Epidural Stimulation May Improve Function in People with Spinal Cord Injury

Research under way at the University of Louisville is using a new application of epidural stimulation to study whether this approach helps improve function in people with spinal cord injury.

CNN reported on the research earlier this week in a news story posted at http://cnn.it/14A3gsZ. The report shows a video of a paralyzed man undergoing epidural stimulation, which results in him being able to move his toe, foot and leg while lying flat on his back.

Four other people with spinal cord injury who have undergone epidural stimulation in the past five years have experienced improvements in bowel and bladder function and sexual function, the report said. The University of Louisville plans to test this treatment in seven other patients this year, according to the CNN report.

“The Louisville group has undertaken an interesting new application of the epidural stimulation work that has been ongoing for decades at Baylor University,” said Edelle Field-Fote, director of spinal cord injury research at Shepherd Center.

“Essentially, when the spinal cord is damaged, the brain has diminished ability to activate the cells in the spinal cord that, in turn, activate the muscles,” she explained. “The epidural stimulation acts kind of like an amplifier. It amplifies the signal coming from the brain so that the signal is better able to activate cells in the spinal cord so that the spinal cord cells are better able to activate the muscles.

“The limiting factor is still how much of the signal from the brain can actually make it to the cells in the spinal cord,” Dr. Field-Fote added. “If a small amount of the brain signal is able to get through to the cells in the spinal cord, then the person will have the ability to do a small amount of movement, such as moving the legs while lying down.

“The problem is that it takes quite a lot of signal from the brain to do movements that are functional, such as standing up and walking using the leg muscles (and not just relying on the arm muscles to support weight on a walker),” she said. “It still remains to be seen if epidural stimulation will be able to amplify the signal to a great enough level that is required for functional movements in functional positions.”