In the United States, more than 280,000 people—including 42,000 military veterans—are affected by spinal cord injury (SCI), including limb weakness and paralysis. While rehabilitation can be helpful, the benefits are slow and inadequate to restore patients' lost independence. A team of researchers at Cleveland Clinic is trying to speed recovery using noninvasive brain stimulation.
Ela B. Plow, PhD, PT, of Cleveland Clinic's Lerner Research Institute, recently received a four-year, $2.5 M award from the Department of Defense (DoD) to lead a brain stimulation study in patients with paralyzed upper limbs due to SCI. The award was granted under the DoD's Spinal Cord Injury Research Program.
Dr. Plow's preliminary work with stroke patients has shown promise that the noninvasive techniques of transcranial magnetic stimulation and transcranial direct current stimulation (tDCS), applied from atop the scalp, may assist the brain in encouraging weakened upper-limb muscles to respond again. The premise is that tDCS can be used as an adjunct to standard rehabilitation therapy to more speedily achieve better functional outcomes for patients.
Advantages of her group's protocol include the simplicity and affordability of brain stimulation, its potential for widespread dissemination, and design and controls adopted to reduce heterogeneity and improve power.
This ambitious DoD study is the first multi-site, phase I/II, randomized, controlled, double-blinded clinical trial of the technique and will involve local colleagues and patients from Cleveland Clinic and the Louis Stokes Cleveland VA Medical Center and those from the Kessler Foundation/Kessler Institute for Rehabilitation in the eastern US. Dr. Plow and her associates are hopeful that this promising new avenue will improve quality of life for the hundreds of thousands of patients living with weakened or paralyzed muscles due to SCI.
Dr. Plow is a staff member in Lerner Research Institute's Department of Biomedical Engineering and the Neurological Institute's Center for Neurological Restoration. In addition to her collaboration with the Kessler Institute, she credits strong partnerships within Cleveland Clinic's Neurological Institute and regional associations with the Cleveland VA's Functional Electrical Stimulation Center and Advanced Platform Technology Center and the MetroHealth Rehabilitation Institute of Ohio.