BACKGROUND: John McDonald is a neurologist and director of the International Center for Spinal Cord Injury at the Kennedy Krieger Institute, an independent affiliate of the Johns Hopkins University School of Medicine in Baltimore. Best known for having treated paralyzed actor Christopher Reeve, Dr. McDonald has developed an approach called Advanced Restoration Therapies that is giving hope to people suffering from spinal cord injuries and paralysis.
WHAT IS RESTORATION THERAPY? Dr.McDonald's specialty is activity-based restoration therapy that combines rehab therapies and advanced restoration technologies to help patients recover more quickly. He says that this approach demonstrates that patterned physical activity, such as cycling or walking movements, helps regenerate stem cells and help patients' bodies "remember" how to move. For instance, one method uses a computer to send electrical messages to a patient's legs, signaling the leg muscles to contract and pedal a specially designed bike. In normal development of the nervous system, cells are born and differentiate themselves through patterned neural activity; injury to the spinal cord interrupts this vital process.
WHAT'S NEXT: The next step for spinal cord injury researchers is to evaluate the results of several clinical trials designed to measure the efficacy of the therapies. One such trial, focusing on pediatric spinal cord injuries, is already underway as part of a new collaboration between KKI and Philadelphia's Shriner's hospital. Dr. McDonald is also exploring new ways to perform cell transplantation. Current techniques involve expensive, complex procedures and require a long-term hospital stay, and the cell supply is limited. He is using animal models to develop a new transplantation process that can be done on an outpatient basis using nuclear transfer of embryonic stem cells.
ABOUT THE SPINAL CORD: The spinal cord is the longest nerve in the human body; it is a bundle of nerves that carry electronic signals to and from the brain to the rest of the body. The brain and spinal cord together constitute the central nervous system. The spinal cord is surrounded by rings of bones called vertebra, which make up the spinal column (back bones), and the vertebra are named according to their location. Spinal cord injury results when damage to the spinal cord leads to a loss of function, such as mobility of feeling. Where the damage occurs determines what parts of the body are affected by the injury. Generally, the higher in the spinal column the injury occurs, the more dysfunction a person will experience.