Stem Cell Therapy Restores Movement to Paralyzed Man’s Arms and Hands

Lifting weights is part of Kris Boesen’s regular program of physical therapy.

 
On March 6, 2016, just before Kris Boesen’s 21st birthday, his car skidded across a wet road in Bakersfield, California and slammed into a telephone pole. He broke bones in his neck and suffered a traumatic injury to his cervical spine that left him paralyzed from the neck down. However, thanks to a bit of luck and timing, he qualified for a current clinical trial conducted as a partnership between Rancho Los Amigos National Rehabilitation Center and Keck Medicine at the University of Southern California (USC), headed up by Charles Liu, director of the USC Neurorestoration Center. Today, Kris can move his arms and hands, operate his motorized wheelchair, breathe on his own—and even feel some sensation below the waist.

In April, just five weeks after his accident, researchers injected an experimental dose of 10 million AST-OPC1 cells into Kris’s cervical spinal cord. These AST-OPC1 cells were developed by Asterias Biotherapeutics, in Fremont, California from embryonic stem cells, which they converted into oligodendrocyte progenitor cells (OPCs) normally found in the brain and spinal cord of healthy bodies.

When a spinal cord injury occurs, Liu tells mental_floss, “The neurons can die, the axons can be severed, or the myelin can be damaged.” These AST-OPC1 cells have been designed to address the myelination and are neuroregenerative—that is, they can restore connections and tissue within the spinal cord, thus potentially restore feeling and movement to the limbs.

“Quite frankly, my expectations were not very high,” Liu says. “People have been talking about regenerative medicine for a while now, but in the nervous system we haven’t had a whole lot of success.”

Charles Liu, director of the Neurorestoration Center at the University of California

Kris has what is known as a grade A injury on the ASIA scale (American Spinal Injury Association). This means he couldn’t move anything more than the smallest shrug of the shoulders at the neck line, and nothing from the neck down. Rodney Boesen, Kris’s father, tells mental_floss that he recalls Liu saying he hoped that at most Kris might be able to move from a grade A injury to a grade B, which means he'd regain some feeling below the neck. “The real key word there was hope,” says Rodney.

Six weeks after the stem cell therapy, Kris left the hospital. And now, just five months after the treatment, hope has become a reality: Kris has surpassed everyone’s expectations and “moved up two additional motor levels,” says Liu, which he calls “extremely significant," adding, “Think of all these patients that are quadriplegic: they’re basically not able to move their arms or legs. Now you can turn them into patients who can actually brush their teeth and do stuff for themselves.”

Indeed, Kris can now do most everything with his hands and arms that someone without a spinal cord injury can do: brush his teeth, feed himself, write his name, text his girlfriend, and even lift weights, which is an important part of his physical therapy.

Liu says Kris’s improvement “is very atypical in natural improvement or just rehabilitation alone. He had no improvement at all until he got the cells,” he says. He expects Kris will continue to improve.

Kris Boesen and his father, Rodney 

Even more encouraging, says Kris’s father, “There’s sensation going on below his waist.” This is how his doctors realized recently that he had a bladder infection; Kris could feel it. Most people with spinal cord injuries of his kind wouldn’t be able to. Moreover, Rodney says, “The stem cells have given him back a lot of functions,” including breathing without a ventilator, coughing, and even sweating. Sweating, which most people take for granted (and don't especially enjoy), is a process that most para- and quadriplegics can no longer do, as it requires the spinal cord to send signals to the sweat glands. This is another promising sign that Kris’s treatment has had a regenerative effect.

He has also had involuntary movement in his feet and some sensation returning in his knees and thighs. “The nurses noticed when you touch his legs that they’re warm," Rodney says. "They told me that it’s unusual for people with his injury to have warm legs because they have such a problem regulating their body temperature."

Rodney credits Liu for “moving heaven and Earth” to get Kris into the trial.

Liu is encouraged by Kris’s results and feels that the new "biological engineering" technologies emerging to treat spinal cord injuries— such as cell transplantation, new prosthetics, and brain wave interface processing—will come together to make huge strides “toward restoring function in either a conventional or unconventional way," Liu says. "It’s really exciting.”

Kris was not up for an interview at this time, but in a statement provided by Keck Medicine, he said, “Just because you went through something bad doesn’t mean you have to suffer the rest of your life … now, thankfully with technology, we have some stuff that’s working, and it’s obviously worked for me so far.”

The initial results of this ongoing trial, which includes six patients at six sites across the United States, will be published sometime in September.

All images: Greg Iger/Keck Medicine of USC

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16 Facts About Migraines
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Unless you suffer from migraines yourself, you may think that having a migraine means having a really bad headache. But debilitating head pain is only one part of the medical condition called migraine disorder. Other common symptoms are nausea, dizziness, fatigue, sensitivity to light and sound, and even temporary blindness. The symptoms and causes of migraine look different in different patients, and researchers are only now beginning to understand what the condition is and how to treat it. Here are some of the most enlightening facts we know about migraine disorder.

1. IT'S THE THIRD MOST COMMON DISEASE IN THE WORLD.

Even if you don’t suffer from migraine, chances are you know someone who does: The disorder affects 14.7 percent of the population, or one in seven people, around the world. In the U.S. alone, roughly 39 million people are affected by the condition. Chronic migraine (experiencing at least 15 headache days per month over a three-month period, with over half being migraines) is more rare, impacting about 2 percent of the world population.

2. WOMEN SUFFER MORE THAN MEN.

Of the one billion people on Earth who have migraine disorder, three-fourths are women. Medical experts suspect this has to do with the cyclical nature of female hormones. According to research presented earlier in 2018, NHE1, the protein that regulates the transfer of protons and sodium ions across cell membranes, is a crucial component of migraine headaches. NHE1 production likely fluctuates a lot more in women than in men. When scientists looked at the brains of lab rats, they found that NHE1 levels were lowest when estrogen was at its peak. In general, female rats also had four times the amount of NHE1 in their brains as males. If the same holds true for people, that could explain why women are not only more likely to suffer migraines in the first place, but why they experience them more frequently and more intensely, and have more difficulty responding to treatment.

3. MIGRAINE TRIGGERS VARY WIDELY.

For doctors and sufferers, migraine triggers can be a source of confusion. They vary from patient to patient and often come from unexpected sources that have no relation to each other. Stress, too much or too little sleep, dehydration, alcohol, and caffeine are some of the most common triggers. Some people get migraines after eating specific foods, like cheese, and others are sensitive to changes in weather conditions like barometric pressure. Some people manage their migraines by pinpointing and avoiding triggers.

4. FOR SOME, AURAS ARE A WARNING THAT A MIGRAINE IS COMING.

Before the nausea, dizziness, and splitting head pain begin, auras warn some people that a migraine is on its way. Less than 25 percent [PDF] of migraine sufferers experience distorted senses, such as numbness or tingling in the hands or face, or blotches of light or darkness disrupting their vision. Auras usually occur 10 to 30 minutes before the migraine develops and last from five minutes to one hour.

5. SYMPTOMS CAN INCLUDE TEMPORARY BLINDNESS …

Unlike migraine with aura, retinal migraine is limited to one eye. Symptoms range from seeing twinkling stars to partial or complete loss of vision. The same eye is almost always affected, and the person typically regains their sight after 10 to 20 minutes.

6. … AND LOSS OF LIMB FUNCTION.

One of the rarest, and scariest, subtypes of migraine is hemiplegic migraine. People with this variant can experience weakness, numbness, tingling, or loss of motor function in parts of one half of their body, including their arm, leg, or face. Though sensations usually dissipate within 24 hours, they can last anywhere from one hour to several days. Sometimes they’re accompanied by typical migraine symptoms, such as head pain, but they can also occur on their own.

7. KIDS GET MIGRAINES TOO.

Migraine isn’t just a problem for adults—up to 10 percent of all school-aged kids are affected by the disorder, with reported cases coming from children as young as 18 months. According to the documentary Out of My Head (2018), migraine is the third most common reason for child emergency room visits. The symptoms of migraine in kids are similar to what’s seen in older patients: They may experience intense head pain, sick feelings, distorted vision, and sensitivity to sound and light. The major differences are that child migraines often develop suddenly and are shorter than they are in adults. In children, it’s not uncommon for the nausea and abdominal pain to feel worse than the actual headaches. Just as some sufferers don’t experience their first episodes until after puberty, some children with migraine grow out of it. According to one study, migraine symptoms disappeared completely in 23 percent of former child sufferers by age 25.

8. MIGRAINE MAY BE HEREDITARY.

For most people with migraine disorder, it runs in the family. Anywhere from 80 to 90 percent of migraine sufferers report having at least one family member who has it as well. If one parent has migraine, there’s a 50 percent chance their child will eventually have to live with migraine—and that risk shoots up to 75 percent when both parents have the condition.

9. MANY VETERANS RETURN HOME WITH MIGRAINES.

Genetics isn’t the only factor that contributes to someone’s chance of having migraine disorder. One study found that after a 12-month deployment in Iraq, 36 percent of veterans exhibited symptoms of migraine. The cause often stems from head or neck trauma sustained from explosions, falls, or other accidents during their service. While post-traumatic migraine goes away in most patients within a few months, in some cases it can develop into a chronic condition.

10. MIGRAINE IS LINKED TO THE "SECOND BRAIN" IN YOUR GUT.

In addition to the part of our nervous system that responds to outside stimuli, humans have an enteric nervous system: the part responsible for regulating digestion. Some medical experts believe that migraine is closely tied to this “second brain.” People with migraine are twice as likely to have IBS as people with tension headaches. Abdominal migraine, where the pain is concentrated in the stomach rather than the head, is one form the condition takes. It's most often seen in children, but it can affect adults as well.

11. DESPITE THE HIGH COST OF MIGRAINE DISORDER, RESEARCH IS UNDERFUNDED.

In 2017, the National Institutes of Health invested $22 million in migraine research. Asthma research received $286 million, breast cancer $689 million, and diabetes $1.1 billion.

12. THE DISORDER COSTS US UP TO $13 BILLION ANNUALLY.

Though migraine isn't life-threatening like these other conditions, it is widespread enough to have a negative impact on society as a whole. Workers with migraine often end up taking a lot of time off from their jobs, which can cost their employers. According to Out of My Head, it’s estimated that 113 million work days are missed annually due to migraine, adding up a to $13 billion loss.

13. MIGRAINE MAY HAVE INSPIRED PARTS OF ALICE IN WONDERLAND …

In the famous children’s book, Alice drinks a liquid that makes her grow many times her size and eats a cookie that shrinks her to tiny proportions. Migraine sufferers may recognize themselves in these passages. Possible symptoms of the disorder include micropsia and macropsia, or perceiving objects to be much smaller or larger than they really are. Some theorize that Alice in Wonderland author Lewis Carroll suffered migraines and wrote his experiences into his story. The book’s connection to migraine is so famous that today the related symptoms are commonly known as Alice in Wonderland Syndrome.

14. … AND PLAGUED A FOUNDING FATHER.

Another famous person from history who likely suffered from migraines was Thomas Jefferson. His symptoms could last for weeks and often appeared during stressful times in his life. There was even an episode that coincided with one of the most important nights of his political career. One night in June 1790, he invited Federalist Alexander Hamilton and Republican James Madison to his home for a dinner party in the hopes of getting his peers to agree on a location for the new U.S. capital. Despite dealing with lingering head pain from a migraine, he successfully brokered the compromise that landed the capital at its current spot on the Potomac River between Maryland and Virginia. In return, Madison agreed that he would not block Hamilton's plan for the federal government to take on state war debt, thus helping establish the young nation's credit.

15. MIGRAINE IS LINKED TO DEPRESSION.

In the U.S., up to 40 percent of people with migraine also have depression. Risk of anxiety, bipolar disorder, and panic disorder are also higher in migraine sufferers. Researchers are still figuring out the connections between mental illness and migraine. While the anticipation of painful symptoms can cause depression and anxiety in some people, experts believe that mental illness is often more than just an effect of living with migraine. The production of the brain chemical serotonin is involved in both migraine and depression. That’s why tricyclic antidepressants designed to increase serotonin levels are sometimes prescribed to treat migraine.

16. A NEW SHOT CAN TREAT MIGRAINE.

Many migraine therapies from the past few decades have been the result of trial and error. Medications designed to treat other conditions, such as antidepressants, epilepsy medicine, and botox, have all been prescribed to migraine sufferers, with mixed results. Earlier in 2018, the first-ever shot made to treat migraines specifically secured FDA approval. The shot, which blocks a peptide linked to migraine, is taken once a month and can improve symptoms or completely eliminate them in some cases. Before the new injection came along, the only other migraine-specific medications patients had to choose from were triptans, which stimulate the neurotransmitter serotonin. They can't prevent migraine, but they can help dampen symptoms by reducing inflammation and constricting blood flow. According to Out of My Head, triptans were first approved more than two decades ago—so new medication options are long overdue.

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11 Facts About the Appendix
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Illustration by Mental Floss / Images: iStock

Despite some 500 years of study, the appendix might be one of the least understood structures in the human body. Here's what we know about this mysterious organ.

1. THE ANCIENT EGYPTIANS CALLED IT THE "WORM" OF THE BOWEL.

The human appendix is small, tube-shaped, and squishy, giving ancient Egyptians, who encountered it when preparing bodies for funerary rites, the impression of a worm. Even today, some medical texts refer to the organ as vermiform—Latin for "worm-like."

2. THE APPENDIX SHOWS UP IN LEONARDO DA VINCI’S DRAWINGS.

The earliest description of a human appendix was written by the Renaissance physician-anatomist Jacopo Berengario da Carpi in 1521. But before that, Leonardo da Vinci is believed to drawn the first depiction of the organ in his anatomical drawings in 1492. Leonardo claimed to have dissected 30 human corpses in his effort to understand the way the body worked from mechanical and physiological perspectives.

3. IT'S ABOUT THE SIZE OF A PINKY FINGER.

The appendix is a small pouch connected to the cecum—the beginning of the large intestine in the lower right-hand corner of your abdomen. The cecum’s job is to receive undigested food from the small intestine, absorb fluids and salts that remain after food is digested, and mix them with mucus for easier elimination; according to Mohamad Abouzeid, M.D., assistant professor and attending surgeon at NYU Langone Medical Center, the cecum and appendix have similar tissue structures.

4. CHARLES DARWIN THOUGHT IT WAS A VESTIGIAL ORGAN …

The appendix has an ill-deserved reputation as a vestigial organ—meaning that it allegedly evolved without a detectable function—and we can blame Charles Darwin for that. In the mid-19th century, the appendix had been identified only in humans and great apes. Darwin thought that our earlier ancestors ate mostly plants, and thus needed a large cecum in which to break down the tough fibers. He hypothesized that over time, apes and humans evolved to eat a more varied and easier-to-digest diet, and the cecum shrank accordingly. The appendix itself, Darwin believed, emerged from the folds of the wizened cecum without its own special purpose.

5. … BUT THE APPENDIX PROBABLY EVOLVED TO HELP IMMUNE FUNCTION.

The proximity and tissue similarities between the cecum and appendix suggest that the latter plays a part in the digestive process. But there’s one noticeable difference in the appendix that you can see only under a microscope. “[The appendix] has a high concentration of the immune cells within its walls,” Abouzeid tells Mental Floss.

Recent research into the appendix's connection to the immune system has suggested a few theories. In a 2015 study in Nature Immunology, Australian researchers discovered that a type of immune cells called innate lymphoid cells (ILCs) proliferate in the appendix and seem to encourage the repopulation of symbiotic bacteria in the gut. This action may help the gut recover from infections, which tend to wipe out fluids, nutrients, and good bacteria.

For a 2013 study examining the evolutionary rationale for the appendix in mammal species, researchers at Midwestern University and Duke University Medical Center concluded that the organ evolved at least 32 times among different lineages, but not in response to dietary or environmental factors.

The same researchers analyzed 533 mammal species for a 2017 study and found that those with appendices had more lymphatic (immune) tissue in the cecum. That suggests that the nearby appendix could serve as "a secondary immune organ," the researchers said in a statement. "Lymphatic tissue can also stimulate growth of some types of beneficial gut bacteria, providing further evidence that the appendix may serve as a 'safe house' for helpful gut bacteria." This good bacteria may help to replenish healthy flora in the gut after infection or illness.

6. ABOUT 7 PERCENT OF AMERICANS WILL GET APPENDICITIS DURING THEIR LIFETIMES.

For such a tiny organ, the appendix gets infected easily. According to Abouzeid, appendicitis occurs when the appendix gets plugged by hardened feces (called a fecalith or appendicolith), too much mucus, or the buildup of immune cells after a viral or bacterial infection. In the United States, the lifetime risk of getting appendicitis is one in 15, and incidence in newly developed countries is rising. It's most common in young adults, and most dangerous in the elderly.

When infected, the appendix swells up as pus fills its interior cavity. It can grow several times larger than its average 3-inch size: One inflamed appendix removed from a British man in 2004 measured just over 8 inches, while another specimen, reported in 2007 in the Journal of Clinical Pathology, measured 8.6 inches. People with appendicitis might feel generalized pain around the bellybutton that localizes on the right side of the abdomen, and experience nausea or vomiting, fever, or body aches. Some people also get diarrhea.

7. APPENDECTOMIES ARE ALMOST 100 PERCENT EFFECTIVE FOR TREATING APPENDICITIS.

Treatment for appendicitis can go two ways: appendectomy, a.k.a. surgical removal of the appendix, or a first line of antibiotics to treat the underlying infection. Appendectomies are more than 99 percent effective against recurring infection, since the organ itself is removed. (There have been cases of "stump appendicitis," where an incompletely removed appendix becomes infected, which often require further surgery.)

Studies show that antibiotics produce about a 72 percent initial success rate. “However, if you follow these patients out for about a year, they often get recurrent appendicitis,” Abouzeid says. One 2017 study in the World Journal of Surgery followed 710 appendicitis patients for a year after antibiotic treatment and found a 26.5 percent recurrence rate for subsequent infections.

8. AN INFECTED APPENDIX DOESN’T ACTUALLY BURST.

You might imagine a ruptured appendix, known formally as a perforation, being akin to the "chestbuster" scene in Alien. Abouzeid says it's not quite that dramatic, though it can be dangerous. When the appendix gets clogged, pressure builds inside the cavity of the appendix, called the lumen. That chokes off blood supply to certain tissues. “The tissue dies off and falls apart, and you get perforation,” Abouzeid says. But rather than exploding, the organ leaks fluids that can infect other tissues.

A burst appendix is a medical emergency. Sometimes the body can contain the infection in an abscess, Abouzeid says, which may be identified through CT scans or X-rays and treated with IV antibiotics. But if the infection is left untreated, it can spread to other parts of the abdomen, a serious condition called peritonitis. At that point, the infection can become life-threatening.

9. SURGEONS CAN REMOVE AN APPENDIX THROUGH A TINY INCISION.

In 1894, Charles McBurney, a surgeon at New York's Roosevelt Hospital, popularized an open-cavity, muscle-splitting technique [PDF] to remove an infected appendix, which is now called an open appendectomy. Surgeons continued to use McBurney's method until the advent of laparoscopic surgery, a less invasive method in which the doctor makes small cuts in the patient's abdomen and threads a thin tube with a camera and surgical tools into the incisions. The appendix is removed through one of those incisions, which are usually less than an inch in length.

The first laparoscopic appendectomies were performed by German physician Kurt Semm in the early 1980s. Since then, laparoscopic appendectomies have become the standard treatment for uncomplicated appendicitis. For more serious infections, open appendectomies are still performed.

10. AN APPENDIX ONCE POSTPONED A ROYAL CORONATION.

When the future King Edward VII of Great Britain came down with appendicitis (or "perityphlitis," as it was called back then) in June 1902, mortality rates for the disease were as high as 26 percent. It was about two weeks before his scheduled coronation on June 26, 1902, and Edward resisted having an appendectomy, which was then a relatively new procedure. But surgeon and appendicitis expert Frederick Treves made clear that Edward would probably die without it. Treves drained Edward's infected abscess, without removing the organ, at Buckingham Palace; Edward recovered and was crowned on August 9, 1902.

11. THE WORLD'S LONGEST APPENDIX MEASURED MORE THAN 10 INCHES.

On August 26, 2006, during an autopsy at a Zagreb, Croatia hospital, surgeons obtained a 10.24-inch appendix from 72-year-old Safranco August. The deceased currently holds the Guinness World Record for "largest appendix removed."

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