Stroke research: Tested implant offers hope to survivors
A stroke left Heather Rendulic with little use of her left hand and arm, putting certain everyday tasks like tying shoes or cutting foods out of reach.
“I live one-handed in a two-handed world and you don’t realize how many things you need two hands for until you only have one good one,” the Pittsburgh woman told The Associated Press.
So Rendulic volunteered for a first-of-its-kind experiment: Researchers implanted a device that zaps her spinal cord in spots that control hand and arm motion. When they switched it on, she could grasp and manipulate objects — moving a soup can, opening a lock and by the end of the four-week study, cutting her own steak.
It’s not a cure — the improvements ended after scientists removed the temporary implant — and the pilot study included only Rendulic and one other stroke survivor. But the preliminary results, published Monday, mark a step toward one day restoring mobility for this extremely common type of paralysis.
“They’re not just getting flickers of movement. They’re getting something important,” said Dr. Jason Carmel, a Columbia University neurologist who wasn’t involved with the new experiment but also studies ways to recover upper-limb function. “It’s a very exciting proof of concept.”
Nearly 800,000 people in the U.S. alone suffer a stroke each year. Even after months of rehabilitation, well over half are left with permanently impaired arm and hand function that can range from muscle weakness to paralysis.
Experiments by multiple research groups have found that implanting electrodes to stimulate the lower spine shows promise for restoring leg and foot movement to people paralyzed after a spinal cord injury — some have even taken steps.
But upper-limb paralysis has gotten little attention and is inherently more challenging. The brain must signal multiple nerves that control how the shoulder lifts, the wrist turns and the hand flexes. Stroke damage makes it harder for those messages to get through.
“People still retain some of this connection, they’re just not enough to enable movement,” said University of Pittsburgh assistant professor Marco Capogrosso, who led the new research with colleagues at Carnegie Mellon University. “These messages are weaker than normal.”
His idea: Stimulate a pathway of related nerve cells so they’re better able to sense and pick up the brain’s weak signal.
“We’re not bypassing their control. We’re enhancing their capabilities to move their own arm,” he said.
Researchers turned to implants the size of spaghetti strands that already are used to stimulate the spine for chronic pain treatment. The implants carry electrodes that are placed on the surface of the spinal cord to deliver pulses of electricity to the targeted nerve cells — which for hand and arm control are in the spine’s neck region.
Rendulic and a second, more severely impaired volunteer could move better as soon as the stimulator was switched on — and by the study’s end showed improved muscle strength, dexterity and range of motion, researchers reported Monday in the journal Nature Medicine. Surprisingly, both participants retained some improvement for about a month after the implants were removed.
Rendulic, now 33, was performing some fine-motor tasks for the first time since suffering a stroke in her 20s. That unusually young stroke, caused by weak blood vessels that bled inside her brain, initially paralyzed her entire left side. She learned to walk again but — with the exception of those four weeks with spinal stimulation — cannot fully open her left hand or completely raise that arm.
“You feel like there’s a barrier between your brain and your arm,” Rendulic said. But with the stimulation on, “I could immediately sense that, like, oh my arm and hand are still there.”
Two other researchers who helped pioneer experiments stimulating the lower limbs of people with spinal cord injuries say it’s logical to now try the technology for stroke.
While bigger and longer studies are needed, the new results “are really promising,” said Mayo Clinic assistant professor Peter Grahn.
Scientists have learned from research with lower limbs that “it may not matter where that injury occurs, if it’s something in the brain or it’s a spinal cord injury,” added University of Louisville professor Susan Harkema. “Targeting the human spinal cord circuitry has a lot of potential.”
With National Institutes of Health funding, Capogrosso is studying the approach in a few more stroke survivors. The researchers also have formed a company to further develop the technology.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
Respiratory Outbreak Over: Jasper Place – Thunder Bay District Health Unit
March 27, 2023 – The Thunder Bay District Health Unit (TBDHU) and The City of Thunder Bay – Jasper Place confirm that the respiratory outbreak at Jasper Place, located at 1200 Jasper Drive, has been declared over. All outbreak restrictions have been lifted.
TBDHU recommends the public refrain from visiting hospitals, long-term care facilities and other high risk settings when feeling unwell to avoid spreading infections to those most vulnerable and at higher risk of severe outcomes.
The Health Unit reminds the public that they can prevent getting and spreading infections by:
- Staying at home when sick. Wearing a well-fitted mask in indoor spaces, especially when around vulnerable people or when recovering from illness.
- Keeping up-to-date with influenza and COVID-19 vaccinations.
- Washing hands often, for at least 20 seconds with soap and warm water, or by using an alcohol-based hand sanitizer.
- Covering coughs/sneezes with the upper sleeve if no tissue is available.
- Being familiar with the Ontario screening tool, to self-assess and know what to do next.
For more information on current outbreaks, please visit the following link: https://www.tbdhu.com/outbreaks.
For more information – TBDHU Media: email@example.com
Diseases & Infections
COVID cold and flu assessment centre to close Friday
It’s the end of an era of the pandemic.
The COVID Cold and Flu Care Clinic at 400 Southgate Dr. is closing at the end of the week.
The location will take patients until the end of day Friday.
Guelph General Hospital said in a news release the closure is because of the steady few months of low volumes and stable COVID hospital admissions.
“The COVID, Cold, Flu Care Clinic played a significant role in meeting the needs of the community during the pandemic by providing community residents a much-needed alternative to the emergency department and primary care,” Guelph General Hospital president and CEO Marianne Walker said in a release.
“As care transitions back to community providers, I’d like to thank the over 100 team members from Guelph General Hospital, Guelph Family Health Team and other partner organizations for their valuable service during some very difficult times.”
The clinic opened in September 2020, after moving over from the Victoria Road Recreation Centre. The clinic also used to operate on Delhi Street.
The Southgate Drive location expanded last December to include treatment for cold and flu symptoms.
Anyone looking for COVID-19, cold and flu treatment are now asked to go to family doctors, walk-in clinics, pharmacies and clinics led by Guelph Family Health Team physicians and nurse practitioners.
Severe COVID cases should still go to the emergency department.
Wellington-Dufferin-Guelph Public Health said it will still offer COVID-19 and flu shots at its Chancellors Way building.
The hospital does caution that COVID-19 is still prevalent in the community, and to continue taking precautions if you’re not feeling well.
Whooping cough on the rise in southern Ontario
Several public health units in southwestern Ontario say they’ve seen a spike in cases of whooping cough and are urging residents to get vaccinated against the respiratory illness that can be particularly severe in young children.
Southwestern Public Health – which serves Oxford County, Elgin County and St. Thomas, Ont. – said it recorded 82 cases of whooping cough from January 2022 to the end of this February.
“This was 40 per cent of the provincial total from that time period,” Dr. Ninh Tran, medical officer of health for Southwestern Public Health, said in an interview.
“It’s a significant increase … that is certainly striking.”
Previous years have seen annual caseloads in the single digits, Tran said.
Whooping cough, or pertussis, can see a person’s cough intensify to the point where a “whooping” sound is heard when they try to catch their breath, Tran said.
Lower rates of immunization against whooping cough could be a factor in the rise in cases, he said.
“In our region, we have relatively lower rates of immunization compared to others,” Tran said.
“We’ve had a few cases that were hospitalized. That’s why we just really need folks to get up-to-date on their immunization.”
Huron Perth Public Health, which serves Stratford, Wingham, Listowel and Clinton, said it has confirmed at least 21 cases of whooping cough so far this year. In 2022, there were only three cases.
“The illness can be serious for infants younger than 12 months of age who are not vaccinated, or who have not received all doses of the pertussis vaccine,” Dr. Miriam Klassen, the medical officer of health for Huron Perth, wrote in a statement.
“Young children have the highest risk for severe complications, such as hospitalization and death, if they get sick.”
Klassen said the COVID-19 pandemic might have put residents of southern Ontario behind on routine immunizations, and urged residents to catch up on their vaccines.
The Windsor-Essex County Health Unit said there had been “a recent dramatic rise” in whooping cough cases in its region. It said last week that it counted 18 cases since November 2022.
“Cases have predominately been clustered in the Leamington and Kingsville communities, and exclusively in children who are unvaccinated or partially vaccinated,” it wrote in a statement, urging residents to get vaccinated.
The health unit noted that the cough brought on by pertussis can be so severe that it can cause vomiting. If left untreated in infants, young children and the elderly, it “can lead to complications such as pneumonia, dehydration, brain damage, hospitalization and death.”
Wellington-Dufferin-Guelph Public Health said it recorded 12 cases over the fall and winter, which is “higher than normal for the region.”
“Many individuals may be behind in their vaccinations because they were unable to get them due to COVID-19,” it wrote in a statement. “Now is the time to get fully vaccinated as we engage in more community activities.”
This report by The Canadian Press was first published March 27, 2023.
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