Drs. Michael Fehlings and Narihito Nagoshi give commentary on electrical stimulation

Recently, much attention has been directed at therapeutic strategies for spinal cord injury (SCI), including cell transplantation and/or drug administration. Clinical trials of neural precursor cells for SCI have already taken place, as have trials of mesenchymal stem cells, and medication such as sodium/glutamate antagonists, and the antibiotic minocycline.

The striking point of this study is that the therapeutic strategy for SCI focused not on the lesion site itself, but below the level of the lesion site on the spinal cord. In cell transplantation therapy, the focus is on replacing the damaged neural cells and promotion of axon regeneration and remyelination at and across the lesion site. However, the results from this work demonstrate a new strategy of activating the spared spinal cord circuitry below the level of injury by epidural stimulation, without any direct treatment of the lesion site. In the lumbar spinal cord, central pattern generators (CPG) which control the locomotor behavior of the hindlimbs are known to exist, and the epidural stimulation in this work could contribute to the reactivation of CPG neural circuitry.

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