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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

#31

"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/

Roughly how close was max nerve use to how it was before the accident? 60%? 80%?

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

#32

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 y…

(I'm sorry, but what follows is likely a bad analogy…)

I imagine this is similar to the difference between fixing a low-level bug (e.g. a kernel or CPU bug) and a bug in a relatively high-level application.

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

#33
post #30
post #4

Earlier quoted context omitted.

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?

A lot of stuff is preprogrammed or developed before birth. Most of the senses work and the motor system atleast knows what nerves do what (though coordination is 0).

Other animals come out far more developed when born and have a functional motoric system and brain, our species doesn't do that mainly because it would be difficult to have the baby fit through.

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

#34
post #30
post #4

Earlier quoted context omitted.

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?

I wonder if they learn some of it still in the womb. After all, most mothers say they can feel "kicking" sometimes. That might actually be the fetus learning how to extend its limbs

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

#35
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.

The physical therapy to help the brain remap the wiring following nerve transfers is pretty intensive. It's not something that happens quickly or easily. But even limited function after a long therapy period is much, much preferable to no function at all for these patients.

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

#36

Good reference book is The Body Electric. Except it's about regrowing limbs.

Seconded, awesome book about human tissue regeneration.

Michael Levin's lab is doing mindblowing stuff: "What Bodies Think About: Bioelectric Computation Outside the Nervous System"

https://news.ycombinator.com/item?id=18736698

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

#37
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.

Th limitation is due to changes in the distribution of receptors on the muscle, and the muscles health, once it loses neuro stimulation.

Progress here is something I’m very optimistic about.

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

#38
post #4

Earlier quoted context omitted.

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 how similar that is to the effect of the "backwards bike" shown in "Smarter every day": https://www.youtube.com/watch?v=MFzDaBzBlL0 It seems like there's a very deep idea of how a bike should work and instead of learning the new behaviour bit by bit the new idea just "clicks" at some point. I've heard people with up/down flipped goggles also say it's quite sudden change. I'm curious if it's similar for recon…

That instant clicking is exactly how it feels (for me at least) learning to play music.

I'll practice the same thing over and over, for an hour maybe. It takes so much brain power, it feels weird, sometimes it's good, mostly it's not.

Then stop, go to sleep, come back tomorrow, and 25% of the time it'll just be there with no thought or effort required whatsoever.

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

#40

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 y…

Our insurance agent had his arm in a sling a year or so ago when we went to talk to him. Routine surgery nicked a nerve and he lost control of his hand. Saw him a couple times after and sounded like it was just something he'd have to live with.

Then we bought a house and were in to talk to him about insurance for that. His hand was working fine.

Asked him about it. Apparently they took a nerve out of his leg and put it in his arm. "Can't feel my foot, but that's a heck of a lot better than not being able to use my hand"

It's a wild world.

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