Modulating the activity of nerves
What is Neuromodulation?
It involves implanting electrical devices or drug delivery systems on, or within, the body that moduate the activity of nerves.
For example, electrodes can be implanted next to the spinal cord, the brain, or elsewhere in the body, so nerve pathways can be stimulated.
It is currently used in hospitals and clinics for pain relief caused by nerve damage and for bladder control in urinary incontinence or retention. Recently, epidural stimulation, where electrodes have been placed next to the spinal cord, has been shown to benefit people with spinal cord injury. This, and other modes of neuromodulation that do not require invasive surgery, are being actively researched.
What are we doing?
Our research at the University of Leeds, led by Dr Ronaldo Ichiyama, and in collaboration with University of Cambridge, is studying how combining epidural stimulation, which has been proven to change the behaviour of nerves, with two other therapies could benefit people with a spinal cord injury.
The three therapies are epidural stimulation, chondroitinase, and motor training (repetitive actions of the arm or leg).
In the laboratory, the research showed improvement of lower limb function, in terms of walking and gait. The combination of treatment proved crucial in determining outcome.
Testing and understanding how combinations interact and work in the laboratory is vitally important if we are to navigate efficiently what could otherwise be a very complex and time consuming clinical trials pathway, often envisaged for combination treatments. Ascertaining which combinations work, but also which could produce worse outcomes, reduces risks to patients.
Dr Ichiyama's team have found that individually, and in different combinations, the therapies bring very different results: some unexpected and surprising.