvement in his condition.
“She was saying, come on, come on, you have to see this.
"One patient is a young lad who was injured playing rugby at the age of 16 and had been completely paralysed - there was nothing happening at all from his neck down.
“He had the intervention three times a week for a month. After two weeks he had some movement in his arms. Bear in mind these are arms that haven’t moved in 16 years, the muscle was completely wasted away.
“He was able to bend and straighten his arm at the elbow which he had never been able to do and he had a little bit of movement in his fingers. He also had some movement in his toes for the first time.
“He was now able to use a mobile phone and move his wheelchair. These are big changes after a small period of treatment.”
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Dr Purcell said the man had been waiting on surgery to improve his bladder function but did not require it after the treatment and there were major improvements in his temperature control. His previously low blood pressure returned to normal.
While doctors caution that reversing the damage to the spinal chord is “currently out of reach” the machine has not yet been tested on newly injured patients and the team believe the improvements could be even more significant for those people.
The first half of the study involved eight weeks of intensive therapy to optimise upper limb movement and function.
During the second phase, participants received stimulation of the spinal cord in addition to traditional upper limb therapy for a further eight weeks.
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“We’ve been working with chronic patients, who have recovered as much as they are going to but I see in the future we will be using it on patients with new injuries, early on in their rehabilitation,” said Dr Purcell.
“They are the ones who are going to benefit most.”
She said the results were sustained “after just a short period of treatment.” Three more patients have now been recruited for the next phase of the study, which will test the device on a larger cohort.
One patient has relocated from England to take part and fourteen centres are involved in the trial world-wide.
“We are still early on in establishing how much therapy they should be getting, how long should they get it for, what is happening to the nervous system when they are getting it and how long is the improvement going to last.
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