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Nerve transfer restores hand function, elbow extension in paralyzed patients

sciencedaily.com

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Re: Nerve transfer restores hand function, elbow extension in paralyzed patients

#21

Post by TaupeRanger »

Whenever I see a post like this I am struck by the huge disparity in our grasp of (and ability to treat) different types of human ailments. Are you a tetraplegic? Don't worry, we will just literally rewire your nervous system to give you functioning limbs again. Do you have tiny tumor in your pancreas? Sorry, you won't know about it for a while, and when you do your only recourse is for a surgeon to cut out half of your digestive system and then we'll inject literal poison into your body with the hope that you die in 1 year instead of 3 months.

I know, there are plenty of reasons that certain diseases have been harder to crack, but the disparity always seems so striking. This nerve transfer study seems so incredible and futuristic, and yet there is still so far to go.

Re: Nerve transfer restores hand function, elbow extension in paralyzed patients

#22

Post by Epholys »

It's really heartwarming to have progress in this field of medicine! I feel anxious just imagining being unable to move my arms.

But there's a catch:

> Despite these achievements, nerve transfer surgery still has some limitations. For the best results nerve transfers should ideally be performed within 6-12 months of injury.

I hope this method will progress to have a much longer span of time allowing this surgery.

Re: Nerve transfer restores hand function, elbow extension in paralyzed patients

#23

Post by dsfyu404ed »

Epholys wrote: post #22

It's really heartwarming to have progress in this field of medicine! I feel anxious just imagining being unable to move my arms. But there's a catch: > Despite these achievements, nerve transfer surgery still has some limitations. For the best results nerve transfers should ideally be performed within 6-12 months of injury. I hope this method will progress to have a much longer span of time allowing this surgery.

>I hope this method will progress to have a much longer span of time allowing this surgery.

I think it becoming cheap/common enough that 6-12mo is not a limitation in practice would be a far better outcome.

Re: Nerve transfer restores hand function, elbow extension in paralyzed patients

#24

Post by Filligree »

dsfyu404ed wrote: post #23
Epholys wrote: post #22

It's really heartwarming to have progress in this field of medicine! I feel anxious just imagining being unable to move my arms. But there's a catch: > Despite these achievements, nerve transfer surgery still has some limitations. For the best results nerve transfers should ideally be performed within 6-12 months of injury. I hope this method will progress to have a much longer span of time allowing this surgery.

>I hope this method will progress to have a much longer span of time allowing this surgery. I think it becoming cheap/common enough that 6-12mo is not a limitation in practice would be a far better outcome.

The problem isn't with treating new injuries. There are a lot of paraplegics in the world today who were injured a long time ago, and it would be nice to fix them...

A much harder problem, I'm afraid.

Re: Nerve transfer restores hand function, elbow extension in paralyzed patients

#25

Post by jschwartzi »

raducu wrote: post #16
yomly wrote: post #6

Earlier quoted context omitted.

I seem to have awareness that people have redirected the auditory and visual cortexes as an experiment and found that sight and hearing were recovered eventually? Unfortunately I can't find a source to verify this so hoping someone with better knowledge could confirm that this is just how plastic the brain can be?

I kind of doubt that you can do that because blind people still use their visual cortex when they make out the shape of objects by tough, or when they navigate the world, so I would assume the visual cortex is a specialized "hardware".

It strikes me that it's less specialized to processing sensory input from light and more specialized to constructing a model of where things can be expected to be in relation to where the body is. So it's like a proprioceptory map.

It's interesting because I can look around my bathroom in the light, turn the light off, then reach for and grasp EG a toothbrush from memory on the first try without feeling around. It's like the images are a map of where things are and that map doesn't require the sensory images once it's constructed, nor does it require visual stimulation to construct.

Re: Nerve transfer restores hand function, elbow extension in paralyzed patients

#26

Post by porpoisemonkey »

Causality1 wrote: post #11

"Australian surgeons attached functioning nerves above the spinal injury to paralysed nerves below the injury." How was that done, exactly? Were they just sort of clamped together? Some sort of special bonding device that encouraged synapse formation?

Might have been a neuragen tube.

I had one of these placed in my hand after I severed the nerves in one of my fingers... It took about 1 year before I regained any feeling and 2 before I regained maximum nerve use.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920394/

Re: Nerve transfer restores hand function, elbow extension in paralyzed patients

#27

Post by Vrondi »

icefo wrote: post #13

What I remember from biology class is that nerve cells are very long (up to ~1 meter) and when they are cut they die. I wonder how they transferred nerves given that. If someone know and can explain I'd be very thankful !

Not all types of nerve cells are the same size. Some are several feet long, but some are only millimeters long. I assume this technique must make use of the shorter ones that survive?

Re: Nerve transfer restores hand function, elbow extension in paralyzed patients

#28

Post by yomly »

DavidSJ wrote: post #10
yomly wrote: post #6

Earlier quoted context omitted.

I seem to have awareness that people have redirected the auditory and visual cortexes as an experiment and found that sight and hearing were recovered eventually? Unfortunately I can't find a source to verify this so hoping someone with better knowledge could confirm that this is just how plastic the brain can be?

You may be thinking of this experiment on ferrets: https://www.ncbi.nlm.nih.gov/m/pubmed/1527604/

Yes this is along the right lines - thank you!

Re: Nerve transfer restores hand function, elbow extension in paralyzed patients

#30

Post by dplgk »

zaarn wrote: post #4
grenoire wrote: post #2

How exactly does a nerve transfer work? I always imagined that certain control and reception signals would have their dedicated nerve connections, such that rewiring from a transplanted nerve would jumble up the wiring and give 'incorrect' results.

Even if the result is incorrect at first, the brain is adaptable and will simply remap to correct the bad wiring. There are videos on youtube of people who put on googles that invert the view of the world upside down. After a few weeks/months of adaption, they can live in that condition as normal.

I wonder if babies work this way? i.e.The brain doesn't know which connection is which until the it performs thousands/millions of movement tests to see what moves what? Then over time it solidifies the muscle memory?
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