Melanie Reed’s left hand had “flopped around like a bunch of bananas” since she broke her neck in a horse-riding accident 14 years ago.
She can now use it to scroll on her smartphone and unbuckle her seatbelt after an innovative new treatment using electrical pulses.
This treatment, combined with physical therapy, is thought to restore some movement to people who are paralyzed from the neck down. A study of this technique in 60 patients found that 43 of them showed some improvement in the use of their arms and hands.
The team is applying for regulatory approval to use its system to treat patients in hospitals in the United States.
It works by using electrodes attached around the affected area. High-frequency pulses of electricity enhance the impulses our brain sends to our hands and arms via our nerves, signals that were weakened in Melanie’s case due to her spinal injury.
Melanie, 67, a journalist at The Times of London, is one of the first patients to try the new technique. The movement of her hands and arms was restricted, especially her left hand, which she could not move at all.
She underwent two months of electrical impulses along with intensive physical therapy. She says this has led to some small, lasting improvements that have made a big difference in her daily life.
She told me: “I can unbuckle the seat belt with my left thumb, and now I trust this hand to lift a cup of coffee, and I can pick up small objects and do tasks like filtering rice with hot water.”
While most trial participants had more movement with the device on, it’s impossible to say yet how much of the long-term improvements — when the patient is not wearing the device — are due to the electrical pulses and how much is from physical therapy.
Professor Robert Brownstone, a surgeon and professor of neuroscience at University College London, said: “When you enroll someone in a study and pay a lot of attention over several months, there will be a certain amount of improvement.” Independent of the research team.
Aside from physical therapy, the feeling of hope and support that comes from participating in a potential treatment can also make a difference, he said.
Melanie said there were some things she could only do with the pulses turned on, such as squeezing water out of a face cloth and lifting objects, but she felt the treatment had left her with a lasting improvement in her strength.
“I can’t attribute all the improvements to electrical stimulation, but I feel they were accelerated and encouraged by it,” she said.
“There are no miracles in spinal injury (but) if this device is able to allow someone with quadriplegia to lift their arm to put food in their mouth or take a drink, it will change their life.”
It has been proven that patients with spinal injuries do better immediately after the injury. Those selected for the study had had accidents between 1 and 34 years ago, with little or no improvement since their initial recovery.
Mariel Purcell, research director of the Scottish Center for Innovation in Spinal Cord Injury at Queen Elizabeth University Hospital in Glasgow, has been treating Melanie since her injury 14 years ago.
Her unit was invited to participate in the study because it is a world-leading research center in this field.
She said she had never seen such progress with the injury she had for such a long time before.
“Currently, there is no single drug or device that has been approved that is of clinical benefit to patients,” she said.
This device is the latest development in the work of a Swiss team, led by Professor Gregoire Courtin from the Medical Research Laboratory at EPFL in Lausanne. So far, they’ve helped 26 people with spinal injuries below the neck walk again using surgically implanted devices to stimulate the spine — but so far only in laboratory tests.
The new system, which does not require any surgery, is also the team’s first effort to find a treatment for people with neck fractures who have lost movement in their arms.
Professor Curtin has published evidence that electrical stimulation combined with physical therapy leads to limited repair of damaged nerves.
“We are very close to providing the technology that will change the lives of these patients,” he told the BBC.
The US regulatory body, the Food and Drug Administration (FDA), is studying data from the clinical study, which was published in the journal Nature Medicine, to evaluate whether this technology is safe and the benefit is great.
If satisfied, the agency will license a medical device based on the technology, developed by a commercial subsidiary, for use in treating quadriplegics in US hospitals.
If the device gets the green light in the US, the team behind the technology will apply for use in other parts of the world.
