Reggie Edgerton

You might have to use a hook to get me off the stage here. That’s okay, I’mused to it

I am one of 8 owners of a comp

Major points:

  1. understand the role of automaticity in sensory-motor interactions
  2. recognize how amplification provides a mechanism to re-engage those networks of automaticity
  3. understand how re-engagement of spinal networks enables re-learning more effectively via training

What we’re doing has been put in the category of miracles, but that’s absolutely the wrong word. There’s not any ONE thing that we should track and forget about everything else. For each patient, condition, person, one intervention might be better than another. We need to develop them all. If you call something that has evolved over a 40-year period a miracle, then okay.

About 7 or 8 years ago we got to a point where we realized that there was a real possibility of using the residual circuitry in the lower cord to take advantage of automaticity. We didn’t know how much we could get out of it . . . but we thought we might be ready to work with humans. Everything was pointing in the direction that the spinal cord of humans isn’t that different from that of all other species. It’s a project that’s hundreds of millions of years old. And because we’ve all evolved in a 1G environment, it makes sense that just getting up and standing and walking will have a major effect on multiple systems.

To relearn, there must be re-engagement of the circuits. This can be accomplished pharmacologically and via electrical neuromodulation when combined with training.

What we’re doing is changing the physiological state of the spinal cord. We want to make it more likely to engage the circuitry. We’ve been doing this with drugs and with various kinds of stimulation, including epidural, which has gotten a lot of attention lately. What a lot of people don’t know is that when you add drugs, the two things work synergistically together very well.

So what’s automaticity in movement? It’s not thinking about the details of the movement you want to make. Your brain is generally not engaged in directing your movements.

He’s got a spinalized rat up on the screen that was given a dose of strichnine. It couldn’t walk on the treadmill before the dose. It’s motoring along just fine afterward in this video. We started working with cats, and it took us five years to get this working in rats. Sorry it took so long, but that’s what happened.

The rat’s legs are getting no input from the rat’s brains. It can walk forwards and backwards and sideways. Oh my god, hilarious — they turn the rat harness sideways so we’re watching its legs do sidestepping while its face looks out at us. The weirdness of sci science, I swear to god.

Where’s the intelligence in the spinal cord? In the interneurons. He’s showing a set of videos of a guy with an intact cord lying on his side with some equipment attached to his legs and feet. The equipment provides stimulation of various kinds and measures what happens. He’s been told not to step, but there are certain inputs that make his legs “walk.”

So, they asked. Do we have enough information to get standing or stepping in a human with a complete injury? We had a meeting, we got funding. We had a hunch that it might work, but we didn’t know. We decided that the present technology would be good enough fro proof of principle. We implanted that technology into four young men, and all of them regained voluntary control.

All of them also got some return of autonomic functions like bowel, bladder, sex, temperature regulation.

What shocked us was the return of voluntary control. Our subjects #2,3 and 4 were motor and sensory complete chronics. According to our old theories, a damaged nerve was dead. These men should not have been able to move their feet and legs if that were true. There have to be surviving axons in order for this to happen. These men can even control their movements based on visual information — without any sensory input through their feet — they can look at a sine wave on a screen and time their movements to the rise and fall of the curve.

What’s going on? There’s some residual capacity, sort of hiding like a submarine under the surface. And the application of a specific amount of electrical stimulation will lift that submarine up above the surface where it can reach the level needed to cause functional return.

I’m goin’ to his breakout.

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