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Most patients with spinal cord injury suffer from weakening pressure drops or dangerous pressure peaks. In a series of advances published simultaneously in the nature and medicine of nature, the neuroscientists and neurosurgeons of Switzerland, the Netherlands and Canada introduce an innovative neurotecnological solution.
“I have my life back,” says Julie, participant in the clinical study. After a spinal cord injury he left her with chronic dizziness and fatigue episodes, he had little energy to chase even basic daily tasks. “Now I can return to school and finish my doctorate.” Daniel, another participant, has spent decades sailing through life in a wheelchair after a ski accident. Thanks to a new type of implant, he was able to pursue his love for him to ski for the alpine with greater confidence and stability last winter.
These personal stories, although striking, reflect a less known reality for people who live with spinal cord injuries (SCI): the inability to regulate blood pressure. Although much of the focus on the care of SCI has been to restore movement, most patients with more than 70%, according to a survey in 1,479 people conducted for the study of life with chronic hypotension, a condition that leaves them exhausted, cognitively opaque and prone to faint.
This is because the projections of the brainstem to the spinal cord region that regulates blood pressure is interrupted, letting the body cannot adjust the vascular tone and heart rate in response to daily activities. And if the hypotension was not weakening enough, this deregulation can also lead to potentially mortal peaks in blood pressure, known as autonomous dysreflexia.
An important discovery to stabilize blood pressure
In a double rare publication in nature and nature medicine, a couple of historical studies led by Grégoire Courtine (EPFL), Jocelyne Block (University of Lausana/Chuv) and Aaron Phillips (University of Calgary) describe the development of a specific therapy to address the regulation of blood pressure in patients with SCI. Working with the EPFL spin-off onwards, the team has shown how a implanted neurostimulation system successfully restored the stability of blood pressure.
“First, in the study that we have published in Nature, we were able to identify all the neuronal architecture of the spinal cord that is responsible for the elevation of the non -controlled and non -mortal blood pressure, called autonomous dysreflexia. Also. Says Grégoire Courtine, director of .nr together with Jocelyne Bloch. Continue saying:” In the study of nature medicine, we take advantage of this understanding of a system to go to this hemodynamic access point with electrical stimulation to prevent chronic low blood pressure. “
During the last decade, the Swiss and Canadian teams filed a series of patents about this technology as their discoveries and development advanced. Developed by Onward Medical, this implantable system, commercially known as ARC -im, consists of a new kind of electrodes, carefully formed and spacing to point to the hemodynamic access point. These matrices connect to a specially designed pulse generator similar to a cardiac pacemaker, which offers finely tight electrical stimulation, calibrated to the needs of each patient. The result is a compact and adaptable system capable of restoring the stability of blood pressure through directed neuromodulation.
Safe and effective deployment in multiple clinical studies
The therapy for the hypotension involved 14 patients and was validated in four clinical studies in Switzerland, the Netherlands and Canada, each treated by independent clinical teams.
“International deployment shows that surgery and therapy are safe and effective regardless of local practices. It is a key milestone to make this technology widely available,” says Jocelyne Bloch.
“Our mechanistic discoveries in nature were crucial to close the gap from the fundamental neuronal mapping to the clinical application and allowed us From the SCI it can be issued by the decrease in clinical aspects, “they say that our neuromodulation therapy says that the pressure of neuromodipio, says a neurosf warming and director of the restoration network of the University of Calgary.
The results were consistent: once activated, the system restored blood pressure to a functional range, often in minutes. “Based on Our Experiences with This Novel Treatment, Participants Report Experience Less Brain Fog, Having More Energy, Being Uble to Speak Louder, and Suffering Less From A Postprandial Dip. In Addition, eleven the surgery was performed by neurosurgeon erkan kurt at radboudumc, this System Provd relativly Easy to use in their home Environment, ‘Says Dr. Ilse van Nes, Who Successfully Deployed The System at the Rehabilitation Center Sint Maartenskliniek in Nijmegen, Netherlands.
“Its impact extends beyond physical health: by stabilizing blood pressure, therapy improves mood and the elements of independence of daily life that often compromise after the injury of the spinal cord,” Bloch adds.
Towards Large Scale Tests
“The objective now is to move towards generalized clinical adoption,” says Professor Grégoire Courtine. “Onward Medical has recently received the approval of the exemption of research devices (FDA IDE) to initiate a fundamental essay of this therapy, which is expected to imply approximately 20 leading neurorrehabilitation and neurogical research centers in the United States, Canada and Europe. This multicenter study will be crucial to demonstrate the safety and effectiveness of the system on scale. within the reach of the broader science fiction community. “
