Epidural stimulation refers to a medical procedure where tiny electrical pulses are delivered to the spinal cord using a small device placed in the outer layer of the spine. This technique helps stimulate nerves in the spinal cord, which can potentially restore or improve certain bodily functions that may have been affected due to injury or illness.
Full definition
The therapeutic benefits
of epidural stimulation have been well - documented for chronic back pain, but a small number of experimental trials are testing the treatment on people with spinal cord injuries.
This study will include 36 people with spinal cord injuries who will be treated
with epidural stimulation — a technique in which a device is used to apply electrical current to the spinal cord.
The research was reported this month in Frontiers in Human Neuroscience (Normalization of Blood Pressure with Spinal
Cord Epidural Stimulation After Severe Spinal Cord Injury).
To that end, UofL is screening participants for a six - year study that will further explore the life - enhancing effects of
epidural stimulation on people with spinal cord injury (SCI).
Now three years later, the key findings documented in Brain detail the impact of
epidural stimulation in four participants, including new tests conducted on Summers.
The participants were implanted with an electrode array
for epidural stimulation, and individual configurations for stimulation were identified for each participant.
«The implications of this study for the entire field are quite profound and we can now envision a day
where epidural stimulation might be part of a cocktail of therapies used to treat paralysis.»
Kent Stephenson, the second person to
undergo epidural stimulation of the spinal cord, voluntarily raises his leg while stimulated at the Human Locomotion Research Center laboratory, a part of the University of Louisville's Kentucky Spinal Cord Injury Research Center, Frazier Rehab Institute, Louisville, Kentucky.
• Kent Stephenson was the second person to undergo
epidural stimulation after sustaining an injury at T5 - T6 during a motocross accident in 2009.
Edgerton is also working with various collaborators on NIBIB - funded projects to explore
whether epidural stimulation can be used to help patients with paralysis of the upper limbs.
Because of the undesirable side effects of pharmaceutical and non-pharmaceutical interventions, Hirsch
said epidural stimulation for chronic low blood pressure in SCI could have significant benefits.
«
Epidural stimulation shown to normalize blood pressure following spinal cord injury: Research supports future study of beneficial effects of stimulation.»
Epidural stimulation involves surgically inserting electrodes permanently above the spinal cord and then stimulating the nerve cells in the spinal cord with electrical currents.
That study will measure the extent to
which epidural stimulation will improve cardiovascular function as well as facilitate the ability to stand and voluntarily control leg movements below the injury level in 36 participants with chronic, complete spinal cord injuries.
Darrel made the decision to have electrodes surgically implanted over his spinal cord in 2016 to test out a treatment known
as epidural stimulation in the hopes of improving some of the side effects.
In addition, Kessler is partnering with the University of Louisville to
investigate epidural stimulation, in which a chip is implanted to deliver an electrical current through the spine to trigger walking.
«
Epidural stimulation electrodes are implanted during surgery and are located right on the surface of the spinal cord, so they require little current to activate the spinal cord,» Moritz explained.
This work builds on previous research at KSCIRC showing benefits of spinal
cord epidural stimulation, along with activity - based training, in which individuals with SCI have achieved voluntary movement, standing and stepping, and improved bladder, bowel and sexual function.
To that end, UofL is screening participants for a six - year study that will further explore the life - enhancing effects of
epidural stimulation on people with spinal cord injury.
However, the implications of this study for the entire field are quite profound and we now can envision a day
where epidural stimulation might be part of a cocktail of therapies used to treat paralysis.»
This research builds on an initial study, published in the May 2011 edition of The Lancet, which evaluated the effects of
epidural stimulation in the first participant, Rob Summers, who recovered a number of motor functions as a result of the intervention.
Krassioukov and his colleagues are currently collaborating with colleagues in the U.S. on a larger trial, examining the benefits
of epidural stimulation on a bigger group.
Prior to
epidural stimulation, they had all suffered chronic conditions caused by completely severed spinal cords.
Research in animals with spinal injuries has shown that this type of
epidural stimulation can activate neural circuits in the spinal cord and enable them to use sensory information from the legs to coordinate the muscle contractions necessary for standing and taking a step, Edgerton said at the press conference.
«Because of
epidural stimulation, they can now voluntarily move their hips, ankles and toes.
The initial research hypothesis stated that the two participants with the American Spinal Injury Association Impairment Scale (AIS) classification of AIS A would not elicit any voluntary movement, despite the therapy intervention, and the two participants who were AIS B would develop voluntary movement following a combination of training and
epidural stimulation.
Epidural stimulation, in the context of paralysis of the lower extremities, is the application of continuous electrical current, at varying frequencies and intensities to specific locations on the lumbosacral spinal cord, corresponding to the dense neural bundles that largely control movement of the hips, knees, ankles and toes.
However, in the presence of
epidural stimulation, all four recovered voluntary control of their lower extremities, surprising researchers who believed at least some of the sensory pathway must be intact for epidural stimulation to be successful.
Working with human research participants, Hirsch and researchers at the Kentucky Spinal Cord injury Research Center (KSCIRC) at UofL, have found that spinal cord
epidural stimulation can safely and effectively elevate blood pressure in individuals with SCI along with chronic hypotension.
Working with human research participants, Hirsch and researchers at the Kentucky Spinal Cord injury Research Center at UofL, have found that spinal cord
epidural stimulation can safely and effectively elevate blood pressure in individuals with SCI along with chronic hypotension.
«Going into it, I spent months reading every article dating back to the 1950s that had ever been written on
epidural stimulation, animal models, and hypotheses — the science behind it, the theories that went along with it,» he says.
Other avenues of exploration for Kessler include Hocoma's LokomatPro V6 and
epidural stimulation.