Keith TanseyPosted: October 18, 2014
A couple of harsh realities.
Only 1 in 10 clinical trials is successful. Hardly any rat model therapies translate well into humans.
Sensory Input in the Injured Spinal Cord: Plasticity, Pain and Automonic Function, and Use in Neuromodulation of Motor Function
How many people in this room are in pain right now? Lots of hands go up.
Okay. After injury you have altered descending input and normal sensory input. You have changed integration inside the cord, which results in new motor or autonomic output.
Hmmm. In rats if you pinch the back of a rat, you get this weird skin shrinking thing. Showing this on a video of an anesthesized rat. Tweezers. Skin shrinks up all around the pinch.
It’s called the CTM intersegmental pain reflex. He’s going into technical detail about how this works, using a wiring diagram . . . eventually he’s going to circle back to how it relates to sci pain. Cross section of a cord showing big fat axons with lots of myelin and thinner ones with a lot less, and then abundant axons with no myelin at all.
Okay. Has anybody had to get medical care because they burned their thighs with a hot laptop? Half a dozen hands go up. So, pain is good, sometimes. But neuropathic pain is backwards, because lighter touch makes it happen instead of harder touch.
Why do we have pain above the injury level? Why do we have pain at all? Oh, people, this is a fail. He’s talking very fast, using a lot of jargon, and showing busy slide after busy slide, each one covered in data that I’m sure would be super helpful and informative if I could slow him down by about a factor of six. And he just said, oh, I need to speed up or I’ll run out of time.
He’s showing data that (I assume) explains why electrical stimulation works. It has to do with finding the right level of stimulation and the right sensory input. There are ways to use stimulation to decrease spasticity in motor incomplete type of injuries without taking away any voluntary motor control that the patient might have.
The work he’s discussing is about using sophisticated methods and measurements to home in on the exact quality of stimulation that benefits each individual patient. There could be a device that a person would get in, be assessed, and get a custom-designed stimulation program.