Update from The Miami Project To Cure Paralysis

July 2013

2 MINUTE UPDATE

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BRAIN STIMULATION TO REDUCE PAIN AND AUTONOMIC PROBLEMS

Ian Hentall, Ph.D. and Jonathan Jagid, M.D.Can electrical stimulation to the brain permanently reduce some debilitating symptoms of spinal cord injury (SCI), such as pain and the episodes of high blood pressure called autonomic dysreflexia?  Dr. Ian Hentalland his collaborators, Drs. Jonathan Jagid, Eva Widerström-Noga, Alberto Martinez-Arizala, and Bruno Gallo, recently received funding from the Department of Defense to conduct a clinical trial to test this very question.

The basis for this clinical trial is rooted in Dr. Hentall’s pre-clinical research as well as advances in the field of deep brain stimulation (DBS).   There is a region in the midbrain called the Periaquaductal Gray, or PAG, where electrical stimulation triggers the release of pain relieving molecules.  Dr. Hentall has demonstrated that a few weeks of stimulation in the PAG after SCI reduces pain sensitivity, improves autonomic control of the intestines and breathing, reduces the development of autonomic dysreflexia, and enhances movement.  These changes are likely a result of alterations in various cellular signaling pathways that enhance growth in the damaged spinal cord.  The details of these various experiments have been published in peer-reviewed scientific journals.

Deep brain stimulation (DBS) involves a surgical procedure to implant a “brain pacemaker”.  The device sends different patterns of electrical stimulation to a specific region of the brain to interrupt pathways that are not functioning correctly.  Currently, DBS is approved by the Food and Drug Administration (FDA) for use in individuals with advanced Parkinson’s disease or essential tremor whose symptoms are inadequately controlled by medication.  The electrode is placed deep in the brain.  This has been performed in over 100,000 people and the procedure and technology have been proven to be safe and effective.  DBS has been used in the PAG in a few hundred people experiencing treatment-resistant chronic pain.  Approximately 40 of those individuals had SCI.  The results have been variable because those trials were all done differently using various stimulation patterns and targets, injury types, pain symptoms, and durations of follow-up.  So the question of whether DBS can effectively reduce SCI-induced pain remains unanswered, plus nobody seems to have looked at permanent benefits of this stimulation after SCI or at symptoms other than pain.

Our multi-disciplinary team will attempt to answer these questions.  Dr. Hentall has partnered with neurosurgeon Dr. Jonathan Jagid, who is very experienced with DBS surgery and technology.  Dr. Jagid also partners with neurologist and clinical neurophysiologist Dr. Bruno Gallo, who will fine-tune the stimulators on a monthly basis to adapt to the needs of each individual.  Dr. Eva Widerström-Noga is an expert in SCI-induced pain and Dr. Alberto Martinez-Arizala is head of the SCI Clinic at the Miami Veterans Administration Hospital and an expert in clinically managing secondary complications associated with living with SCI.  With their collective expertise, a very well controlled trial can be conducted to comprehensively evaluate the usefulness of DBS to manage pain and potentially prevent the onset of life threatening autonomic dysreflexia.

The team has already obtained FDA approval to use the Medtronic Activa PC DBS device in up to 12 participants in a Feasibility Clinical Investigation.  The study is collaborative between the University of Miami and the Miami Veterans Administration Hospital.  The group is in the process of obtaining ethical approval from both institutions, after which enrollment will begin.   The end goals of the trial are to use DBS to (1) immediately block ongoing or intermittent SCI pain without acute or long-term adverse reactions, (2) simultaneously reduce spontaneous or evoked autonomic dysreflexia, and (3) gradually lead to permanent improvements in pain and autonomic symptoms of SCI.  If the method works, it will be a fairly simple matter to go forward with further study and eventual clinical application, since no further device development or preclinical research would be required.

28TH ANNUAL GREAT SPORTS LEGENDS DINNER

NBC’s Brian Williams will serve as the Event Master of Ceremonies
Special Musical Performance by Broadway’s Jersey BoysBrian Williams

Join The Buoniconti Fund as we host the 28th Annual Great Sports Legends Dinner onMonday, September 30, 2013 at the Waldorf=Astoria in New York City.  We are gearing up for a spectacular line-up of Sports Legends and Honorees this year! We are thrilled to announce NBC’s Brian Williams will join us as the Master of Ceremonies for this extraordinary evening.

Our “Legend Alumni” and Honorees include:  Muhammad Ali, Michael Jordan, Troy Aikman, Willie Mays, Tom Brokaw, Andre Agassi, Tony Hawk, Cal Ripken, Jr., Gloria Estefan, Magic Johnson,  Jack Nicklaus, Mia Hamm, Bill Russell, Wayne Gretzky, Roger Penske, Charles Barkley, Buzz Aldrin, George Foreman, Shaquille O’Neal, Dara Torres, Julio Iglesias, Helio Castroneves, Joe DiMaggio, Mario Andretti, Joe Namath, Mike Piazza, Julius Erving, Walter Cronkite, Bruce Jenner, Gabrielle Reece, Pat Riley, Kelly Slater, Marshall Faulk,  Dorothy Hamill, Joe Torre,  Dr. Maya Angelou, and many other athletes and heroes who recognize that paralyzing injuries can and do occur in the pursuit of athletic careers and everyday lives.

Don’t miss your opportunity to see the best of the best in sports receive their Legend Awards! In addition to honoring these amazing sports icons supporters will witness a special musical performance by Broadway’s Jersey Boys!

For table and ticket purchase information, please contact Stephanie Sayfie Aagaard at 305-243-4656 or email saagaard@miami.edu

 

NATIONAL CHAPTERS OF THE BUONICONTI FUND

The Orlando Chapter celebrates their “Totally 80s Party” on Saturday,August 10. The event will be held at The Abbey in Orlando. Tickets, sponsorship and event details available atwww.thebuonicontifund.com/orlando

The Buoniconti Fund proudly announces the new Claddagh Foundation Chapter. We invite you to join us on Friday, August 16 for their “17th Annual Golf Outing” at Ridge Country Club in Chicago, IL. For player spots and sponsorship, visitwww.thebuonicontifund.com/claddaghfoundation

The Philadelphia Chapter invites you to its “5th Annual Race for the Pennant” on Friday, September 20. Philadelphia Phillies take on the New York Mets at Citizen Bank Park. For tickets and tailgate info, visitwww.thebuonicontifund.com/phillies

Chapters Challenge” has launched its 3rd year and we encourage our volunteers and supporters that are participating in local, regional, national and international races (i.e. marathon, triathlon, community walk, bike race) to utilize this new web-based program to raise funds and awareness of The Buoniconti Fund and The Miami Project to Cure Paralysis. http://chapterschallenge.thebuonicontifund.com

There’s no better time to raise funds and awareness for spinal cord injury research. You can help us find a cure!  If you’d like to be more involved in your local Chapter or start a new Chapter, please contact Kristin Wherry, Director of National Chapters, atbfchapters@med.miami.edu or call (305) 243-3863.

 

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