Spinal cord work 'is a breakthrough'

1. Resolution of neuropathic pain 2. Use of hands 3. Sexual function 4. Bladder and bowel function 5. (a few other things) 6. The ability to walk

I should note that the discussions/polls I've read are mostly from the United States. The U.S. is probably the most accessible country in the world, and as a citizen I don't miss walking so much because I can still do almost anywhere I want to. If the discussion was among people from undeveloped countries, the ability to walk might score much higher.

Like how the Reeve Foundation is actually making progress.

I'm guessing this patient has more of a partial spinal cord injury (So the spinal cord itself was still intact). Stimulation may have then allowed weaker signals to make it all the way though. This is definitely a big deal, but it won't work for every patient. One of the biggest challenges in the area of brain-controlled movement is that brains are so unique to everybody, and stimulating the spinal-cord directly is hard to do without accidentally stimulating other parts of the body (In general, stimulators are past the spinal cord and closer to the appendage they're going to move. Implants for the hand are usually located in the shoulder, and stimulate the nerve going off of the spinal-cord for example). If someone has a completely severed spinal cord, this technique won't make a bridge for the signal so it's not going to be a fix-all type of thing (Though, I'd be happy to be wrong!).

Either way, 'stimulating' a nerve means applying an electric current to it to simulate a brain-signal. It's not as complicated as it sounds, it's not much more then sticking an electrode around the nerve and then applying an AC or DC current (Though AC and DC do actually produce slightly different effects). I've had it done to my hand before (Via some simple surface electrodes), depending on the placement and nerves which receive the current different muscles start pulling. If you stimulate the correct nerves, you can have the correct muscles pull and create Ex. a fist, or a clenching motion. Implants right now don't do a ton more then a simple 'open-close' type motion for a hand (Since the intent is not so you can type on a computer, but so you can eat by yourself or pick-up a glass, etc.)

FES works on different levels. For one, many FES systems cycle electricity to various muscle groups in a coordinated fashion to try to get the patients body to 'take over'.

Examples of this would be with electrodes on the glutes, thighs, and around the knees in an effort to get an incomplete spinal cord patient to stand. This exploits the patients natural spasticity, along with the physiology of the body (joints can only go so many ways) to get the patient able to stand with parallel bars or in some other controlled manner.

Nerve stimulation also supposedly reduces the 'trigger energy' of certain muscle sets, thus sidestepping the impedance problem. An overly simplistic example : imagine a knee muscle requires 1mW to trigger into an action, however the circuit leading to this nerve only allows for half of that due to damage adding resistance along the pathway. FES can artificially increase the energy available to that muscle set so that the trigger may be more properly interpreted, hopefully leading to a successful 'firing' of the muscle.

source: i'm a quadriplegic, and FES makes me spasm into a 'stiff as a board' plank.

Specifically, it's known (At least, it was known among the group I worked with, and I saw this result happen) that extended use of the DC block will damage the nerve (On higher frequencies - IIRC 40hz was the highest we tested). AC doesn't have that issue, but AC has the issue that it actually sends a fairly large signal back up the nerve when it's turned on (So you feel a sharp pain when you turn it on). I couldn't tell you how bad it is since I've never felt it, but obviously it's still useable if Ex. you just turn it on to go to sleep at night.

Now, something unfortunate I feel obligated to tell you is that not to long ago my Dad traveled to go give a talk at a conference relating to a company that's been marketing a pain-relief type stimulator with no side-effects. From what my Dad saw, the block was mostly from nerve damage being created from the stimulation (I apologize, I don't remember all the specific details). Bottom line, I'd research any company you're considering getting a stimulator from.

Note: I'm more knowledgeable then the average person, but I'm no biomedical engineer. Definitely look into this stuff yourself and get other opinions. I do know it's definitely worth looking into.

I'm a guy who had the opportunity to attend a Women's College [1]. As a result I'm more aware then most men of things like only including men in a medical study. Since HN is predominantly male, I feel a personal responsibility to highlight such things, because things like gender and ethnic heritage do matter in medical conditions, even conditions that may look very generic in nature (e.g. heart disease or paralysis).

To be clear, my original comment didn't say this particular study should have been conducted with a different sample, I said simply that "it'd be really nice to hear about generalizable research being inclusive of minorities (e.g., 4 Chicana women instead of 4 Caucasian men) earlier in the research process."

[1] Only women were admitted as residential students. There were a myriad of reasons that guys could attend classes. But we were still very outnumbered!

[2] For more than a decade my grandmother complained of what turned out to be primarily female symptoms of heart disease, but her GPs were only aware of the primarily male symptoms. It was only when she visited a emergency room and was treated by a doctor that was cognizant of the differences that she got a proper diagnosis. In the end she died of heart disease, who knows how much longer she would have been with us if heart disease research had been more inclusive earlier on or her doctors were made aware of more recent research.