Spinal injury Glasgow study shows promising results

Participants were treated with a device that delivers electrical stimulation to the spinal cord above and below the section that has been damaged.

This damage results in signals that travel between the brain and body and control movement being interrupted and the treatment aimed to enhance the connection across the damaged part.

All the patients had been living with their injury for some time and had not experienced any improvement for a considerable period, in some cases many years.

NHS Greater Glasgow and Clyde was the only UK health board taking part in the world-wide trial of ARC-EX Therapy.

Participants were required to have some strength in their hands to qualify for the treatment, which was administered alongside physiotherapy.

Of those taking part, 72% showed an improvement and of those that didn't, there was no further deterioration.

Dr Purcell, who led the Up-LIFT study involving five patients at the Queen Elizabeth National Spinal Injuries Unit, said: "These are all patients who have tetraplegic paralysis from the neck down to some degree or another.

"Overall, 72% of patients met the primary endpoint, which was an improvement and the others didn't deteriorate.

"For one patient the device brought a significant impact on their ability to play the guitar and, while the study focused on upper limb and hand function, in some patients we also saw an improvement in blood pressure and temperature control, along with bladder and bowel function.

Dr Mariel Purcell said the study showed promising results (Image: NHS GGC)

"The study looked at upper limb and hand function in chronic patients, but applied acutely in newly injured patients with standard rehabilitation, non-invasive spinal cord stimulation may have profound benefit.

"There’s no other treatment like this.”

She added: "One of my five patients was able to walk before the study and he spoke about how much his gait and walking pattern had improved."

She said a "little bit of work" had now been done to establish if there is an improvement in patients who were able to walk before they took part.

She said: "We expect that this device in a large number of patients is going to result in some benefit in a lot of modalities - their leg movements, their arm movements, their blood pressure control, their bladder control.

"This opens the door for doing the work in patients who have got a spinal cord injury to look at their leg power and all the other aspects which can be affected."

The Up-LIFT study, which was published in the journal Nature Medicine, was run by ONWARD Medical.

Asked if she believes the therapy has the potential to allow people with catastrophic spinal injuries to walk again Dr Purcell said: "I do."

She added: "I'm jumping ahead in a way but we have demonstrated that this is safe [and] we've demonstrated that in patients who have stopped improving - and many were many years down the line from their spinal injury - we've demonstrated that they can improve more.

"I see in the longer term where we would be best applying this treatment in patients who have recently had a spinal cord injury and they are having physiotherapy and occupational therapy and that's when their improvement is going to be at a maximum.

"If we can apply the treatment at this stage, that's where I see it making the most gains for patients."

The Herald revealed early results from the trial in 2021 (Image: Newsquest)

Award-winning Scottish journalist Melanie Reid was among the five people who took part in the Glasgow trial, which started in November 2021.

The former Herald writer broke her neck and back in a horrific riding accident on Good Friday, 2010 and began writing a column for The Times three weeks later.

"Everything thinks spinal injury is all about being able to walk again but for tetraplegia, it's not," said Ms Reid, who lives in Stirlingshire.

"It's about being able to use your hands again, feed yourself or scratch your nose - these are massive things.

"It was a big commitment... about three times a week going into Glasgow and it was very intense and tiring but I wanted to try to improve the function of my left hand and hoped to get some grip.

“It’s a woman’s right to be able to put her hair up in a scrunchie, and the therapy allowed me to do that.

"I can scroll on my tablet with my left thumb and scroll on my phone.

Journalist and writer Melanie Reid suffered catastrophic injuries after a riding accident (Image: Newsquest)

“After many years in my chair, I’d learned just to accept my limits, so it was great just to think ‘Yes, I can do more’.

“The benefits were real – and I’m still feeling them more than two years after the study.

“There are no miracles here – we’re talking about tiny gains – but even something as basic as being able to feed yourself for the first time … wouldn’t that be fantastically profound?”

She added: "The big excitement is that they will able to use the device [at an earlier stage] to open some of the connections that shut down after an injury and scar tissue forms."

Trials are now underway on a "sister device" which would involve placing electrodes directly onto the spinal cord.

"It's a lot more invasive but is completely specific," said Dr Purcell. 

" They've implanted about 30 patients and they are doing it largely for blood pressure control.

"People with a spinal cord injury from the mid-thoracic region and above their blood pressure control can be very poor and they can faint very easily."

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The device is expected to be approved for use in the US this year, with approval across Europe anticipated shortly afterwards.

Professor Gregoire Courtine, co-founder of ONWARD Medical, said: “The study has shown that the device is safe and effective, and we have demonstrated the principle.

Gregoire Courtine with Dr Mariel Purcell (Image: NHSGGC)

"Now we can look at applying stimulation to other functions, such as walking.

“This is not a cure – it’s important to stress that – but we’re at the beginning of a journey that makes recovery from spinal injury a real possibility.”