How brain and spinal stimulation can improve arm function

We caught up with Dr Antonio Capozio, a researcher at the University of Leeds, to learn about his background and find out how the simultaneous electrical stimulation of the brain and spinal cord can improve hand and arm function after spinal cord injury.

Key Terms

• Plasticity: the formation of new synapses, which can be induced after injury with electrical stimulation
• Synapse: the connection between two neurons (nerve cells) allowing for messages (electrical impulses) to be sent between the brain and the body. ‘Messages’ are transferred when neurotransmitters are released from one neuron and bind to a receptor on another, generating an electrical impulse in that cell. 

Did you always want to be a scientist, what did you want to do if not?

I grew up in a small village in Southern Italy, so being a scientist wasn’t much of an option at the time. However, I had great teachers and was always interested in how the brain and body worked so ultimately it became an obvious choice to go in a scientific direction.

How did you progress into your current position?

I was also volunteering for an association working with children with spina bifida and decided a combination of researching plasticity in neurological conditions was what I most wanted to do.

I went on to do an internship in Trinity College Dublin investigating brain plasticity while looking for PhD positions in Europe, which I ultimately found in Leeds! I completed my PhD and have been there for 7 years now.

Can you tell us simply about your area of research?

We are investigating the effects of transcutaneous spinal cord stimulation (a non-invasive approach to stimulating the spinal cord) which uses low intensity high frequency electrical stimulation.

We specifically focus on the effects on upper limb function, exercising the arm while stimulating the cervical level of the spinal cord as well as the brain to induce plasticity and promote recovery, as well as measuring the effects of our interventions on independence and quality of life.

We then analyse the impact of stimulation on the cortico-spinal tract which is one of the major pathways in the spinal cord for skilled movements.

How will this help someone with a spinal cord injury?

It appears to be very effective at increasing strength, but we are still investigating the effect on dexterity. We have also had some unexpected results – because of the positioning of the electrode, it is stimulating the torso where people have gained some trunk stability too. However, we need to do bigger trials to characterise these effects.  

Does length of time after injury affect the outcome of the research?

The earlier you treat something the better, however, that absolutely does not mean that no benefit can be had for those with longer injuries. We see plasticity even after 30 years. The more active after injury the better though, as we find results are better with active participants.

What is the current state of play in terms of research progress?

It has been accelerating a lot during the last decade. We are making a lot of progress as we are finally looking at spinal cord injury from many points of view – not just the neuroprotective perspective, but combining pharmaceutical approaches with neuromodulation, advanced technologies developed through engineering and rehabilitation.

Do we know when any meaningful therapies may be available?

There is no simple answer – it is a huge field of research with different approaches. With clinical trials at the moment we are close to treatments that can really help people. In terms of the jigsaw puzzle that is solving spinal cord injury, we are getting much faster and better at putting pieces down, but we don’t yet know how big this puzzle is.

In your particular area of focus, what are the next steps for your research?

We are interested in acute injury, not only because there is more plasticity occurring, but also because of the way SCI is diagnosed and prognosed. We want to start thinking about what other ways we have to differentiate between injuries.

Each participant’s injury is very different, so characterising the injuries better will help identify the treatment most appropriate for that type of injury.

Any specific plans for this year?

For now I am focused on collecting data for my project. I am looking forward to presenting my work at the International Spinal Cord Society (ISCOS) and the Society for Neuroscience (SfN) conference this year.

I also look forward to visiting Edinburgh and Washington – getting back to life and travelling after the recent few years!

Researchers are always looking for members of the community to help their projects. If you’re interested in taking part in a research trial, please visit https://scitrials.org/ for more details