September 5, 2011

Back on His Feet: Paraplegic Man Stands

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September 5, 2011
Bottom Line's Daily Health News
In This Issue...
  • 8 Times More Heart- and Brain-Boosting Power!
  • Back on His Feet: Paraplegic Man Stands
  • Why NSAIDs Are Making Your Arthritis Worse
  • A Honey of a Weight-Loss Trick

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Back on His Feet: Paraplegic Man Stands

The news stories made it sound too good to be true: A man who had been paralyzed from the mid-chest down since 2006 was able to stand up on his own (with some assistance for balance), thanks to an implanted stimulation device that sent electrical pulses to his spinal cord. That’s right -- he got up and stood. It sounded amazing. When I called the lead researcher to learn more, I found out that the results aren’t exactly what they seem at first glance... but they are exciting nonetheless.

Minor Changes, Big Results

Surprisingly, the device used in this groundbreaking procedure is an off-the-shelf epidural stimulator -- a device that is typically used to interrupt pain signals in patients with chronic, debilitating back pain. In those patients, the implanted device -- made up of a small controller box from which wire leads extend to electrodes in the areas where the pain is felt -- sends out pulsed electrical signals to mute the back pain. For the paralyzed test subject, the electrodes were placed in the lumbrosacral area of the spine (basically the very bottom of the spine), and the researchers adjusted the electrical pulses to fine-tune the nerve stimulation.

"We were quite surprised by the dramatic results we got," says Susan Harkema, PhD, professor in the department of neurological surgery at the University of Louisville, Kentucky, who oversaw the research. "Our goal was modest. We were simply trying to find the circuitry that would eventually allow us to achieve these results. We had no expectations of a real breakthrough for behavior at this point."

Waking Up the Nervous System

Here’s where things get interesting: The "circuitry" that Dr. Harkema mentions isn’t the device, but the spinal cord itself. That’s because Dr. Harkema and her team have found that the spinal cord is able to control complex movements with minimal input from the brain. According to Dr. Harkema, the concept has been recognized in other species for decades -- but this study is strong evidence that humans do have the same capacity.

"In animals, there’s circuitry in the lower spinal cord that really takes care of all the details of walking," Dr. Harkema explains. "In animals that don’t have sophisticated brains, there’s just a minimal signal needed from the brain -- just a general command like 'run’ or 'walk’ or 'I want to pick that up.’ And the spinal cord itself takes care of all the details."

The results achieved with this implant show that the spinal cord can control specific behaviors in humans, as well. To understand what that means, it’s important to realize one thing that news stories on this research haven’t expressly pointed out -- the implanted device doesn’t reconnect the brain to the lower body below the area of injury. Instead, the device serves to stimulate the spinal cord so that it can respond to external stimuli -- in this case, the stimulated spinal cord senses the pressure of the patient leaning forward and putting weight on his feet, which triggers the response (meaning the muscle and motor patterns) to stand.

Additionally, after seven months of using the stimulator, the patient reported improved bowel and bladder control and sexual function (significant issues for those with paralyzing injuries), and Dr. Harkema says that they've found that the patient’s bones are stronger, his body fat percentage is lower, and his heart rate is better. His breathing also is stronger and deeper. In other words, because the patient is able to put weight on his bones and to move his muscles, the benefits to his overall health and well-being have been substantial. When combined with the ongoing gains the patient is seeing -- he has been able to take a few steps on a treadmill, with assistance, and has been able to voluntarily move his hips, knees, ankles and toes when the device is turned on -- it’s easy to see that this technology is truly a breakthrough.

Return to Well-Being

When I spoke with Dr. Harkema, there were two more patients lined up to receive similar implants (the results will need to be repeated in multiple patients), and her group has FDA permission to do as many as five such implants. The results achieved with those implants will likely determine what happens next. Dr. Harkema says that, if this proves successful, a device targeted specifically at treating those paralyzed by injury would need to be developed, with specific control algorithms, improvements in the delivery of the stimulation, and an interface specifically designed for those with paralyzing injury instead of those trying to manage pain. But these early days should give hope to anyone with a paralyzing injury: A device that can help you stand on your own -- and possibly do even more -- isn’t too good to be true. It might almost be here.

Source(s):

Susan Harkema, PhD, rehabilitation research director, Kentucky Spinal Cord Injury Research Center, Owsley B. Frazier Chair in Neurological Rehabilitation, professor, department of neurological surgery, University of Louisville, Kentucky.


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Joe’s doctors had prescribed painkillers such as NSAIDs and aspirin to ease his agony. But Dr. Stengler worried they were making matters worse. When he told Joe these medications could actually cause his joint cartilage to deteriorate faster, Joe replied, "Great! Why didn’t the other doctors tell me this?"

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A Honey of a Weight-Loss Trick

I just read some interesting new research that immediately made me think about dear old Winnie-the-Pooh, who struggles with a honey obsession and a weight problem. Might giving in to the former help him conquer the latter? Maybe so!

A recent (albeit small) study conducted at the University of Wyoming in Laramie found that honey, used as a sweetener, brought about hormonal changes that may suppress appetite.

A Sweet Study

Researchers fed 14 healthy, young (average age 22), non-obese women a breakfast consisting of a peanut butter-oatmeal cookie and a cup of tea on two separate mornings. At one breakfast meal (in a randomly assigned order), the cookie and tea were sweetened with honey, while white table sugar was used for the other meal. Both meals contained exactly the same amount of calories, and none of the participants was told which sweetener was used for which breakfast. Blood samples and hunger ratings based on a scale of 1 to 100 were taken before eating and at 30-minute intervals for four hours afterward. Subjects were then invited to eat as much as they wanted from a lunch buffet. While they did so, researchers discretely tracked exactly how much food each consumed.

What the researchers found: Analyzing the blood samples showed that when the women had the breakfast sweetened with honey, they had delayed response of the hunger hormone ghrelin -- the higher your level of ghrelin the hungrier you feel. At the same time, their blood contained greater amounts of the hormone peptide YY (PYY) after the honey-containing meal -- PYY is associated with the feeling of satiety after a meal. So, compared with sugar, the breakfast made with honey brought about hormonal changes that would be expected to make people feel less hungry and more satisfied... a combination that you would naturally expect to lead to less eating.

Except... it didn’t! It seems that psychological cues can still override biological ones. While the blood tests showed hormone levels that would lead any scientist to predict fewer trips to the buffet table, in reality there was no difference following the two breakfast meals in how hungry the subjects reported feeling or in how much they ate at lunch.

I asked the study’s lead author, Enette Larson-Meyer, PhD, RD, assistant professor of human nutrition at the University of Wyoming in Laramie, to tell me why. She said that scientists are still trying to understand exactly how these hormones affect appetite. She noted that habit can trigger a desire to eat that may override real hunger. "We might be satisfied, but if the right food or a free meal appears, we’ll say, 'Oh yeah, I can eat,'" she said, noting that further research will explore what might happen when the next meal is not so readily available.

Honey, Do...

So, the lab work said that the participants who ate honey should have been less inclined to eat, but the offer of a free meal seems to have overridden that. Where does that leave us?

Dr. Larson-Meyer said that we now know that honey produces chemical changes that suppress appetite. We simply need the mind to follow.

It’s fairly easy to substitute honey for sugar if you like sweetened coffee or tea... and you can use honey for cooking and baking, too.


Source(s):

D. Enette Larson-Meyer, PhD, RD, assistant professor of human nutrition at the University of Wyoming in Laramie.


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Be well,


Carole Jackson
Bottom Line's Daily Health News


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