1. New Hope for Hurt Neurons Is there recovery after damage to the spinal cord or brain? Can stem cells be used to reconstruct broken pathways? A few years ago, the stuff of myths. Perhaps a reality

2. Christopher Reeve as Superman

3. Christopher Reeve Paralysis Foundation www.paralysis.org

4. Reeve’s Goal To Stand and Raise a Glass on 50 th Birthday. 9/25/2002

5. Traditional Divisions KW 2-13

6. Functional Divisions KW 2-13

7. CNS and PNS KW 1-2

8. Brain in Skull KW 2-1

9. CNS and PNS (sketch) Skull Brain Spinal cord Nerves (PNS) Vertebrae

10. Neurons and Glial Cells KW 2-12

11. Neuron KW 3-3

12. Types of Neurons KW 3-7

13. Neuron (detail) KW 3-5

14. Neuron (info flow) KW 3-6

15. Types of Glial Cells KW 3-1

16. Glial Cell Functions Supportive glial = glue Nutrition Waste disposal “vacuum cleaners” Insulate neurons

17. Neurons vs Glial Cells Neurons Transmit message. Mature cells don’t replicate. Dead cells are not replaced. Glial cells Supportive role. Mature cells do replicate. Dead cells are replaced.

18. CNS and PNS Myelin

19. Astrocyte KW 3-9

20. Myelin Wrap CNS PNS

21. Myelin Sheath in PNS Axon Myelin Sheath Schwann Cells in PNS

22. Schwann cell beakdown KW 3-11

23. Schwann Cell Recovery KW 3-11

24. Combo Schwann KW 3-11

25. Can axons regrow in CNS? Yes, but their path is blocked by CNS Glial Cells. CNS Glial cells (Oligodendrocytes) form scar tissue. Pathway is blocked by scar tissue. scar

26. CNS Solutions Block scar tissue from forming. Schwann cell bridges (Lars Olson). Spinal motor pathways cut in rats. Loss control of hind limbs.

27. Other CNS Solutions Nerve growth factors. Stem cell implants. Quick response to spinal cord injury. “Golden Hour” = first hour after injury. Prevent further damage.

28. Rapid Response to Injury Steroids to reduce swelling. Provide support. Cord usually not severed. Relieve pressure. Stabilize vertebrae.

29. Recovery from injury Drugs to help remaining neurons function better. Retrain body to use back-up systems. Functional Electrical Stimulation (FES): a computer assisted movement system

30. Functional Electrical Stimulation

31. Hand Grasp in Operation

32. Spinal Cord Outcomes 12,000 new cases a year Most young men. 90% survive accident. Lifetime disability Greater hope for recovery.