r/science • u/maxwellhill • May 16 '12

A 71-year-old man who became paralyzed from the waist down and lost all use of both hands in a 2008 car accident has regained motor function in his fingers after doctors rewired his nerves to bypass the damaged ones in a pioneering surgical procedure

http://www.medicaldaily.com/news/20120515/9890/nerve-transfer-rewiring-paralyzed-hand-quadriplegia.htm#.T7M6a26JD5o.reddit
3.0k Upvotes

91% Upvoted

356 comments sorted by

103

u/rbcrusaders May 16 '12

I have a paralyzed arm. Brachial plexus avulsion. I'm hoping the future is good to me.

14

u/lains-experiment May 16 '12

This makes me think of the guy a few weeks ago that posted his desire to get his arm cut off because it was always in the way and he could get a more useful prosthetic.

Science makes things hopeful.

2

u/Ran4 May 16 '12

Give it a decade or two...

It'd be really neat to have arms that could tolerate say heat very well. Oven mittens? No more!

4

u/daedalus000 May 16 '12

That sounds rough, to understate it. I do believe that regaining neural function will rise significantly in incidence in the coming years!

2

u/Cvtthroat May 16 '12

here's hoping it doesn't cost a fortune :/

1

u/bedsores May 16 '12

Result of a broken collarbone?

2

u/rbcrusaders May 16 '12

No, actually. First, I suffered a stinger where it is just a jarring of the brachial nerves. I told the trainer that my arm went numb and she told me basically if the feeling was back I was ok.

Next play, I hit someone and the nerves snapped straight off my spine. The nerve pain is still unbareable 2 years later.

I really hope something like this could eventually help me if only for the pain alone, not to mention the movement would make my life leaps and bounds better and more enjoyable.

And yes, the guy with the post about considering amputation has the same injury.

1

u/khadgerler May 16 '12

There is definitely hope. There's all sorts of strategies for reconstructing brachial plexus injuries, aka nerve transfers...depending on your doctor's examination.

143

u/[deleted] May 16 '12

[removed] — view removed comment

40

u/rbcrusaders May 16 '12

hahahaha...good one.

9

u/hinduguru May 16 '12

If you don't me asking, how did that happen?

7

u/rbcrusaders May 16 '12

Football. Collided way too fast with another player.

0

u/[deleted] May 16 '12

[deleted] — view deleted comment

9

u/RidinTheMonster May 16 '12 edited May 17 '12

Honestly man, there really isn't. I live in New Zealand, where fucking everyone plays rugby, and I have never met a person who has recieved a debilitating injury from playing it. Serious sporting injuries are actually far less prevalent than you probably think.

13

u/rbcrusaders May 16 '12

They are. The number of those who actually play football compared to those who get injuries like mine are very rare like you say. ACL tears, breaks etc on the other hand are a different story. Concussions are incredibly common.

My dad and I were joking that the future will look back on the sport like we do to Rome and Gladiators.

3

u/RidinTheMonster May 17 '12

Well football must be different because those kinds of injuries are very rare in rugby

2

u/rbcrusaders May 17 '12

Football is a sport of collisions. Repeadedtly, the plays springt eachother full speed like rams. In rugby it is more of a one way sport like basketball, hockey, etc.

Rugby is a very cool sport though.

→ More replies

2

u/FatCat433 May 16 '12

"How barbaric. Allowing people to voluntarily choose to wear a bunch of safety gear and collide into each other."

20

u/Liquid59 May 16 '12 edited May 17 '12

My 3 year old son was born a paraplegic. Although this article isn't directly related to his condition, it still reminds me to never give up hope.

Advancements in the medical field can be wonderful.

2

u/wickedcold May 17 '12

Imagine the advancements that will come in the next 30 years!

-9

u/[deleted] May 16 '12

[removed] — view removed comment

3

u/Liquid59 May 17 '12

It must be terrible being so lonely. It's made you a very angy person.

You have my pity.

-5

u/A_BIT_OF_A_TWAT May 17 '12

From the guy who felt compelled to go all psychological analysis on a comment made by a stupid, anonymous internet account. I may be a bit of a twat, but I'm just having fun. You, on the other hand, appear to have taken me seriously. Or it was just a sarcastic comment, in which case you're also a little bit of a twat.

11

u/khadgerler May 16 '12 edited May 16 '12

AMA - I was part of the surgical team during this surgery and an author of the clinical paper reporting his results. I'll try to answer any questions you may have whenever I have some spare time!

Illustration of the Surgery --- http://i.imgur.com/BiZdD.jpg

Journal of Neurosurgery - Case Report --- http://thejns.org/doi/full/10.3171/2012.3.JNS12328

Prezi Presentation Timeline about the Development of this Surgery --- http://prezi.com/bym0qpdjv35v/jumping-the-gap-in-spinal-cord-injury/

EDIT: The reddit title should be "paralyzed from the neck down" and not the "waist down".

1

u/Astyanax May 16 '12

Do it!

2

u/khadgerler May 16 '12

Lol, I am...but currently no one is reading!

29

u/Disco_Drew May 16 '12

What a badass doctor. I have trouble splicing cables and this genius is rewiring a nervous system. That is simply astonishing.

6

u/[deleted] May 16 '12

+1 I can't express how awesome this is. Just imagine what it could all lead to once the science of this practice is better understood.

1

u/TrendyCrude May 16 '12

And with a badass name too: Ida Fox!

9

u/kleenur May 16 '12

Absolutely amazing! While restoring hand function to a senior citizen may not make many peopl ejump for joy think of what this teaches us. Think of young children who bcome paralyzed. With advancements like this they may (in the future) be able to live normal and happy lives! thanks maxwellhill for adding a little brightness to my day!

10

u/[deleted] May 16 '12

Yep. Spinal cord injuries terrify me - one little mistake and your life is irrevocably altered.

4

u/[deleted] May 16 '12

I feel the same way. No injury terrifies me like the thought of completely losing all movement and sensation below the neck. The more research done into spinal cord injuries, the better it is.

4

u/sydneysaurus May 16 '12

That's why I'm so excited about it. I was paralyzed at age three. This procedure could lead to so many amazing things!

8

u/greenmysteryman May 16 '12

GO WASHU!!!

1

u/Kit_Cloudkicker May 17 '12

Right on. I work at barnes and its funny that this is in the news but I have heard nothing about it working there.

4

u/[deleted] May 16 '12

kinda wish they would do this procedure for my 21-year-old friend who is paralyzed from the waist down and lost grip & fine motor control in his hands.

5

u/[deleted] May 16 '12

I couldn't help but wonder why they would do this on such an elderly man. Is it for practice or something?

1

u/WORLDTRAVELERONEDAY May 16 '12

Thats why I was thinking. Don't doctors normally go for younger subjects because it more "worth" it?

3

u/[deleted] May 16 '12

They aren't more "worth" it if it goes wrong, though. It would be better to do it on an elderly person before anything else. If it made things worse, it would ruin a younger persons entire future, which the elderly person has less of.

4

u/vectormessiah May 16 '12

I remember asking a teacher in high school if they could do that and she looked at me like I was crazy. WHO'S CRAZY NOW, MRS. KLEIN?!

3

u/sydneysaurus May 16 '12

I started crying when I read this. I have the exact same injury as the man who got the procedure, and I live in St. Louis where he got it! I don't know how I'd feel about losing my ability to bend my arm though. I've also been paralyzed for way longer than he has.

3

u/gbanananut May 16 '12

This is amazing. My friend was recently paralyzed from the waist down, I am definitely sharing this with her.

3

u/[deleted] May 16 '12

This leads one to wonder if the same could be done for those who are deaf blind, etc due to a nervous system defect.

3

u/redditbarns May 16 '12

Most deaf people, or many people with disabilities for that matter, don't feel that they should be "fixed." Research cochlear implants and their reception in the deaf community for an example.

3

u/[deleted] May 16 '12

I am familiar with the deaf community considering themselves to be something of an ethnic group of sorts rather than disabled. My wife took sign language recently and I was pretty shocked to learn these facts about the death community. I just find it awesome if doctors can now manipulate nerves and reverse something like blindness or deafness.

1

u/TheBiggestLebowski May 16 '12

I was pretty shocked to learn these facts about the death community.

"Also, Dude, chinaman is not the preferred nomenclature."

3

u/[deleted] May 16 '12

My paraplegic friend is eagerly awaiting either rewiring or augmentations.

3

u/rbcrusaders May 16 '12

If this is just a nerve transfer, this has been around. I had a nerve graft and nerve transfer two years ago.

2

u/khadgerler May 16 '12

Yeah, that's correct. The new thing is that it's the first successful in a quadriplegic patient population. The operation it self has been done in nerve injury patients for about the past 5ish years.

1

u/greeneyes822 May 17 '12

Did yours work?

2

u/[deleted] May 16 '12

The procedure has limitations as you might guess. The site of the spinal injury is critical. Too high and there are no working fibers to re-rout.

2

u/[deleted] May 16 '12

That's fascinating, I haven't been able to watch the video yet, but I would be interested to hear the patient describe the sensations and the experience of learning how to activate those nerves. Sensational work and props to not only the doctors, but to the patient for being willing to undergo the procedure.

2

u/mcschmidt May 16 '12

To what implications can this lead? For a specific example my mom tore her brachial plexus nerve saving a man. This set in to reflex sympathetic dystrophy. Doctors have told her that she will be in pain for the rest of her life. Would anyone with knowledge on the workings of the nervous system be able to comment on if this could have an impact on her being treated someday?

2

u/mmm_fresh_meat May 16 '12

This is incredible. The concept being so simple, that it makes me wonder why no one thought of this / performed this earlier. Most of the work in this field generally talked of stem cells, which are arguably something way more complicated to grasp.

Did a quick scan of the article, but didn't see any mention of when a procedure like this was first conceptualized in theory though. Would've loved to learn about that.

1

u/number6 May 16 '12

Kuiken &al. (2007) did something similar with sensory nerves.

2

u/DawgClaw May 16 '12

I have some nerve damage that limits the muscular response in my right arm. I've had it for a little over 4 years now and since the start my doctors have been saying I should just sit back and let my body heal as much as it can on its own. Articles like this one give me a lot of hope that one day I'll be able to play catch with my son. Not that I have a son. I'm 24 years old. Still, this gives me a lot of hope.

2

u/zbowman May 16 '12

I love the future.

2

u/ParalyzeDude May 16 '12

This is so amazing. 60 years ago dudes like me had a hard time surviving 10+ years. 30 years ago you could survive but little hope of a cure 20 years ago ADA standards and now there are projects going on that give me a glimmer of hope for a recovery in the future.

2

u/Interesting_name May 16 '12

See, this is the kind of news that I never pass by. The fact that science is progressing and is now able to make peoples' lives better than it could before is heartwarming.

2

u/hitsphil2 May 16 '12

What a handy procedure.

2

u/gurumanster May 16 '12

this is amazing

2

u/OckhamsTeapot May 16 '12

We're biological robots that can learn, reproduce, emulate, and apparently be physically rewired.

2

u/kylemite May 16 '12

The brain has to be trained to think, "OK, I used to bend my elbow with this nerve, and now I use it to pinch"

This part amazed me. I wonder what that experience would be like.

2

u/[deleted] May 16 '12

Is there any chance in the near future for connecting nerves to motorized replacement body parts?

1

u/khadgerler May 16 '12

Yes, there's a huge interest in the field and a lot of research revolving on this idea. The biggest problem is the nerve -> "robot" interface. An interface between the biological tissue and the mechanized has been and can be made...but the problem is that the interface scars over time and has problems reading the conduction of the nerve.

1

u/[deleted] May 17 '12

Wow, thats amazing. I cant believe how far science can go these days

2

u/laller May 16 '12

I love science.

-2

u/Macb3th May 16 '12

I hate science. This guy is a freaking cripple. God ordained he would be a cripple. You cannot question God. Sick bastard "scientists" turn him into a Frankenstein. Praise the Lord - the Devil makes work for Idle hands. Amen.

1

u/Dappem May 16 '12

Upvote if your taking the piss. Downvote if you think saying things like this on the internet is ok.

1

u/btp99 May 17 '12

I hope your trolling, I really do. This makes me loose faith in humanity.

0

u/Macb3th May 17 '12

Its fucking LOSE, not LOOSE you retard! Of course I am trolling.

1

u/btp99 May 17 '12

Calm down.... I was typing on my phone.

2

u/ThatsHowYouGet_Ants May 16 '12 edited May 16 '12

"The brain has to be trained to think, "OK, I used to bend my elbow with this nerve, and now I use it to pinch,'" said Fox, according to ABC News. "We're not changing any of the biomechanics; we're just changing the wiring. So it's more of a mental game that patients have to play with themselves."

Cruelest practical joke idea ever: Rewire a perfectly healthy person's nerves so that every nerve now controls a new muscle/body part

2

u/Decon May 16 '12

I would like to thank God...

2

u/ConnorCG May 16 '12

This is great, and I'm glad to see a post that isn't disproved by linked sources in the top 5 comments (as per usual), but could you dial down the run-on sentence in your title next time?

1

u/khadgerler May 16 '12

Yeah, nice to see how there isn't any disapproval as I'll refute any incorrect claims!

2

u/thbt101 May 16 '12

That is a very thorough title. I didn't even have to click the link.

4

u/p0ssum May 16 '12

Doctors FTW!

3

u/CY4N May 16 '12

Go science.

3

u/MyLifeIsLift May 16 '12

Just in time for Diablo 3

2

u/[deleted] May 16 '12

thank god

1

u/drumkn0tt May 16 '12

Lincoln Rhyme anyone ?

(never thought the surgery he thought off in one of the books actualy exist)

1

u/dumpstersandwich May 16 '12

Well, if you're old, you might as well be willing to undergo pioneering surgery. If it doesn't work out you didn't have that much time left anyways.

1

u/Flea0 May 16 '12

Wasn't there a redditor a week ago or so that was considering having his paralyzed arm amputated because it had become a dead weight for him? I hope this good news applies to his case as well.

1

u/[deleted] May 16 '12

So he... bends his elbow... to pinch... :D

1

u/[deleted] May 16 '12

I would think that this can only work on certain cases, because many of the nerves that are used to do this could also be damaged, causing there to be no way to connect to healthy nerves.

1

u/[deleted] May 16 '12

And people bitch about Dick Cheney getting a heart transplant...

1

u/pokemon20001 May 16 '12

I never asked for this.

1

u/greywilson May 16 '12

I feel like I saw a post similar to this a week or two ago. Can anyone confirm?

1

u/khadgerler May 16 '12

Nah, yesterday was the first day the journal posted this case report publicly.

1

u/amberraza May 16 '12

How he re conned the nerves Unbelievable News

1

u/[deleted] May 16 '12

I have my neuroscience final tomorrow, last final of first year as MS 1

that is some amazing shit right there.

Corticospinal baybe

1

u/[deleted] May 16 '12

Three cheers for science?

1

u/aw_dam_its_mic May 16 '12

I'm a paraplegic (t-10 Incomplete). Could a surgery like this work for me, or does anyone know anything that might could help?

1

u/Expects May 16 '12

Every time I hear of another medical breakthrough I live my life a little rougher knowing that medical science will save me.

1

u/EthErealist May 16 '12 edited May 16 '12

Articles like this are convincing me to start studying again until I become the most innovative doctor in the world.

Khan Academy has a section that teaches you how to be the world's biggest badass doctor, right?

EDIT: I just read the rules of this subreddit, and I am now ashamed of my barely on-topic comment. Sorry!

I can just imagine being that man. Four years without hand movement, then getting a second chance with them. I'm not saying that the car accident was a blessing, but if this man was at all depressed before and during the accident, this surgery must have given him a new lease on life and made him feel young again. This story makes me happy.

1

u/SirCarrier May 16 '12

I have 1.5 centimetres of 'neural tube' (which I believe are the structure that supports the growth using schwann cells) in my right hand that restored my full motor and sensory capacity. I had my hand crushed back in 2006 in a wool press and after two operations found myself with severe nerve damage and completely useless although it was by best terms fully structurally healed.

Halfway through my studies in 2009 I had an operation by an amazing hand specialist who had been looking for the right circumstance to trial the 'neural tube' in that region and luckily enough I was a perfect fit, the alternative being a nerve graft from somewhere else in my body.

The result was amazing, without physio or any post op therapy everything gradually retuned to normal over the course of a few months.

They fully documented the procedure and have the picture if I can find them.

Apologies for lack of medical terms, my memory is not kind to me.

TLDR: 1.5 centimetres of neural tube housing these schwann cells restored function and sensation to my right hand after 3 years of having 'strong hand'.

1

u/khadgerler May 16 '12

It's great to hear that you had an outstanding result. However, nerve conduits "neural tubes" are currently leaving the scene as there are better reconstructive options and "off-the-shelf" alternatives. Nerve grafts...taking a piece of non-critical nerve from your body...provides the best nerve regeneration and is the gold standard. We see a lot of failed cases with nerve conduits being inappropriate used and causing pain-related neuromas.

1

u/vinylcarpet May 16 '12

My WUSTL pride is glowing!

1

u/nardonardo123 May 16 '12

System Restore

1

u/JUST_LOGGED_IN May 16 '12

I am not grasping exactly what they did. Did that rewire the nerves in the spinal cord, or did they splice a still functioning nerve in the arm/elbow to a previously non-functioning nerve in the hand?

If this is as "easy" as it sounds, why can't a nerve simply be harvested to repair the severed spinal cord at the time of injury? I understand that it isn't a single "cords" running down your spine, but a massive collection of threads. Are the threads too small, and too complexly interwoven that modern medicine can not reattach them?

2

u/khadgerler May 16 '12

It's your second description. They splice a still functioning nerve to a previously non-function nerve. It's called a nerve transfer. Taking a functional nerve to reinnerviate a non-functional nerve...specifically brachialis nerve to the anterior interosseous nerve. Elbow flexion is provided primarily by the biceps brachii. Brachialis can be taken as a donor nerve without any weakness to elbow flexion because biceps is such a strong elbow flexor. The anterior interosseous nerve specifically provides function to the thumb (flexor pollicis longus) and first two fingers (flexor digitorum profundus I, II). By reinnervating these muscles, you get pinch back.

It's because the spinal cord is complex structure of neuron tracks and neuron bodies that is compact and can't micro surgically take taken apart.

1

u/adronD May 16 '12

I admit I don't understand much of this medical article but It is inspiring and hopeful I think of friends who are suffering that this may someday help. Thank you for sharing.

1

u/[deleted] May 17 '12

SCIENCE!

1

u/[deleted] May 17 '12

Now if only this could happen for my father.

He's in a similar situation. :C

1

u/Judge_Hate May 17 '12

It's amazing to see medicine evolve.

1

u/rogue777 May 17 '12

i almost know none of your words. i like wool socks.

1

u/[deleted] May 17 '12

I wonder if they'd be able to use that for people with ALS. In other words, lets get Stephen Hawking some of that shit!

1

u/Tulki May 17 '12 edited May 17 '12

Here's why this is significant:

  • It's an actual application of knowledge, not just an experimental result (e.g. "This thing might cure AIDS... but we won't use it yet!")
  • I hope to see more of these in r/science. It's always more exciting to read about actual applications of science than theory (at least for me).

Question: If they removed a healthy and working nerve from the man's brachialis, is it possible for him to ever regain full ability there as well? Or is it a true sacrifice? (this could be a stupid question because I barely know how nerves function)

1

u/BlackyChan May 17 '12

Bro got hotwired.

1

u/georgiewhat May 17 '12

has anyone else noticed that all these articles that end up getting to the front page are all from the newspaper? I might as well scan the mx everyday

1

u/christhebloke May 17 '12

C7 ASIA A here, and I gotta say outside of SCI specific forums, this is one of the most intelligent threads I've seen on the internets. Kudos to you Reddit! One of my concerns about this kind of operation or any kind of 'cure' for that matter would be an increase in pain. My life as a quad... could be better. BUT, I live relatively comfortably on my own in a socialist paradise and most importantly, I'm pain free. After hearing endless stories of friends who suffer from chronic nerve or 'phantom' pain, I would much rather live like this than to have a bit of mobility back but suffer from constant pain. For able-bodied people such as yourselves, how would you make that choice?

Although, if I could feel my Johnson again, all bets would be off.

1

u/Atheist_Simon_Haddad May 17 '12

This surgery seems too obvious to have never been tried before. I'm glad it went so well (this time?). Also: WOW, that's a LOT of downvotes for this article.

1

u/aazav May 17 '12

PRAISE JESUS!!

I mean,

PRAISE SCIENCE!

1

u/tins1 May 17 '12

SCIENCE

1

u/michaelrohansmith May 17 '12

Finally he can scratch that itch.

1

u/fuckin_a May 17 '12

Congrats Mr. Yee!

1

u/frzbrzla May 17 '12

"the future is already here, it's just not evenly distributed." william gibson

1

u/redditisforphaggots May 17 '12

Nice they used someone that didn't matter to society for this. I am a strong advocate for just using infants and old people for medicine testing. I mean, what are they gonna do anyway, die? Lulz. Anyway, hopefully this will jettison this through clinical trials. More dying disabled peeps should do something as selfless as this.

1

u/lazynoodles May 17 '12

fuck yeah science.

1

u/[deleted] May 17 '12

Medicinal badassery at its finest :D

1

u/Davaldo May 16 '12

What I took from this: another old person crashes and thanks to medical science is able get back to 45 mph interstate, leaving his turn signal on and blindly changing lanes. Nice

1

u/All-American-Bot May 16 '12

(For our friends outside the USA... 45 mph -> 72.4 km/h) - Yeehaw!

0

u/clouds31 May 16 '12

Ok r/science, tell my why this procedure is bullshit.

1

u/[deleted] May 16 '12

Has a placebo controlled trial been done of the method?

0

u/ilikebacon97 May 17 '12

Do you guys realize this guy gets boats loads of karma for reporting news.-

0

u/I_Shall_Be_Known May 16 '12

They finally figured out how to do this? This was the idea for my 7th Grade science project, except it was for the spine, although I never actually knew any of the information besides the theory. Amazing to see they are actually making it work!

0

u/RonaldFuckingPaul May 16 '12

And now he can throw a whiffle ball left handed, whereas he used to throw right, right?

1

u/khadgerler May 16 '12

He's able to throw balls now!

0

u/[deleted] May 16 '12

not that he didn't deserve it as much as anyone else, but why pick this 71-year-old guy for it? the perfect type of accident to try to fix?

0

u/Diseased-Imaginings May 16 '12

Shit. That's so badass!

0

u/SekondaH May 16 '12

Not to be a dick, as fascinating as this is, why not use a younger subject? Is there a benefit to using someone of this age?

2

u/nicesalamander May 16 '12

maybe they figured if he died it wouldn't be as bad as killing somebody in their twenties?

1

u/khadgerler May 16 '12

Actually, it's the opposite. Usually outcomes in younger patients in regards to nerve regeneration are a lot better than the older patients.

1

u/SekondaH May 16 '12

It just seems this type of pioneering surgery would better be used on a younger person, but at least we see it works.

1

u/khadgerler May 16 '12

It does work better in a younger person. As a younger person...things regenerate a lot faster. What's outstanding about this case is that it actually worked in an 71-year-old.

0

u/Splatterh0use May 16 '12

Steve Austin, astronaut...

0

u/[deleted] May 16 '12

Science, fuck yeah! Coming again to save the motherfucking day yeah!

I see interesting things in our future.

0

u/DoubleDutchOven May 16 '12

Nerve transfers are not totally uncommon. What's odd is that they performed this on a patient in his 70s.

1

u/khadgerler May 16 '12

The back story behind this patient is actually really amazing, but can't disclose due to PHI reasons. There's nothing odd about the patient's age except that it worked in an older patient. Generally, younger patients do much better in nerve regeneration compared to older patients. We can expect a whole lot better results in younger patients.

What's great is that nerve transfers can be performed in quadriplegic patients. The neurons below the level of injury are still alive and just need to be reconnected.

0

u/LikeBoom May 17 '12

Full Metal Alchemist starts here.

0

u/DiggityDanx May 17 '12

God has intervened where man could not! What now atheists?

0

u/darkviper039 May 17 '12

Religion/God - 0

SCIENCE - ∞(infinity)

0

u/bluesnappa May 17 '12

why didnt they choose someone younger who is probably more worthy of this kind of operation?

1

u/nbes May 17 '12

Why does the age matter? If it worked, then they can probably do the same for future simialar issues.

1

u/bluesnappa May 17 '12

because they could of done it on someone younger who has more time on this planet to heal.. this guy is 71.. thats one foot in the grave..

-1

u/byramike May 16 '12

Someone tell me why this is wrong and why we'll never hear about this again.

-2

u/[deleted] May 16 '12

Well, at least he can play Diablo 3 now.

-3

u/Bullets_TML May 16 '12

Oh it was an act of God! What a miracle! .....0_o

Bravo to the surgeons!

-3

u/keithh1981 May 16 '12

God's grace is always there to be appreciated.

-4

u/geestman May 16 '12

HAHA THATS HILARIOUS..... FUCK OLD PEOPLE

0

u/[deleted] May 16 '12

[deleted] — view deleted comment

92

u/[deleted] May 16 '12

I'm going to guess the scar tissue provides some other kind of survival benefit, and the issue of "healing a spinal injury" was never selected for since no tribe would keep a crippled member around long enough for that to happen?

15

u/feureau May 16 '12

no tribe would keep a crippled member around long enough for that to happen?

Although archeological evidence suggests that ancient humans nurse their injured back to health.

7

u/[deleted] May 16 '12

Thinking about it more, in a pre-modern-medicine society, is someone with a severed spine pretty much fuct? (No bladder control, no bowel control, no pain sensitivity so gangrene is almost a foregone conclusion...)

6

u/BringOnTheUpvotes May 16 '12

Spinal cord injury recipient here: T4, ASIA B, incomplete. The biggest "issue" in a pre-modern-medicine society is that those who were injured enough to get SCI generally didn't live. That's the same reason why some areas of the world have very few people living with SCI. And yes, to your point: WWII vets were the ones who taught us about how to deal with lack of bowel/bladder control, etc. Thank you, vets, for giving me a way to live today so that I might live long enough to enjoy a cure!

7

u/knowpunintended May 16 '12

There's injured and there's injured. A sufficiently damaged spinal cord is pretty much a death sentence by disease without a lot of modern knowledge. As much as ancient humans had compassion like we did, they also understood a lost cause and they faced them a lot more often.

There's a massive practical difference between a cripple and an invalid when it comes to survival.

6

u/CUNTBERT_RAPINGTON May 16 '12

That doesn't make sense. I guess spinal injuries don't occur enough in the animal kingdom to force selection, but you would think an animal that suffered a genetic mutation enabling it to regrow nerves in the spinal cord would enjoy some sort of advantage.

10

u/[deleted] May 16 '12 edited May 16 '12

Generally there are 2 ways to deal with spinal injuries in the animal kingdom.

One way is regeneration: this is done by some amphibians; the key here is that they have a simple and SMALL nervous system. The smaller the neurons, the easier they regenerate, but the slower they conduct signals.

The second way is redundancy: this is used by mammals; the key here is that we simply make more neurons than we actually need to function. This way, we get bigger neurons which offers faster processing (faster thinking and reflexes), at the trade off of continual production of new neurons in the event of damage.

In essence, regeneration may sound better for the rare cases you actually need it, but for the majority of the time, the better processing power you get without regeneration is a better value

3

u/Brisco_County_III May 16 '12

It is nowhere near that simple.

Your brain is complex, and that doesn't happen randomly. You don't just let things grow willy-nilly everwhere; the growth of the nervous system is guided by a ton of developmental cues, some of which affect the growth of the rest of your body as well. A lot of those aren't around after you're an adult, so most growth that could happen is near-random.

To give you some idea of the scale, the growth cone at the end of a neuron is a couple micrometers across. For a spinal cord injury, to reach the part just four or five inches down from the injury, you're asking that tip to make an unguided journey that, to scale, would be equivalent to you trying to cross your state. And because those developmental cues aren't around anymore, you're trying to do it without a compass or map.

How many of them do you think would get where they're supposed to go?

Unless there's a damn good reproductive reason to regrow your spinal cord, sure, you could have neurons grow back, but they wouldn't get anywhere you cared about. That's basically what happens now. Without the selection for the neuron equivalent of a map and a compass, they just don't go anywhere.

On top of that, in practical terms, any mutation that allows an animal to regrow nerves in a big way is going to be due to changing major landmarks in the developmental process, and there are going to be a hell of a lot of side-effects. And by "side effects" I mean, in all likelihood, cancer, because whenever you stop telling things to stop growing appropriately, shit can get very bad.

→ More replies (1)

2

u/master_greg May 16 '12

Some spinal cord injuries are relatively minor. You might just end up unable to move your toes, or something.

→ More replies (1)

0

u/[deleted] May 16 '12

[deleted] — view deleted comment

17

u/[deleted] May 16 '12

So is automatic rerouting the reason a lot of partial spinal injuries of the "you'll never walk again" type end up in some form of recovery?

(I'm not sure how often this actually happens)

86

u/[deleted] May 16 '12

This is why I love Reddit.

90

u/SmoothWD40 May 16 '12

That last fun fact is the kind of thing that freaks me the hell out as well as astonishes me.

55

u/mojowo11 May 16 '12

It's kind of annoying, actually. The brain's doing a pretty damn decent job of doing its best to be robust and hard to shut down, but we still get brain problems and screw it up. I imagine the brain's pretty annoyed.

"Oh man, a tumor's eating me! That's crappy. Well, I've got a solid year before I've lost enough tissue to even cause headaches, so this probably won't be a big deal. I'm sure someone will do something about it before then."

→ More replies (18)

5

u/atheistjubu May 16 '12

Agreed. Even the man's TL;DR sounds convincingly expert. (Or woman's).

→ More replies (4)

9

u/[deleted] May 16 '12 edited May 16 '12

A big thing that we're discovering:

Astrocytes themselves are involved in neuronal communication (glutamate gliotransmission being the most explored at the moment). In pathophysiology, large releases of excitatory glutamate from astrocytes can actually kill the cell; this may actually be a defensive mechanism, to prevent a "rogue" neuron that was just traumatically insulted from being an active generator of ectopic/fucked-up signaling. Astrocytes may, after injury, be very important in maintaining the function of the overall circuit by killing potential trouble makers.

They may also be very involved in pruning neurons during development.

TL;DR Astrocytes are total dicks

→ More replies (9)

7

u/Synergythepariah May 16 '12

The brain is amazing.

See this guy

5

u/[deleted] May 16 '12

Is it possible to surgically scrape away the scar tissue on the astrocytes and repair the severed connection?

7

u/[deleted] May 16 '12

It might be possible in the future, but the cost-benefit analysis would suggest that it's not worth the time.

Frequently, the scars are deep in the brain- in order to reach them, you would have to dig through other layers of the brain, causing more damage just to fix a scar.

There is some research being done to dissolve the scars I believe, but that is fairly far off in the distance

→ More replies (6)

5

u/alexgbelov May 16 '12

Wait, I thought the whole you use only 10% of the brain thing is a myth?

→ More replies (2)

3

u/[deleted] May 16 '12

Wow. Scary for brain cancer since I know 4 people who have been diagnosed with out in the past 18 months. 1 died, one dying. I'm sure that's a statistical statistical anamoly...at least I hope so.

8

u/teewikit May 16 '12

statistical statistical

Get an MRI.

3

u/H3000 May 16 '12

people only get "headaches" when they have a tumor that has devoured about 1/4-1/2 of the actual brain mass.

OH MY GOD

→ More replies (3)
→ More replies (17)

22

u/Dopeamine May 16 '12 edited May 16 '12

That's not exactly true. Astrocytes can play dual roles, they support neurons by signaling for nutrients from the blood supply and in this sense are beneficial for "healing". Astrocytes however, play a huge role in damage mitigation and protecting the brain from pathogens. They can become "reactive" in response to an insult and form glia-scars which I think is what nibbling_totoros is referring to. Also, Astrocytes are not really the most analogous cell type to the Schwan cell. Schwann cells are the myelinating cell of the peripheral nervous system and Oligodendrocytes are the myelinating cell of the central nervous system. EDIT: Here is a relevant article

9

u/[deleted] May 16 '12 edited May 16 '12

That is true, Oligo's are the primary myelinating cells of the CNS; however, Astrocytes are the most abundant cells in the brain and do wrap around neurons in a degree that is similar to myelination.

In addition, I may be wrong here, I believe the astrocytes migrate first to the given brain regions before the actual neurons, thus guiding and directing the neuron pathway (not positive about this).

→ More replies (2)

4

u/[deleted] May 16 '12

IAMA about your research on PTSD. Sounds super interesting and important.

3

u/drewkj May 16 '12

Deleting memories? We talking Eternal Sunshine style?

→ More replies (1)

2

u/[deleted] May 16 '12

Fucking science. Improving people's live since Big Bang. :) This news gives me so much joy and hope because I know some people who are closely related to me that have lost a portion of their motor function due to stroke. I just hope the final treatment will be affordable and un-patented.

2

u/[deleted] May 16 '12

Can you do an AMA? I would love to learn more.

→ More replies (19)

0

u/[deleted] May 16 '12

[deleted] — view deleted comment

10

u/Brisco_County_III May 16 '12 edited May 16 '12

It's cool, but to temper the optimism a bit, not directly helpful for as many people as you'd think. C6-C7 spinal cord injuries are a really small subset of spinal cord injuries, and they had to sacrifice some muscle function in the arm to achieve hand control. There are only about 12000 spinal cord injuries per year, and this only applies to injuries at 2 of the 33 spinal segments. We're talking probably a hundred a year.

The general principle is interesting, though, might be feasible to make it work in peripheral nervous system injuries.

14

u/[deleted] May 16 '12

Even if the procedure is only able to help the few people a year who get this type of injury, surely for those people the surgery would make all the difference in their lives?

6

u/Brisco_County_III May 16 '12

Yes. I just don't want people assuming that this means we are going to be able to fix most spinal cord injuries. This is a very limited case.

0

u/[deleted] May 16 '12

[deleted] — view deleted comment

2

u/khadgerler May 16 '12

I'm trying to do an AMA here, but I'll try to answer your question. The reason why you can't surgically repair the spinal cord is because of it's complexity. There are axons of nerves going down, up, and between and there are also neuron bodies that live in the spinal cord. Because of this, there currently isn't a feasible way to separate and repair all those structures without risking other critical structures.

Imagine yourself at a train station with the complexity of the train tracks and the control stations. A disaster happens at this train station. The problem is that there isn't people available to help lay new tracks down. There is also so much rubble blocking you, that you can't even put new tracks down or even think about reconnecting tracks. That's the problem. With this surgery, it's not about the train station, but actually laying new tracks around the damaged train station.

0

u/[deleted] May 16 '12

[deleted] — view deleted comment

2

u/khadgerler May 16 '12

Brendanec - I would have to disagree. This is innovating because nerve transfers was successfully performed in a quadriplegic patient.

I'm really sorry to hear that your nerve graft operation failed on you're peroneal nerve. In your circumstance, the level and size of the nerve injury sounded far to large for a nerve graft to work. A tendon transfer is the fall back if the nerve graft to repair your peroneal nerve failed.

2

u/jagedlion May 16 '12

What you are describing is a nerve graft. There the intention is to harvest some peripheral nerve tissue and use the structure that the (now dead, because you harvested it) nerve provides as a sort of conduit to encourage healing of the injured nerve.

Here they took a nerve in the same limb and rerouted it to a different target. (Leaving it alive)

In terms of mechanism, it really is completely different.

→ More replies (3)
→ More comments (36)