【医学研究】脊髄損傷患者の下肢の運動機能回復

A patient with a complete spinal cord injury, resulting in the loss of sensory and motor function below the level of the injury, has progressively regained the ability to move their legs voluntarily and stand without the use of spinal cord epidural stimulation, according to a study in Scientific Reports.

Previous tests involving four patients with chronic clinically motor complete spinal cord injury found that the use of lumbosacral spinal cord epidural stimulation (scES) - an approach that that sends electrical signals to motor neurons - and activity-based training led to the participants recovering the ability to stand when the scES device was activated. In addition, delivering scES enabled these individuals to perform relatively fine volitional lower limb movements.

Susan Harkema and colleagues report that on completion of the original study, one participant was recruited to perform additional activity-based training with scES at home and in the laboratory. Over the course of the next 44 months, the authors found that the participant recovered substantial voluntary lower-limb motor control and the ability to stand independently, without the use of scES. The authors note that the ability to stand independently was observed for the first time after a training period that differed substantially from previous training periods in terms of the frequency of the training, the tasks trained and the volitional involvement of the research participant.

The authors suggest that future studies should attempt to better understand the influence of different activity-based training components on the physiological adaptations resulting in motor function improvements after severe spinal cord injury.