One of the most amazing things about science is that it allows us to push the boundaries of what we know to be true into the realm of what we believed was impossible. A great example of this in medical science is the research of Dr. Susan Harkema. Her work in the field of spinal cord injury, specifically paralysis, has opened the door to a world of new possibilities and treatment options for those considered to have motor complete injuries.
A whole new world
When Dr. Harkema talks about her breakthrough 2011 study, one of the first things out of her mouth is “I almost missed it”. Her original aim was to identify sophisticated networks found in the spinal cords of other animal species, but not yet verified in humans. The goal was to duplicate the locomotion found in previous animal experiments by placing paralyzed subjects on a treadmill, moving their feet in a step-like pattern, and hoping the efferent information transmitted by the motion would be enough to generate independent steps. What she did not account for is finding a neuromodulation configuration that allowed one of her subjects to stand without any manual assistance.
This was a huge paradigm shift! The idea that one of these SCI patients would ever independently move a joint again wasn’t even a part of the initial design. The study itself was supposed to be purely scientific and provide no functional benefit because as far as Harkema and her team were concerned, there were supposed to be no residual motor fibers available, and sophisticated control of these movements was at the cortex level. How could they be able to move simply by continuous stimulation that excited the spinal cord? Yet here was the data, clear as day, defying the odds. Little did she know, science had more surprises in store.
At the speed of progress
Dr. Harkema’s initial study on neuromodulation through epidural stimulation served as a gateway for several other advancements in the treatment of paralysis. While an inability to move is the main consequence for those suffering from paralysis, it is often the secondary consequences that make the condition unmanageable. Paralysis patients deal with reduced cardiovascular function, respiratory function, bladder function, sexual function, circulation, pressure sores, fatigue, and metabolic issues on a daily basis. So Harkema and her team were delighted to discover that bladder function, bowel function, circulation, and even blood pressure saw improvements simply from subjects bearing weight and having their spinal cords stimulated through neuromodulation.
The improvements to cardiovascular function and blood pressure are what seemed to excite Dr. Harkema the most. So much of a patient’s quality of life and cognitive function can be restored by regulating blood pressure. While neuromodulation is not regenerating the spinal cord back to pre-injury levels, it is giving patients back a piece of normalcy they thought was gone forever. This is what motivates Dr. Harkema to continue with her research. Our healthcare system does not currently provide sufficient resources for those dealing with spinal cord injury to properly recover or get the assistive technology that they need. And while we are a long way off from where I believe we can be in the field of spinal cord injury and paralysis, Dr. Harkema is helping us get there faster than we thought possible.