“The smell of a walk”.
A man who was completely paralysed from the waist down can walk again after a British-funded surgical breakthrough which offers hope to millions of people who are disabled by spinal cord injuries.
Polish surgeons used nerve-supporting cells from the nose of Darek Fidyka, a Bulgarian man who was injured four years ago, to provide pathways along which the broken tissue was able to grow. The 38-year-old, who is believed to be the first person in the world to recover from complete severing of the spinal nerves, can now walk with a frame and has been able to resume an independent life, even to the extent of driving a car, while sensation has returned to his lower limbs.
The cells from the patient’s olfactory bulb in the brain were removed and grown in the lab. The olfactory bulb is on the inferior side of the brain and it transmits smell information from the nose to the brain, and is thus necessary for a proper sense of smell. The olfactory bulb is, with the subventricular zone, one of only two structures in the brain observed to undergo continuing neurogenesis in adult mammals. In most mammals, new neurons are born from neural stem cells in the sub-ventricular zone and migrate rostrally towards the main and accessory olfactory bulbs.
The cells taken from the nasal cavity were injected into the spinal cord above and below the damaged site and strips of nerve fibres were taken from the patient’s ankle to form a bridge for the cells to grow across.
Professor Geoffrey Raisman, whose team at University College London’s institute of neurology discovered the technique, said: “We believe that this procedure is the breakthrough which, as it is further developed, will result in a historic change in the currently hopeless outlook for people disabled by spinal cord injury.” Raisman said he had never believed the “observed wisdom” that the central nervous system cannot regenerate damaged connections. He added: “Nerve fibres are trying to regenerate all the time. But there are two problems – crash barriers, which are scars, and a great big hole in the road. “In order for the nerve fibres to express that ability they’ve always had to repair themselves, first the scar has to be opened up, and then you have to provide a channel that will lead them where they need to go.”
He stressed that what had been achieved was a leap forward beyond promoting “plasticity” – the rewiring of remaining connections. The professor added: “The number of patients who are completely paralysed is enormous. There are millions of them in the world. “If we can convince the global neurosurgeon community that this works then it will develop very rapidly indeed.”
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