Though he works now in research and basic science, former clinician James Fawcett can’t stop thinking about his patients. His current work, exploring an enzyme that helps the nervous system return to a more-plastic state, could help people with spinal cord injuries regain more mobility.
Fawcett and colleagues at the Cambridge Centre for Brain Repair have found that the enzyme chondroitinase digests the structures in the brain that are responsible for turning off the ability of the nervous system to grow new connections. That “opens up a window of opportunity during which rehabilitation can be dramatically more successful,” he said during a lecture at the Federation of European Neuroscience in Geneva, Switzerland, on Tuesday.
Other researchers, including Martin Schwab at the University of Zurich, also are working toward restarting this form of plasticity. But this is only part of the problem of recovering from spinal-cord injuries, they said. It’s one thing to regrow neuronal connections, and another to train those new connections to link up correctly.
That training, it appears, is what good physical rehabilitation therapy does; when paired with chondroitinase in animal studies, improvement in fine-motor movements is strikingly improved. When chondroitinase is used alone, there is no improvement at all.
While this success is still only in the lab and no one can predict how long it will take to translate into human care or how much it could help restore function, it is encouraging to patients, Schwab says. “Most patients know the field is in early stages, and they are grateful for solid scientific progress. Fifteen years ago, the field was called absolutely hopeless; now it is the focus of much attention.”
“Everyone knows someone who has a central nervous system injury,” says Fawcett. “These are conditions that don’t kill someone but that don’t get better. Even quite little bits of help can be quite meaningful.”