In reviewing the current state of affairs with chronic paralysis research, some interesting facts and issues need to be addressed and accessed within the community. Questions arise about the extent, focus and costs of paralysis research and the recent discoveries of changes need to be highlighted.
In an academic SCI animal laboratory I visited recently that works with rats in the study of spinal cord injury, I found that the rat care per diem is around a dollar per day. They cost about $35 per animal. So that is about $400 per year per animal. A typical experiment might entail 6-8 animals per group. Experimental drugs and various reagents can be costly but their amounts don’t vary much between an acute or chronic experiment. The world-renowned neurobiologist running the lab at Case Western Reserve University in Cleveland, Ohio is Dr. Jerry Silver. He commented that in his opinion, “The greatest impediment to doing chronic experiments is lack of creative ideas as well as fear of failure. We need spinal cord neuroscientists to step up to the plate and JUST DO IT! Labs do not need special technicians to do the work. Many academic labs do all of the animal care for considerably less than what is often quoted or advertised to the paralyzed community. There is no need to propagate the idea that we can’t perform chronic experiments because they cost too much. Indeed, a successful pilot experiment in a chronic SCI setting showing regeneration/sprouting with return of function should easily garner NIH funding. I believe that it’s time to stop with the excuses and for all of us who claim to be SCI researchers to make a strong effort in every lab and/or via collaboration to perform experiments at truly chronic stages.”
Many laboratory students have attended the Ohio State University Spinal Cord Injury course which is a wonderful learning experience along with several others around the USA. Even with complete transection animals, they learn to accomplish a very low mortality rate on their lab rats and they can keep both acute as well as chronically injured animals for 6 months or longer following surgery. The lab at Case Western Reserve University is a very progressive one working on chronic paralysis and have animals undergoing therapy experiments with animals that are 1.5 years into the chronic stage. That’s pretty remarkable when you consider that the lifespan of a lab rat is typically 2 years. This kind of SCI lab work is being accomplished everyday.
Others have raised the question of ethics when researchers apply for grants to SCI organizations created and supported by people with chronic SCI to later find them only doing acute injury research or very basic science experiments. It’s disappointing and exasperating that anyone would need to explain this situation when it seems so obvious. For organizations assisting with the assembly of grants, initiatives and funding for paralysis research specifically being supported by people suffering with chronic SCI, scientists should be conducting research projects that include chronics and very relevant to recovery, regeneration or restoration from paralysis. Other times, excuses have been made that science can’t have such strict guidelines like asking to focus on a specific problem such as chronic paralysis. Yet, everyone knows that acute injuries sustained in a spinal cord is vastly different from people living with chronic lesions resulting in a lifetime of paralysis.
Would anyone hand over piles of money to a cancer research center and accept the program outcome if all they did was a good job of caring for people after they’ve been diagnosed? Maybe they provide food, water and craft activities to occupy the mind while the patients wither and die in agony and pain with only prevention data being gathered that cannot help them? As silly as this sounds, it’s happened in the paralysis community many times over the years because some still believe there can be no cure or recovery from paralysis even though that has already been proven to be dead wrong. Some scientists will remain stubborn and maintain this stance against progressive cutting edge research in order to sustain an unproductive irrelevant research program that lacks initiative and ingenuity. Thankfully, some progressive SCI research labs have begun a focused transition to include the chronic population that are donating money towards a cure. With this transformation, we’re now looking for more than the same old handshakes with the devil and mediocre science projects that have filled volumes of books on dusty library shelves and soaked up research dollars needlessly for decades.
It’s time for a passionate call to practical wisdom.
Without clear guidelines and community expectations, research funding becomes a bottomless pit with no substantial gains for patients. A few more laboratories are doing chronic spinal cord injury therapies in animals, but we need many, many more and specifically ones that are willing to collaborate with the others already involved in this important research. Currently there are only about 20 labs around the world that are focused on chronic paralysis. We need to nurture and support young budding scientists that choose this as a career path with scholarships and grants focused on chronic research. We need to ask good SCI neurobiologists to focus their studies on progressive recovery projects and include chronic paralysis when applying for NIH grants or asking for funding through SCI organizations. We must see this attitude in spinal cord injury research transitioning and moving forward in the future if there is to be progress made.
Chronic research projects are inexpensive when you consider the large chronic paralysis population throughout the world that could benefit from strides being made in restored breathing for vent patients or restoration of bladder and bowels. Any successful strides brought to the community for recovery mitigates the research dollars a million times over when you compare the ongoing cost for vents, catheters, UTI’s, pressure sores, etc. It’s the most cost-effective research imaginable to do chronic studies for recovery and restoration when the benefits are weighed with lifetime healthcare cost savings.
An important mission is to evaluate research grants, community objectives, and targeted donations towards a cure for chronic paralysis. Millions around the world suffering the effects of paralysis can benefit from transitional therapies by forming serious partnerships in research efforts. Hopefully, quality clinical trials will address chronic spinal cord injury as therapies and treatments are brought out of current pre-clinical development. The community must support good chronic SCI research, but also be vigilant in identifying progressive cutting edge labs and neurobiologists that are willing to do chronic research and working to translate therapies worthy of funding to take their therapies into human clinical trials for the millions already suffering paralysis. A laser focused Scientific Advisory Board and Advocacy Research Committee can make all the difference for chronic paralysis research.