Spinal Cord Injury Research

Around 350 Australians are affected by a spinal cord injury (SCI) each year, many of them at a young age. The effects of a spinal cord injury are major: they can impair many critical functions that are easily taken for granted. Movement, sensation, blood pressure control as well as bowel, bladder and sexual function can all be affected.

The RESTORE Trial

In a recent discovery we revealed that 50% of people with complete spinal cord injury (SCI) still have surviving somatosensory nerve fibres at the level of the spine. For those with complete SCI this is hopeful news as it means — contrary to previous belief that communication to the brain had been severed by injury — that the brain is still receiving messages. This new SCI type is labelled “discomplete SCI” — a SCI person who cannot feel touch, but touch information is still forwarded from the foot to the brain. While recognition of surviving pathways in complete injuries has tremendous implications for SCI rehabilitation, currently no effective treatments exist to promote or restore touch perception among those with discomplete SCI. The purpose of the RESTORE Trial is to examine the efficacy and mechanisms of Immersive Virtual Reality Haptic Walking (VRHapticWalk) treatment for touch restoration in people with dis-complete/complete SCI.

This Trial has been funded by NSW Health. If you are interested in being a trial participant please contact us. We are recruiting people with a complete paraplegia.

T-Restore Trial

In this clinical trial we are combining immersive haptic virtual reality (VR) treatment and trans-spinal electrical stimulation (tsES) to restore touch in people with complete spinal cord injury (SCI). There is growing evidence that spinal cord neuromodulation can promote functional recovery in SCI and specifically augment the benefits of VR training. Particularly, non-invasive electrical stimulation (e.g., tsES) is a well-tolerated form of neuromodulation that has shown tremendous promise to increase the excitability of surviving spinal nerve fibres facilitating weak nerve impulses to reach to and from the brain, restoring some sensorimotor functions in SCI.

The Spinal Cord Stimulation Project

This project will use spinal transcutaneous electrical stimulation (tES) for restoration and improvement of sensorimotor functions in people with dis-complete/complete and incomplete SCI.


Spinal cord stimulation (SCS) via trans-spinal electrical stimulation (tsES) is a promising technique to neuromodulate the spinal cord neurocircuits to activate the dormant lumbosacral cord after SCI. Our recent research on tsES have shown successful restoration of volitional movements, self-assisted standing, and over-ground stepping in an individual with chronic paralysis who sustained a traumatic SCI two decades ago. We also revealed that by fine tuning the tsES parameters and optimizing stimulation locations a potentially better functional recovery may be achieved. However, this appears to vary between individuals with different injury and background. A better understand on the mechanisms of how and at what extend this electrical current activates spinal cord neurocircuits is needed. The current project aims to address this and offers the development of an individualized treatment protocol to restore of sensorimotor functions. The personalized tsES will facilitate each SCI individual to their best recovery state possible. After successful completion of the project a novel versatile tsES treatment protocol will be defined and proposed for further clinical trials.

The Robot-assisted Rehabilitation Project

Millions of people are currently suffering from hand paralysis caused by neurological injuries including brain and cervical cord injury, which severely impacts on the individual’s ability to perform basic tasks in daily living, affecting their independence, social and psychological wellbeing. Hence, improving hand function is the highest priority to return the independence of these individuals. Recently, robot-assisted therapy has shown significant promises on functional rehabilitation by providing intuitive and repetitive training promoting neuroplasticity. Current project combines the advantages of these rehabilitation robots with spinal cord neuromodulation via trans-spinal electrical stimulation (tsES) delivered to the cervical cord. The project would also facilitate to answer a key question whether this novel combination therapy would permanently restore hand functions of individuals with chronic paralysis.

Virtual Reality Walking (VRWalk) Trial

Although loss of mobility is often considered the most serious consequence of spinal cord injury, individuals with spinal cord injury consistently rate pain as one of their most difficult problems to deal with. Neuropathic pain affects approximately 60% of persons with spinal cord injury, is experienced at or below the zone of injury, and is described as burning, sharp, unbearable, unremitting and terrifying.

Spinal cord injury neuropathic pain remains minimally responsive to existing pharmacologic and non-pharmacologic treatment.  We know that this pain is underpinned by brain processes. Over the last 12 years, findings pioneered by Associate Professor Gustin have been central in advancing the understanding of the neuroscience of spinal cord injury neuropathic pain. These findings revealed the key role of thalamocortical changes that underlie the development of spinal cord injury neuropathic pain. Associate Prof Gustin with collaborators from the US (Associate Professor Zina Trost and Corey Shum)  developed a novel immersive interactive virtual reality walking intervention (VRWalk) that targets this thalamocortical changes by reinstating sensorimotor input using visual illusion and thereby ameliorating spinal cord injury neuropathic pain. 

 

"Using virtual reality we actually are tricking the brain. By walking, running, climbing and touching in the virtual world, AND THE BRAIN ACTUALLY BELIEVES THIS IS REAL, the brain’s sensorimotor areas will be reactivated, and thereby the pain these people are in will be eased." says Associate Professor Gustin

This clinical trial has been funded by the US Department of Defence and is in collaboration with scientists at the Virginia Commonwealth University (Richmond, VA, USA) and the University of Alabama at Birmingham (UAB). If you are interested in participating, get in touch!  We are currently looking for participants with a complete spinal cord injury and neuropathic pain.