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Neuromodulation

Alternating nerve activity with stimulation

Electrical stimulation of the spinal cord to modify and enhance the function of nerves

Neuromodulation involves implanting electrical devices or drug delivery systems on, or within, the body that modulate the activity of nerves. For example, electrodes can be implanted next to the spinal cord, the brain, or elsewhere in the body, so nerve pathways can be stimulated. We are researching a number of modes of neuromodulation that do not require invasive surgery - and some of the initial results have been promising.

What You're Funding

Neuromodulation devices and treatments have the capacity to be life-changing, and last year we undertook a pilot clinical study into the safety, tolerability and feasibility of a novel transcutaneous spinal cord stimulation device. Although the primary aim was to test safety, initial evaluation of the patient outcomes suggested that the intervention is capable of improving function. Our research in this field is thus hoping to expand on our findings.

 

For me, the use of hands would be the single biggest leap forward in my life. Without your hands it is so difficult to do even the most basic things

Tara

Dr Ronaldo Ichiyama and Sarah Astill (Leeds University): Transcutaneous electrical stimulation for recovery of arm and hand function in individuals with cervical spinal cord injury

This project builds on a successful pilot study which proved the safety, tolerability and feasibility of a novel non-invasive transcutaneous spinal stimulation device. This two-year clinical project will test the efficacy of the treatment on patients with chronic spinal cord injury - so that any improvements can be ascribed solely to the treatment. The team will be assessing whether using transcutaneous electrical stimulation in conjunction with intense periods of task specific training could lead to progression along The American Spinal Injuries Association (ASIA) scale, which describes an individuals functional impairment after a spinal cord injury.

This therapy has the potential to bring a new, non-invasive treatment to this underserved population. If it can bring lasting improvements in sensory, motor or autonomic function, then this could lead to greater functional independence, participation and quality of life for people with a spinal cord injury.

Dr Mariel Purcell and Dr Aleksandra Vuckovic (Glasgow University): Determining effects of transcutaneous spinal electrical stimulation on sensorimotor function in chronic complete tetraplegia

Similarly, this study is also expanding on the success of a previous pilot study.That study proved that spinal stimulation shows promise in restoring function - but the clinical significance of those observations require further verification and study. To expand on the study effectively, the team in Glasgow will use a larger patient cohort, involving non-ventilator dependent tetraplegics injured at the C2-C6 level. In combination with a functional activity-based exercise training, participants will undergo weeks of personalised neuromodulation.

Through rigorous assessment, this study will determine the immediate and lasting effects of these interventions on motor, sensory and autonomic function. Moreover, it will help to identify an effective dose and duration of neuromodulation needed to reveal and maintain any latent function. The data generated will be essential in determining how this technology can translate to patient clinical rehabilitation. It will also ensure greater access to treatments that benefit those with high level, chronic spinal cord injury, who currently have no treatment options beyond rehabilitation.

Jane Symonds (Neurokinex Charitable Trust): Non-invasive spinal cord stimulation combined with activity-based rehabilitation in chronic spinal cord injury

Unlike the previous two studies, this third project will take place in a specialised rehabilitation centre. Nuerokinex, a charity providing specialised neurological rehabilitation for various forms of paralysis, will recruit patients with either neck or back injuries and provide 12 months of rehabilitative intervention to determine long term effects of this novel treatment. This arm of the package of studies involving neuromodulation will provide valuable information on the effects on lower limb as well as upper limb function and potential for benefits in bladder, bowel and cardiovascular systems.

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