Clinical research into spinal neurostimulation that could give function back to quadriplegics is coming to WA, explains Duncan Wallace from SpinalCure Australia.
Today, like every other day, someone in Australia will have an accident and join over 20,000 people in the country who live with the devastating consequences of a spinal cord injury (SCI). And lying paralysed in hospital, they will probably be told they will never walk again.
This was true 38 years ago when a drunk driver left me at the side of the road, paralysed from the shoulders down.
However, recent research breakthroughs have brought us to a time when those newly injured should not be given such dreadful and finite news.
A spinal cord injury is a lot more than losing ability to walk. Severing communication between the brain and body affects every aspect of your physical and mental wellbeing. Loss of movement is just the tip of the iceberg – ongoing pain, digestive issues, pressure sores, spasms, loss of bladder and bowel control and impaired sexual function are just some of the effects that make everyday life so difficult.
In addition to this dreadful human cost, SCI is estimated to cost the Australian economy $3.7 billion a year with a lifetime cost burden (2020) of $75.4 billion, with $10.3b of this borne by WA.
Apart from the support of loved ones and friends, and the innate capacity of people to handle adversity, there is another factor that feeds the ability to cope with all this – hope. For those of us who live with paralysis, that hope comes from scientific research and the progress towards a cure.
An incredible milestone in SCI research was reached in 2018. Six volunteers recovered the ability to stand and walk with only the aid of a walking frame, years after they were injured. These exceptional results were achieved by an experimental treatment known as neurostimulation.
Most spinal cord injuries in Australia are contusion injuries, where the spinal cord is crushed on one side but not completely severed. Neurostimulation involves applying tailored currents of electricity to the spinal cord to wake up nerve pathways in surviving tissue to attempt to re-establish some communication between the brain and body.
Volunteers overseas have not only seen improvements in muscle control but have relished recovery from those other things that make living with a spinal cord injury so relentless. For a person with quadriplegia like me, even seemingly slight improvements can mean an enormous amount.
Most of the headline results have been achieved by electrical stimulators implanted in the epidural space, but this requires an expensive operation, weeks of hospitalisation and is not without risks. The alternative is to place electrodes on the skin (termed transcutaneous neurostimulation), which is safe, inexpensive and can be made more widely available.
While overseas results have been encouraging, the studies have involved just a few people and don’t provide sufficient scientific evidence for the authorities to approve a stimulator for mainstream use.
SpinalCure and its partners aim to change that through Project Spark – a major, globally significant research program based at Neuroscience Research Australia (NeuRA) in Sydney.
This research builds on the eWalk trial, a world-first blinded randomised controlled trial under way at NeuRA, which is testing the ability of transcutaneous spinal stimulation to restore or improve walking in those with paraplegia.
After a successful advocacy push by SpinalCure, the Federal Government has granted $10 million for spinal neurostimulation projects. This is the first time the Government has offered funding specifically for research that aims to bring us closer to a cure for SCI.
Four NFP organisations have come together to make the first of Project Spark’s community-based clinical trials possible. Directed by Professors Simon Gandevia and Jane Butler at NeuRA, the 75 volunteers will be treated by the therapists at Spinal Cord Injuries Australia’s NeuroMoves exercise centres in three states, including the centre in Joondalup.
SpinalCure and our New Zealand counterparts, CatWalk, have committed to raise the funds required. Starting this year, this trial aims to improve or restore arm, hand and respiratory function for people living with quadriplegia, the first items on the wish list for this group.
I will most definitely be putting my hand up to be considered for this trial. Perhaps with the neurostimulation, I won’t have to do this metaphorically.
A comprehensive cure for paralysis is likely to involve a combination of therapies, but this is no longer a matter of if, but when. Whilst neurostimulation is not that cure, its potential benefits are truly life-changing. In light of this and other research, the person injured today should not be told they will never walk again.
ED: Duncan Wallace is executive director of SpinalCure, Australia’s leading not-for-profit group funding and promoting research towards a cure for spinal cord injury, www.spinalcure.org.au