NR Times updates on the latest breakthroughs in spinal cord injury treatments and approaches.
According to the World Health Organisation, between 250,000 and 500,000 people suffer from spinal cord injury every year; the majority are due to preventable causes such as road traffic crashes, falls or violence.
For most patients, SCI results in permanent disability and there is no known way to reverse damage to the spinal cord.
However, researchers are continually working on new treatments, including prostheses, wearables and medications, which may promote regeneration of nerve cells or improve the function of the nerves that remain after an SCI.
In recent months, developments in electrical spinal stimulation, AI-enabled tech, orally available drugs and gene therapy are offering a vision of a future with better treatments for patients suffering from spinal cord injury.
New intelligent suit uses AI to aid rehab
Researchers from Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) are working on an innovative intelligent suit designed to improve rehabilitation for patients with SCI.
The exo-suit integrates various support systems, including functional electrical stimulation (FES) and pulley mechanics, with a groundbreaking addition: AI-supported recognition of patients’ intended movements.
Using integrated sensors to monitor muscle activity, self-learning algorithms calculate the patient’s intended movements and adjust the relevant assistance systems. This tailored approach allows for precise movement support and a more gentle treatment, addressing the shortcomings of traditional rehabilitation methods.
The research is being carried out in collaboration with Heidelberg University and Heidelberg University Hospital, and funded by the German Research Foundation.
Cracking the secrets of the spinal cord
Researchers at Rice University in Texas are advancing spinal cord research with a groundbreaking tool.
Building on their success with nanoelectronic threads (NETs) in brain research, they aim to adapt NETs for the spine. These flexible probes, which can record high-quality, long-duration data from neurons, are set to heighten understanding of spinal cord function.
By integrating NETs with spinal tissue, scientists hope to gain insights into the neural processes that control motor functions, potentially aiding patients with spinal cord injuries. The project not only optimises probe design but also plans to develop a miniaturised data-processing and stimulation-feedback system, making it a transformative tool for neuroscience.
The new tool could help neuroscientists crack the secrets of spinal cord function and bring new hope to patients dealing with injuries and other associated medical conditions.
A new gene therapy that promotes nerve regeneration
Swiss researchers at NeuroRestore have collaborated with UCLA and Harvard Medical School to develop a gene therapy that promotes nerve regeneration across complete spinal cord injuries.
The international team devised a multipronged gene therapy approach by identifying specific axons and their natural targets using single-cell nuclear RNA sequencing.
This strategy activated growth programmes in mice neurons, upregulated proteins to support neuron growth through the injury site and used guidance molecules to attract regenerating nerve fibres to their natural targets.
The outcome: mice with complete spinal cord injuries regained the ability to walk, revealing a key condition for successful regenerative therapies. The development is a promising step towards more effective future spinal cord injury treatments.
The research team highlighted that the method could be effective when delivered alongside electrical stimulation therapies.
Spinal stimulation could be “transformative”
On the topic of electrical stimulation, researchers at the University of Washington have developed what they believe to be a “transformative” treatment for spinal cord injury called transcutaneous spinal stimulation.
This noninvasive wearable treatment uses electrical stimulation to help people with spinal cord injuries regain their abilities for months or even years after the injury.
In a clinical study, participants who received spinal stimulation saw remarkable improvements in hand dexterity and function, and these gains were maintained for an extended period.
The researchers are making progress in creating a wearable external stimulator device for wider use, offering the potential for long-term recovery and independence.
New orally available drug for SCI gives positive results in Phase 1 clinical trial
Researchers at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London have made strides towards developing a new drug treatment for SCI.
The drug, KCL-286, activates retinoic acid receptor beta (RARb) in the spine to stimulate recovery. In a Phase 1 clinical trial, the drug was well-tolerated by participants with no severe side effects, marking a crucial step in its development.
KCL-286 is one of several regenerative therapies being developed at King’s College London to address the unmet clinical need for effective treatments for the debilitating condition.
With this encouraging safety profile, researchers are now pursuing a Phase 2a trial to evaluate its effectiveness in individuals with SCI, raising hope for future treatments that could improve the lives of those affected by paralysis.
Early promise for experimental therapy, Perineline
NeuroSolv Therapeutics’ therapy, Perineline, shows potential for enhancing neuroplasticity and neuroregeneration.
After receiving Orphan Drug Designation in 2022, pre-clinical data suggests its effectiveness in both acute and chronic cases.
NeuroSolv Therapeutics seeks to expand clinical trials and expedite regulatory approvals for the treatment.
The therapy functions by temporarily removing protective perineuronal nets from spinal cord neurons, facilitating the formation of new synapses. When combined with rehabilitation techniques, this process promotes functional recovery.
It additionally clears signal-blocking glial scars on neuron surfaces, further enabling synapse formation.
The company says Perineline may offer mobility improvements even years after injury, potentially benefitting up to two million spinal cord injury patients worldwide.
The therapy, administered orally with neural signalling interventions, is non-invasive and well-tolerated.
Making SCI therapy more affordable
Engineers at Washington University in St. Louis are developing a low-cost, noninvasive approach to spinal cord stimulation.
Their work focuses on transcutaneous spinal cord stimulation (tSCS) which uses a series of electrodes on the skin to deliver electrical pulses for muscle stimulation.
The team found that using multiple electrodes in specific configurations provided more precise control of muscles.
This research proposes that SCS could be an alternative to costly surgical implants.
While it’s a significant first step, further research is needed to assess its potential to improve mobility in spinal cord injury patients.
Implant shows great promise
In September, Medtech firm Onward announced the successful first-in-human implant of its ARC-IM Stimulator, to restore upper extremity function after SCI.
The patient also received a wireless brain-computer interface (BCI), designed to initiate thought-driven movement when paired with ARC-IM.
ONWARD ARC-IM delivers targeted, programmed “ARC-IM therapy” to the spinal cord to restore movement and other functions after spinal cord injury.
The therapy has been applied across multiple clinical feasibility studies to restore mobility and stabilise blood pressure after SCI. For the first time, it has also now been used to restore upper extremity movement and function.
Two procedures were performed in August by neurosurgeon Jocelyne Bloch, MD, at Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, Switzerland. The ARC-IM implant procedure took place on August 14, 2023, and nine days later the BCI WIMAGINE from CEA-Clinatec was implanted.
Working in concert with ARC-IM, the BCI is engineered to capture the intention of a paralysed individual to move their upper extremities and uses artificial intelligence to decode those thoughts. ARC-IM then converts the decoded information into ARC-IM Therapy – precise stimulation of the spinal cord – resulting in thought-driven movement.
“The implant procedures involving the ONWARD ARC-IM and Clinatec BCI went smoothly,” said Dr. Jocelyne Bloch.
“We are now working with the patient to use this cutting-edge innovation to recover movement of his arms, hands, and fingers. We look forward to sharing more information in due course.”
