close
本篇報導原文及原始論文summary(含譯文)
Time 雜誌的報導:
http://healthland.time.com/2011/05/20/medical-breakthrough-paraplegic-man-stands-up/
Medical Breakthrough: Paraplegic Man Stands Up
By Amie Ninh Friday, May 20, 2011 | 13 Comments
After being struck by a car in 2006, Rob Summers was given a grim prognosis: paralysis from the chest down and the possibility of never walking again. But five years later, he is able to stand on his own two feet unaided — thanks to an experimental treatment, whose success is giving hope to millions of patients with spinal-cord injuries.
Summers, 25, is the first paralysis patient to undergo a combination of electrical stimulation to the spinal cord — delivered through a surgically implanted stimulation device — combined with intense rehabilitation. As part of a research project at the University of Louisville, Summers first underwent 26 months of intense motor training, in which therapists helped him practice trying to move his legs, before receiving the implant. The Wall Street Journal reports:
Mr. Summers then had surgery to implant a device with 16 electrodes placed on key parts of the spinal cord. With the device delivering constant electrical stimulation, Mr. Summers has been able to stand up using his own leg muscles while holding on to bars for support. He can remain standing, bearing his own weight for up to four minutes at a stretch, and take steps on a treadmill with assistance, according to the researchers.
"I didn't move a toe for four years," said Mr. Summers. "I stood up on the third day they turned the stimulator on," he said. "There are not enough words to describe how I felt."
Although he hasn't regained the full ability to walk — and although the researchers working with him remain cautious, given that his is the only such success in the world — spine-injury experts call the results groundbreaking.
With the stimulators on, doctors helped Summers to practice standing and moving his legs. Now he can pull himself up to standing position on his own, not to mention move his toes, ankles, knees and hips while being stimulated. He has also regained control of his bowels and bladder, and sexual function.
Experts say it's too soon to tell whether the same combination stimulation-rehabilitation program will be able to help other patients (there are four others currently planned to receive it), or whether it will work in patients whose spinal cords have been completely severed. Summers' spine was not. The stimulation from the implanted device (adapted from a device originally FDA-approved to control pain) excites the neurons in his spine, which allows them, even without getting input from the brain, to receive and respond to sensory information from the legs.
Researchers still need to design a more sophisticated stimulation device specifically for spinal-cord injury, and the current findings need to be replicated in other patients. But experts say the results — if they hold up — may offer new treatment avenues for paralyzed patients. "It opens a whole new set of possibilities for patients, not just those recently injured but those who have been injured for months and years," said study author Susan Harkema of the University of Louisville, at a press conference to announce the results.
The research was supported by the Christopher and Dana Reeve Foundation and is outlined in the journal Lancet.
* Related Topics:
electrostimulation, Medicine, Pain, paralysis, Rob Summers, spinal cord, spinal-cord injury, stimulation device, susan harkema, tirr research center, university of louisville
Read more: http://healthland.time.com/2011/05/20/medical-breakthrough-paraplegic-man-stands-up/#ixzz1NTYMfeSq
刺絡針的論文原文, 由本人(skywind)隨便翻譯 有誤請來信:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960547-3/fulltext
Topic:
Effect of epidural stimulation of the lumbosacral spinal cord on voluntary
movement, standing, and assisted stepping after motor complete paraplegia: a
case study
Summary
Background
Repeated periods of stimulation of the spinal cord and training increased the
ability to control movement in animal models of spinal cord injury. We
hypothesised that tonic epidural spinal cord stimulation can modulate spinal
circuitry in human beings into a physiological state that enables sensory
input from standing and stepping movements to serve as a source of neural
control to undertake these tasks.
背景說明
針對脊(髓)柱的刺激與訓練反覆施行了數個週期,
脊柱受損動物們控制行動的能力得以有所改善.
我們假設, 脊髓硬膜興奮刺激可以調節影響人類行為的脊髓神經網絡,
啟動感覺中樞, 使人可認知站立、和跨步移動,
達到發起神經控制指令以執行以上動作的目的.
Methods
A 23-year-old man who had paraplegia from a C7—T1 subluxation as a result of
a motor vehicle accident in July 2006, presented with complete loss of
clinically detectable voluntary motor function and partial preservation of
sensation below the T1 cord segment. After 170 locomotor training sessions
over 26 months, a 16-electrode array was surgically placed on the dura (L1—
S1 cord segments) in December 2009, to allow for chronic electrical
stimulation. Spinal cord stimulation was done during sessions that lasted up
to 250 min. We did 29 experiments and tested several stimulation combinations
and parameters with the aim of the patient achieving standing and stepping.
研究方法
一個23歲的男子於2006年七月的一次機車車禍導致C7-T1脫位而全身癱瘓.
失去了自T1脊柱區段以下的所有可被測得的行(移)動能力及部分的感覺能力,
在170次, 歷經26個月的運動訓練後.
於2009年12月, 一個有16個電極的陣列以手術方式被安裝在其dura(L1-S1脊柱區段)上.
給予其溫和的電擊刺激.
每次的刺激約250分鐘. 我們在29次的實驗中, 施行了數種不同參數、刺激組合,
目標是使得患者能夠獲得站立和步行的能力.
Findings
Epidural stimulation enabled the man to achieve full weight-bearing standing
with assistance provided only for balance for 4·25 min. The patient achieved
this standing during stimulation using parameters identified as specific for
standing while providing bilateral load-bearing proprioceptive input. We also
noted locomotor-like patterns when stimulation parameters were optimised for
stepping. Additionally, 7 months after implantation, the patient recovered
supraspinal control of some leg movements, but only during epidural
stimulation.
發現
脊髓硬膜刺激使得男子能在僅幫助其維持平衡的狀況下, 自行承受體重站立達4.25分鐘.
患者利用被標註為"站立"的參數, 提供兩側承重感覺的訊息, 達成了站立目標
在步行的最佳化測試裡, 我們同時標註了一組"可能為運動"的參數.
在術後的七個月, 患者恢復了某些腿部運動的控制能力,
但僅限於在神經刺激存在時才能如此.
Interpretation
Task-specific training with epidural stimulation might reactivate previously
silent spared neural circuits or promote plasticity. These interventions
could be a viable clinical approach for functional recovery after severe
paralysis.
解釋
特定目標導向的訓練, 若伴隨著脊髓硬膜的刺激,
可能得以令閒置的神經迴路恢復活動, 或是提供其可塑性.
這些個神經干涉, 對於因癱瘓而失去部分功能的病人們來說,
在臨床上可能是個得以實現的治療方式
Funding
National Institutes of Health and Christopher and Dana Reeve Foundation.
贊助
國家衛生研究院 及 克里斯多夫基金會
--
※ Origin: 交大次世代(bs2.to)
◆ From: a-baileys.EE.NCTU.edu.tw
推 skywind：我英文好菜 怎麼會翻這麼久啊 囧 05/26 22:01
→ yachu：dura:硬腦（脊）膜 這裡應為 硬脊膜 05/26 22:59
推 skywind：哈哈 感謝~ 05/26 23:21
Time 雜誌的報導:
http://healthland.time.com/2011/05/20/medical-breakthrough-paraplegic-man-stands-up/
Medical Breakthrough: Paraplegic Man Stands Up
By Amie Ninh Friday, May 20, 2011 | 13 Comments
After being struck by a car in 2006, Rob Summers was given a grim prognosis: paralysis from the chest down and the possibility of never walking again. But five years later, he is able to stand on his own two feet unaided — thanks to an experimental treatment, whose success is giving hope to millions of patients with spinal-cord injuries.
Summers, 25, is the first paralysis patient to undergo a combination of electrical stimulation to the spinal cord — delivered through a surgically implanted stimulation device — combined with intense rehabilitation. As part of a research project at the University of Louisville, Summers first underwent 26 months of intense motor training, in which therapists helped him practice trying to move his legs, before receiving the implant. The Wall Street Journal reports:
Mr. Summers then had surgery to implant a device with 16 electrodes placed on key parts of the spinal cord. With the device delivering constant electrical stimulation, Mr. Summers has been able to stand up using his own leg muscles while holding on to bars for support. He can remain standing, bearing his own weight for up to four minutes at a stretch, and take steps on a treadmill with assistance, according to the researchers.
"I didn't move a toe for four years," said Mr. Summers. "I stood up on the third day they turned the stimulator on," he said. "There are not enough words to describe how I felt."
Although he hasn't regained the full ability to walk — and although the researchers working with him remain cautious, given that his is the only such success in the world — spine-injury experts call the results groundbreaking.
With the stimulators on, doctors helped Summers to practice standing and moving his legs. Now he can pull himself up to standing position on his own, not to mention move his toes, ankles, knees and hips while being stimulated. He has also regained control of his bowels and bladder, and sexual function.
Experts say it's too soon to tell whether the same combination stimulation-rehabilitation program will be able to help other patients (there are four others currently planned to receive it), or whether it will work in patients whose spinal cords have been completely severed. Summers' spine was not. The stimulation from the implanted device (adapted from a device originally FDA-approved to control pain) excites the neurons in his spine, which allows them, even without getting input from the brain, to receive and respond to sensory information from the legs.
Researchers still need to design a more sophisticated stimulation device specifically for spinal-cord injury, and the current findings need to be replicated in other patients. But experts say the results — if they hold up — may offer new treatment avenues for paralyzed patients. "It opens a whole new set of possibilities for patients, not just those recently injured but those who have been injured for months and years," said study author Susan Harkema of the University of Louisville, at a press conference to announce the results.
The research was supported by the Christopher and Dana Reeve Foundation and is outlined in the journal Lancet.
* Related Topics:
electrostimulation, Medicine, Pain, paralysis, Rob Summers, spinal cord, spinal-cord injury, stimulation device, susan harkema, tirr research center, university of louisville
Read more: http://healthland.time.com/2011/05/20/medical-breakthrough-paraplegic-man-stands-up/#ixzz1NTYMfeSq
刺絡針的論文原文, 由本人(skywind)隨便翻譯 有誤請來信:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960547-3/fulltext
Topic:
Effect of epidural stimulation of the lumbosacral spinal cord on voluntary
movement, standing, and assisted stepping after motor complete paraplegia: a
case study
Summary
Background
Repeated periods of stimulation of the spinal cord and training increased the
ability to control movement in animal models of spinal cord injury. We
hypothesised that tonic epidural spinal cord stimulation can modulate spinal
circuitry in human beings into a physiological state that enables sensory
input from standing and stepping movements to serve as a source of neural
control to undertake these tasks.
背景說明
針對脊(髓)柱的刺激與訓練反覆施行了數個週期,
脊柱受損動物們控制行動的能力得以有所改善.
我們假設, 脊髓硬膜興奮刺激可以調節影響人類行為的脊髓神經網絡,
啟動感覺中樞, 使人可認知站立、和跨步移動,
達到發起神經控制指令以執行以上動作的目的.
Methods
A 23-year-old man who had paraplegia from a C7—T1 subluxation as a result of
a motor vehicle accident in July 2006, presented with complete loss of
clinically detectable voluntary motor function and partial preservation of
sensation below the T1 cord segment. After 170 locomotor training sessions
over 26 months, a 16-electrode array was surgically placed on the dura (L1—
S1 cord segments) in December 2009, to allow for chronic electrical
stimulation. Spinal cord stimulation was done during sessions that lasted up
to 250 min. We did 29 experiments and tested several stimulation combinations
and parameters with the aim of the patient achieving standing and stepping.
研究方法
一個23歲的男子於2006年七月的一次機車車禍導致C7-T1脫位而全身癱瘓.
失去了自T1脊柱區段以下的所有可被測得的行(移)動能力及部分的感覺能力,
在170次, 歷經26個月的運動訓練後.
於2009年12月, 一個有16個電極的陣列以手術方式被安裝在其dura(L1-S1脊柱區段)上.
給予其溫和的電擊刺激.
每次的刺激約250分鐘. 我們在29次的實驗中, 施行了數種不同參數、刺激組合,
目標是使得患者能夠獲得站立和步行的能力.
Findings
Epidural stimulation enabled the man to achieve full weight-bearing standing
with assistance provided only for balance for 4·25 min. The patient achieved
this standing during stimulation using parameters identified as specific for
standing while providing bilateral load-bearing proprioceptive input. We also
noted locomotor-like patterns when stimulation parameters were optimised for
stepping. Additionally, 7 months after implantation, the patient recovered
supraspinal control of some leg movements, but only during epidural
stimulation.
發現
脊髓硬膜刺激使得男子能在僅幫助其維持平衡的狀況下, 自行承受體重站立達4.25分鐘.
患者利用被標註為"站立"的參數, 提供兩側承重感覺的訊息, 達成了站立目標
在步行的最佳化測試裡, 我們同時標註了一組"可能為運動"的參數.
在術後的七個月, 患者恢復了某些腿部運動的控制能力,
但僅限於在神經刺激存在時才能如此.
Interpretation
Task-specific training with epidural stimulation might reactivate previously
silent spared neural circuits or promote plasticity. These interventions
could be a viable clinical approach for functional recovery after severe
paralysis.
解釋
特定目標導向的訓練, 若伴隨著脊髓硬膜的刺激,
可能得以令閒置的神經迴路恢復活動, 或是提供其可塑性.
這些個神經干涉, 對於因癱瘓而失去部分功能的病人們來說,
在臨床上可能是個得以實現的治療方式
Funding
National Institutes of Health and Christopher and Dana Reeve Foundation.
贊助
國家衛生研究院 及 克里斯多夫基金會
--
※ Origin: 交大次世代(bs2.to)
◆ From: a-baileys.EE.NCTU.edu.tw
推 skywind：我英文好菜 怎麼會翻這麼久啊 囧 05/26 22:01
→ yachu：dura:硬腦（脊）膜 這裡應為 硬脊膜 05/26 22:59
推 skywind：哈哈 感謝~ 05/26 23:21
全站熱搜
留言列表
