#Italy #Milan #San Raffaele #Neurostimulator #Spinal Injury

Promising Outcomes in Spinal Injury Therapy

Overview

A study conducted by a team of medical professionals at the IRCCS San Raffaele Hospital in Milan has unveiled encouraging results in the treatment of spinal cord injuries through innovative spinal neurostimulation. Published in Science Translational Medicine, the research illustrates how a novel high-frequency stimulation approach significantly improves motor functions and reduces muscle spasticity in a select group of patients.

The Innovation of High-Frequency Stimulation

In recent developments, two patients suffering from incomplete spinal cord injuries were treated using a spinal neurostimulator, traditionally employed for pain management. The study indicates that targeted high-frequency electrical stimulations, combined with tailored rehabilitation exercises, have markedly improved not only muscle strength but also walking capabilities and overall motor control.

Notably, this new protocol effectively reduced involuntary muscle contractions and the reflexes that contribute to muscle spasticity, leading to more natural movements. This advancement is pivotal since muscle spasticity presents a significant barrier in the rehabilitation of individuals with spinal cord injuries, affecting approximately 70% of these patients.

Understanding Muscle Spasticity

Muscle spasticity results from disruptions in communication between the spinal cord and the brain, often leading to persistent muscle stiffness and spasms. Established treatments have primarily used low-frequency electrical stimulation, which has proven limited effectiveness for patients experiencing muscle spasms. The adopted high-frequency stimulation, however, marks a promising shift in therapeutic strategy for restoring movement.

Patient Progress and Rehabilitation

The two patients in the study experienced traumatic spinal cord injuries in 2023. Following the implantation of the spinal cord electrostimulator and an intensive rehabilitation regimen under the guidance of Dr. Sandro Iannaccone, they demonstrated significant recovery in their mobility. Remarkably, one patient regained the ability to walk up to 175 meters without active stimulation, highlighting the efficacy of the integrated rehab approach combining both low and high-frequency stimulation.

How the Technology Works

The innovative approach leverages the spinal cord's natural hyperreactivity to stimuli, which is essential for regular reflexes. In patients with spinal cord injuries, this hyperreactivity can spiral into a pathological state due to the absence of inhibitory signals normally communicated from the brain. The researchers postulated that frequencies in the kilohertz range, higher than previously utilized methods, disrupt this pathological condition. As a result, muscle spams and hyperreactivity are effectively reduced, allowing for improved motor control.

Future Directions

The findings from this pioneering study underline the immense potential of neuroengineering within neurorehabilitation. As noted by Silvestro Micera, a leading researcher, this study offers a solid foundation for advancing technology aimed at enhancing the quality of life for individuals with motor disabilities. Both Micera and fellow researcher Pietro Mortini underscore the significance of these developments in providing new therapeutic avenues in treating severe spinal cord injuries.

Looking ahead, further clinical trials are planned to evaluate the results across a larger patient group and expand the application of this technology to various other neurological conditions. This research marks the advent of a transformative era in motor recovery therapies, offering renewed hope to many suffering from spinal cord-related disabilities.

In conclusion, the collaborative efforts between medical and bioengineering teams at San Raffaele highlight how innovative treatments can redefine rehabilitation outcomes, setting new standards in patient care and recovery for spinal cord injuries.