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A Research Update from the International Center for Spinal Cord Injury at Kennedy Krieger Institute
As a therapeutic tool, electrical stimulation is being used in innovative ways to promote recovery of function following nervous system injury or disease. It can restore control and offset atrophy to muscles after injury and has a variety of therapeutic applications in the clinical setting. New research now suggests that electrical stimulation may also enhance central nervous system (CNS) repair.
The International Center for Spinal Cord Injury (ICSCI) at Kennedy Krieger Institute is one of the first facilities in the world to combine innovative research with a unique focus on restoration and rehabilitation for children and adults with chronic paralysis. Founded in 2005 by neurologist Dr. John McDonald, one of the world's foremost experts on the treatment of paralysis, ICSCI researchers are conducting numerous studies in the field of paralysis treatment.
Two recently published studies reveal the results of researchers' efforts to use electrical stimulation to promote CNS repair. Both studies examined the birth of endogenous neural progenitor cells in white matter tracts of the spinal cord. The birth of these cells is thought to be an attempt of the CNS to repair itself in response to injury. In addition, both studies investigated the fate of these progenitor cells and provide evidence that a percentage of these cells become myelinating cells of the CNS, or oligodendrocytes. By restoring these oligodendrocytes, scientists hope that people living with multiple sclerosis (MS) or a spinal cord injury will regain lost myelin and subsequently sensation, movement, cognition, and other functions impaired by these conditions.
Neuroscience Letters, "Electrical Stimulation of the Medullary Pyramid Promotes Proliferation and Differentiation of Oligodendrocyte Progenitor Cells in the Corticospinal Tract of the Adult Rat" (Published online May 2010)
Published in Neuroscience Letters, this study provided the first in vivo demonstration in the adult CNS showing that electrical stimulation can selectively promote proliferation, or rapid increase, and development of myelinating cells. Researchers stimulated the corticospinal tract in adult rats and injected a stain to identify proliferating cells. Upon stimulation, there was an increase in cell birth around the axons along the corticospinal tract. Findings showed that electrical stimulation selectively increased the proliferation and differentiation of oligodendrocyte progenitor cells (OPCs) in the corticospinal tract, compared to the unstimulated side. OPCs are critically important as these cells mature into oligodendrocytes that wrap and insulate bundles of axons (a process known as myelination) and secure the communication signals along the spinal cord.
"This is the first published research examining activity-dependent development of OPCs in the adult CNS, and there are currently no therapies that specifically target remyelination. We predict that these newborn OPCs, after maturation, will contribute to the remyelination in demyelination events," says John McDonald, MD, PhD, lead author of the study and Director of the International Center for Spinal Cord Injury at Kennedy Krieger Institute. "Our findings have important implications for explaining the mechanism of myelin formation, harnessing activity to promote remyelination and devising new approaches for the treatment of multiple sclerosis and spinal cord injury."
This research study was supported by grants from the Hugo W. Moser Research Institute at Kennedy Krieger, the National Institutes of Health and the New York State Spinal Injury Research Program.
Experimental Neurology, "Functional Electrical Stimulation Helps Replenish Progenitor Cells in the Injured Spinal Cord of Adult Rats" (Published in print April 2010)
Published in Experimental Neurology, this study examined whether functional electrical stimulation-induced patterned activity in the chronically injured spinal cord can enhance CNS repair. Researchers provided patterned activity to the spinal cord of chronically-injured rats through electrical stimulation to the peroneal nerve and monitored the birth and survival of neural progenitor cells.
Functional electrical stimulation (FES) induced a selective increase in cell birth that was confined to the lower lumbar spinal cord, an area of the spinal cord that researchers predicted would experience increased activity from the nerve stimulation. Overall results showed that FES induced an approximately 85 percent increase in cell birth in the lumbar spinal cord.
"This study provides the first demonstration that FES can enhance cell generation in the injured adult CNS," says Daniel Becker, MD, lead study author and Head of Pediatric Restoration Therapy at the International Center for Spinal Cord Injury at Kennedy Krieger Institute. "These results raise the exciting possibility that in addition to the physical and rehabilitative benefits of FES, FES may contribute to spontaneous repair and perhaps recovery of neurological function."
This research study was supported by grants from the Barnes-Jewish Hospital and the Barnes-Jewish Hospital Auxiliary Foundations, the Sam Schmidt Paralysis Foundation, the Jack Orchard and ALS Hope foundations, the National Institutes for Health, the State of Maryland Department of Health and Mental Hygiene and the Johnson & Johnson Focused Giving Program.
About the International Center for Spinal Cord Injury at the Kennedy Krieger Institute
The International Center for Spinal Cord Injury (ICSCI) at the Kennedy Krieger Institute is dedicated to restoration recovery of chronic spinal cord injury and paralysis in children and adults. The interdisciplinary team at ICSCI is committed to the philosophy that with the right combination of therapies, recovery is always possible-even many months or years after an injury. The center's therapy programs follow techniques that have shown great promise in helping individuals with chronic spinal cord injuries recover sensation, movement and independence, as well as achieve improved health and quality of life. For more information on ICSCI, visit www.spinalcordrecovery.org. For more information on Kennedy Krieger Institute, visit www.kennedykrieger.org.