First Ever Quadriplegic Treated with Stem Cells Regains Upper Body Motor Control | Hacker News Reader

First Ever Quadriplegic Treated with Stem Cells Regains Upper Body Motor Control

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225 pointssua_300030 comments

This is great news but I would be a bit cautious about it. I love the idea that stem cell therapy can cure spinal cord injuries but I know for a fact that spinal cord injuries are unpredictable as to what the long term impact will be.

Professionals in the field know that people with these injuries can regain mobility months and years after the accident.

I know of a few extreme cases where individuals were told they would never walk but within a few months were able to walk out of the hospital.There are other more common cases where movement to limbs increased in time.

I point this out not to throw water at the cure but it's a bit premature to celebrate and get people's hopes up without knowing the reality of the treatment.

I love the idea but one person does not prove a cure. I sincerely hope that Kris' improvement continues and that the therapy is as good as it's hoped.

The Christphere Reeves foundation has a great area on the subject.

https://www.christopherreeve.org/research/reeve-stem-cell-re...

Here's a press release from the company: http://asteriasbiotherapeutics.com/asterias-biotherapeutics-... They're doing a dosing study, with escalating number of cells injected. Results are promising, but the study includes no controls, so there is no way to know if the cell-based treatment is better than no treatment.

The current study is open-label (i.e. not blinded) single-arm (no controls). Once they establish the right dose, they will need to do a double-blind randomized controlled study to find out if it works.

Blinding isn't especially important for a procedure like this. An RCT would be a sufficiently strong study design, in my opinion.

If you were going to RCT, in this instance, why would you not blind? Sham injections - it's a no brainer. Why get the second best level of evidence if you can get the best?

It's a needle to the spine...

Hmm... maybe use people who require surgery/anesthesia and just tell them they were injected? I've taken a few courses on clinical trial design just out of curiosity, but now I find I can't really say anything substantial about my own idea. Back to the courses?

Sham surgery is a thing (there have been some interesting studies looking at the efficacy of knee surgery compared with sham surgery for a variety of common knee issues...)

https://www.youtube.com/watch?v=P_pAdg8Y70Y

People much smarter than me have been wrong about the placebo effect in the past, but I think it's pretty unlikely that a placebo effect will result in the restoration of function after a traumatic spinal cord injury...

This procedure clearly needs to be tested against "doing nothing" (but it's impossible to blind against that, obviously). You only need to blind a study when you are testing against a placebo.

> I think it's pretty unlikely that a placebo effect will result in the restoration of function after a traumatic spinal cord injury...

You would be amazed. The placebo effect is surprisingly powerful.

https://en.wikipedia.org/wiki/Sham_surgery

Yeah, I'm familiar with the effect (I linked to a Healthcare Triage video on that topic in another leaf). I still think the placebo effect is likely to be very small when it comes to the restoration of movement (as opposed to reduction in pain, or other symptoms).

Yes, but the only way to know for sure is to do the experiment. Wouldn't it be cool if you turned out to be wrong?

Potentially amazing news

Here's the direct Link minus the weird reblog of press release

http://www.prnewswire.com/news-releases/paralyzed-man-regain...

And the source, I believe verbatim...

https://news.usc.edu/107047/experimental-stem-cell-therapy-h...

And the ClinicalTrials.gov record: https://clinicaltrials.gov/ct2/show/NCT02302157

And this video shows how the procedure is performed, and clearly demonstrates its effectiveness: https://www.youtube.com/watch?v=LNJi0zfodI

> Once Kris made the decision to pursue enrollment in the study, dozens of doctors, nurses, rehabilitation specialists and others sprang into action. Because he would need to provide voice confirmation of his desire to participate in the study, Kris had to be able to breathe without a ventilator.

That is an interesting requirement. I don't think it's necessary. morse code via blinking isn't sufficient?

I've never seen a voiced-consent requirement before... and it makes absolutely no ethical sense, either.

Perhaps they actually mean that patients must be capable of breathing independently to enroll in the study, and that voiced consent is the metric used?

I would guess this is either an artifact, or a deliberate requirement to avoid patients who are entirely helpless "agreeing" to something because they have no choice/little control/...

This is incredible. A non-speculative, non-hypothetical-petri-dish-stem-cell-potential announcement, but tangible, life altering progress that's happening now.

I hope they continue with the initiative and other institutions follow their lead soon if it proves successful.

Likewise! I think this is the first time all year I've been moved to deploy the phrase "Welcome to the world of the future" without grim irony. Truly amazing! I hope his recovery proceeds apace and without setback.

I'm really pleased for this guy and hope he can continue to make progress.

Unfortunately the information content of these events is at best modest. After spinal cord injury you can get "spinal shock" which can last for a month or two. When it wears off you can recover a lot of previously lost function. As other comments point out bigger trials will be required to prove any efficacy.

Also there are many things in development to help acute spinal cord injury (some of which are FDA devices) but chronic SCI is a much thornier and challenging problem.

This is really cool! Can anyone comment on what the state of art is on restoring motor function in paralyzed animals (i.e. rats, mice) ?

This is fantastic news. I can't but think of the many people that have contemplated assisted suicide that were in his position. This should give them hope.

That's the best thing I've heard all day!

I'm amazed nobody has tried this before. In any case, it's wonderful news.

All that and he survived living in Bakersfield

San Diego man seeking help with effects of stroke gets stem cell treatments that leave him partially paralyzed and with mysterious tumor.

http://www.kpbs.org/news/2016/sep/20/patients-san-diego-stem...

Perhaps more accurately: San Diego man makes incredibly risky gamble on untested treatment and bad things happen. Given that, I'm curious what your point is here? This is a multiphase clinical trial. That was someone going to another country to bypass the very safety measures this trial is a part of.

Hope you don't hate me for kind of a joke comment, but it's extremely relevant:

https://www.youtube.com/watch?v=TRtlkcQ6brE

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