Tuesday, December 4, 2012

FOXNews.com: Neurostimulation allows paralyzed athlete to walk down aisle at wedding

FOXNews.com
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Neurostimulation allows paralyzed athlete to walk down aisle at wedding
Dec 4th 2012, 17:39

The timing could not have been more eerie.  

It was the night of Friday the 13th in 1998, under the light of the full moon, when then 26-year-old Jennifer French went on a midnight snowboarding run with some friends on a New England mountain.  Everyone made it to the bottom of the slope – except for French.

"I hit a patch of ice," French, who is now 41 and lives in St. Petersburg, Fla., told FoxNews.com.  "I only remember a few vignettes….but I do remember – I was lying face down in the snow, and I looked up and saw the full moon as I was crying for help."

French's boyfriend at the time and current husband, Tim French, soon became concerned about her absence and trudged up the mountain to find her.  Once he discovered her in the snow, he ran for help as fast as he could.  It ultimately took two snowmobiles to get French out of the embankment and to an ambulance.  While the night is a very vivid memory for Tim, French said it was a blur for her.

"Apparently, I was awake for the whole time, but I was in shock, so I don't remember a lot," she added.

The next day at the hospital, the surgeons confirmed to French the worst – she had suffered a spinal cord injury at the base of her neck.

"I went through this denial stage, where I thought there's got to be a cure out there somewhere."

- Jennifer French

The good news: The injury was incomplete.  French was now a quadriplegic, having become motor paralyzed from her chest-line down.  While she still retained the ability to feel some sensations in her legs, such as pain and touch, she lost total control of leg movement.  She still had the basic use of her upper arms, though her hands suffered some impairment as well.

For some time, French had trouble coming to terms with her new condition, believing her paralysis was somehow reversible.

"I went through this denial stage, where I thought there's got to be a cure out there somewhere," French said. "I went through this process of trying to find a spinal cord injury cure, and I soon found there really wasn't one.  Once I came to that realization, I took the stance that if I have this injury, how do I keep myself healthy?"

Those with spinal cord injuries and paralysis are often at risk for other types of complications – such as osteoporosis, muscle atrophy and cardiovascular disease – which can sometimes be life-threatening to the individual.  So French set to work on researching how she could make the most out of her new situation and lead a healthy life – a decision that eventually led her to Dr. P. Hunter Peckham and the Cleveland FES Center.

Bonding immediately

Standing for Functional Electrical Stimulation, the FES Center is a research facility that strives to develop new technologies and therapies to aid those with muscular skeletal and neurological impairments.  At the time of her referral, the center was implementing a new research program to develop implantable neuroprostheses, designed to help restore limited muscular function to her lower region.

Cleveland FES Center

Cleveland FES Center has been pivotal in making sure some of the most advanced neurostimulation technologies come from Cleveland (NeuroInsights Report considers Cleveland one of the neurotechnology regions to watch worldwide and it is rated as 5th in the world for neurotech healthcare and 6th for neurodevice companies).  

Those technologies range from those that restore mobility to patients with spinal cord injuries like Jen to systems that relieve chronic pain by creating an electrical nerve block or providing peripheral nerve stimulation (this provides an alternative to using narcotic painkillers and surgery) to the diaphragm pacing system actor Christopher Reeve used to avoid being hooked up to a ventilator machine.

"In the very broadest way, it's similar to cochlear implants," Peckham, the FES Center's director at the time of French's enrollment and a professor of biomedical engineering at Case Western Reserve University, told FoxNews.com. "Jen is in a research program that is studying in her case to bring this technology to a point where it can supply standing and trunk control…There's some at least restrictive walking, but it's not primarily a walking system."

Peckham said he and French bonded immediately, both being avid sail boat racers.  He said he knew immediately she would be a great candidate for the neuroprostheses program, which can have a very long waitlist of patients hoping to receive treatment. Not everyone is a good fit for the implants, so the FES Center often goes through a lengthy process to determine who should be enrolled in the program.

According to Peckham, French was in great physiological shape and was realistic about the outcome of the procedure – two factors that are very important for patients who are involved in the experiment to have. She also understood and accepted the risks implanting electrodes inside of her body, putting her above most others on the waitlist.  

Works like a symphony

Just one year after her accident, she became the first woman to receive the implantable neuroprostheses, helping to restore limited function to her lower extremities.

"With this system, they have a few different types of electrodes implanted, right in the muscle tissue – they're in my quads, my hamstrings, my glutes and my lower back," French said. "Those electrodes have leads (sophisticated insulated wires) that come off of them, and they go up to a receiver implanted in abdomen.  They are all fully implanted in the body, so no wires are coming out."

French added the electrodes are seamless, and since she is one of the smaller individuals in the study, you can only see the receiver in her abdomen.

According to Peckham, the system works somewhat like a symphony, conducting all the different aspects of a person's muscles to work together in order to perform a specific action.  Just the simple act of standing up utilizes a multitude of muscles and movements, all working at specific times in accordance with one another to propel the body upward. The electrodes essentially direct and jumpstart this entire process.

"The electrodes deliver small pulses of current to the muscles, and these pulses of current are milliamps – 10 or 20-thousandths of an amp," Peckham said.  "They send pulses to these nerves, and when they're received by the nerves, at a conversational level, those nerves don't know that those pulses come from the brain or from someplace else.  All they do is carry information."

"What we then have to do, artificially, is coordinate the action of those muscles together so the action to stand or sit down or to walk has all of them working in concert with another to perform the major body action," Peckham continued.  "And then, we have to give the user a way of controlling that."

French controls her muscle function and the electrical impulses is through a small computer device connected to the receiver inside her abdomen – the only part of the system outside of the body.  

With the push of a button, she can temporarily provide electrical stimulation to her muscles, allowing her to stand and sometimes walk.  According to Peckham, FES researchers are working on a wireless computer control device, which could potentially eliminate the need for any wires to protrude from the body.

Getting married, becoming a top athlete

While the system has allowed her to become more mobile and flexible in her day-to-day life, French said it also has given her something she'll never forget – a way to walk down her aisle at her wedding.

"It was something the technology gave me that I probably would never be able to have otherwise," French said of the experience.  "For that ceremony, it really took away the disability.  It made it feel a lot more normal being able to walk down the aisle with my dad next to me.  It was so surreal and emotional."

Not only was French able to use the system to create the wedding she always wanted, but she has also gone on to become a world-recognized athlete.  She is an eight-time winner of the Milan-Gruson Award for top disabled female skippers, and she most recently represented Team USA at the 2012 Paralympics in the sport of sailing – bringing home the silver.

French, now the executive director for the non-profit Neurotech Network, has also recently published a book about her experience titled, "On My Feet Again," which chronicles her time from the accident to her success as a Paralympian.  She hopes that her story will inspire others about the potential of new neurotechnology devices that could soon be available in the future.

"Because I was involved with the cofounder of Neurotech Network, I've had the pleasure of being exposed to a lot of technology coming up the pipeline," French said.  "It's very promising.  There's a lot going on in the medical world, in terms of electrical stimulation…I'm optimistic about seeing it in my lifetime."

The FES Center continues to work on new research that could help restore function to those with neurological injuries and paralysis.  Click here to learn more about their experimental trials and what they are developing next.

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