Topic Overview

Several types of research on spinal cord injuries (SCIs) are being done. Some of them may be at the point where people with SCIs are using them on a trial basis. Others might still be in the animal-study stage. They all have the potential to lead to a return of some feeling and movement in paralyzed areas.

Neurorestorative and neuroregenerative

These types of research look at ways to stimulate activity of or growth in damaged nerve cells.

• Potassium channel blockers, such as 4-aminopyridine (4-AP), may improve communication between undamaged areas and damaged areas. This medicine is currently in early tests with humans.
• Neurotransmitters, such as serotonin, regulate neuron growth. They may help nerve cells regenerate.
• Nogo blockers are also being studied. Nogo is a chemical that prevents axons, part of a nerve cell, from growing. Axons carry messages between nerve cells. Nogo research looks at ways to block this chemical, thus allowing axon growth.
• Glatiramer acetate is a medicine used in the treatment of multiple sclerosis. It may stimulate the immune system to produce a type of cell (lymphocytes) that in turn protects the spinal cord and may stimulate regeneration.

Neuroconstructive and neurogenetic

Neuroconstructive research explores transplanting cells into the spinal cord, and neurogenetic research involves inserting genes into the spinal cord.

• Stem cells are immature cells that have the ability to grow into any one of the body's cell types, including those destroyed or injured in an SCI. The stem cells are transplanted into the spinal cord. Stem cells can come from animals or humans and can be embryonic, fetal, or adult.
• Other types of cells may also be useful in helping people with SCIs. These include olfactory ensheathing glia, Schwann cells, and precursor cells.

At this time, it is not well known what type of cell to use or when and where to transplant cells.

Functional

Functional research looks at ways to improve what people with SCIs can do physically, leading to an improved quality of life.

• Electrical stimulation uses low-level electrical current to stimulate nervous system cells and muscles. The stimulated activity can change the activity and behavior of cells. This therapy may help people who have limited movement (such as being able to walk a little) to do more and to do it more easily. Activity may lead to some cell regeneration.
• Tendon transfer is a surgical procedure that takes a tendon of an active muscle and attaches it to a paralyzed muscle. This can result in better motion. One example of this is the NeuroControl Freehand System, which, along with electrical stimulation, can provide hand grasp to some people with SCIs.
• Locomotion therapy uses a harness and a treadmill to help people with SCI use their legs and walk. A physical therapist helps with leg movements. Research reports that people with incomplete SCIs showed improvement in walking speeds, endurance, and the need for support.¹