Good news! Amazing stuff! They also discovered a new group of neurons involved in recovery and developed a new molecular way to map neurons.
"A group of Swiss researchers is showing that even chronic spine injuries can be treated to restore a patient’s walking ability using a mix of electrical stimulation and intense physical therapy. ...
The current study identified the exact nerve groups that are stimulated by such treatment, filling in an important gap in our scientific understanding of spinal function. ...
Each participant went through five months of stimulation and rehabilitation, with four to five sessions per week. By the end of the trial period, all of the participants were able to take steps on their own, without the aid of the walker. ...
Subsequent experiments using mice showed that a single population of previously unknown neurons can learn to take over walking after a lumbar spinal injury. This group of cells is found within the Laminae of the lumbar cord and is made up of cells called SCVsx2::Hoxa10 neurons. Normally, these are not needed for walking, but they play an essential role in recovering after spinal injuries ..."
The current study identified the exact nerve groups that are stimulated by such treatment, filling in an important gap in our scientific understanding of spinal function. ...
Each participant went through five months of stimulation and rehabilitation, with four to five sessions per week. By the end of the trial period, all of the participants were able to take steps on their own, without the aid of the walker. ...
Subsequent experiments using mice showed that a single population of previously unknown neurons can learn to take over walking after a lumbar spinal injury. This group of cells is found within the Laminae of the lumbar cord and is made up of cells called SCVsx2::Hoxa10 neurons. Normally, these are not needed for walking, but they play an essential role in recovering after spinal injuries ..."
"Neuroscientists have identified the nerve cells responsible for helping paralysed people to walk again, opening up the possibility of targeted therapies that could benefit a wider range of people with spinal-cord injuries ...
team has now extended the work, showing that the system works in people who have lost all sensation in their legs. The group reports in Nature today that nine participants in the same trial — three of whom had complete paralysis and no sensation in their legs — regained the ability to walk after training paired with EES delivered by devices implanted in their spines. Five months into the trial, all participants could bear their own weight and take steps, using a walker for stability. ..."
team has now extended the work, showing that the system works in people who have lost all sensation in their legs. The group reports in Nature today that nine participants in the same trial — three of whom had complete paralysis and no sensation in their legs — regained the ability to walk after training paired with EES delivered by devices implanted in their spines. Five months into the trial, all participants could bear their own weight and take steps, using a walker for stability. ..."
From the abstract:
"A spinal cord injury interrupts pathways from the brain and brainstem that project to the lumbar spinal cord, leading to paralysis. Here we show that spatiotemporal epidural electrical stimulation (EES) of the lumbar spinal cord applied during neurorehabilitation (EESREHAB) restored walking in nine individuals with chronic spinal cord injury. This recovery involved a reduction in neuronal activity in the lumbar spinal cord of humans during walking. We hypothesized that this unexpected reduction reflects activity-dependent selection of specific neuronal subpopulations that become essential for a patient to walk after spinal cord injury. To identify these putative neurons, we modelled the technological and therapeutic features underlying EESREHAB in mice. We applied single-nucleus RNA sequencing, and spatial transcriptomics to the spinal cords of these mice to chart a spatially resolved molecular atlas of recovery from paralysis. We then employed cell type and spatial prioritization to identify the neurons involved in the recovery of walking. A single population of excitatory interneurons nested within intermediate laminae emerged. Although these neurons are not required for walking before spinal cord injury, we demonstrate that they are essential for the recovery of walking with EES following spinal cord injury. Augmenting the activity of these neurons phenocopied the recovery of walking enabled by EESREHAB, whereas ablating them prevented the recovery of walking that occurs spontaneously after moderate spinal cord injury. We thus identified a recovery-organizing neuronal subpopulation that is necessary and sufficient to regain walking after paralysis. Moreover, our methodology establishes a framework for using molecular cartography to identify the neurons that produce complex behaviours."
Electrical stimulation helps paralysed people walk again — and now we know why Detailed gene-activity map could pave way for more precise treatments for many more people with spinal-cord injuries.
The neurons that restore walking after paralysis (open access)
Fig. 1: EESREHAB remodels the spinal cord of humans and mice
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