Every year, around 25,000 people in the Western world become paraplegic and lose the control and sensation of their lower body. Most of these new patients are young males that were very active: Cars and bike accidents, falls, and sports injuries are the main cause of paraplegia. Damage to the spinal cord means that the link between the brain and the muscles it controls is broken. Re-establishing this link is very difficult and often assumed to be impossible, but two Lausanne-based startups have already made impressive progress.

“It is theoretically possible to pilot a human like piloting a machine, by just electrically triggering the right nerves at the right time,” says Vincent Delattre, COO of GTX Medical. “But that is not what we want. Our magic lies in promoting reconnection between the brain and the nerves to restore voluntary movements.”

GTX reinforces existing neural connections to restore brain control over paralyzed body parts. The result of this approach can seem like magic. Nine people with spinal cord injury managed to get out of their wheelchairs and learned to walk again in a feasibility study. Early clinical results were published by EPFL in the prestigious Nature journal in 2018. Currently, the team is preparing a second, larger study. Although some studies still need to be conducted, the company’s technology has received the ‘breakthrough device designation’ from the US Food and Drug Association (FDA), allowing patients to already make use of the device while the FDA is still reviewing it.

Viagra cannot help when nerves are damaged

Being able to walk again must seem like the most wonderful cure for a paraplegic. But especially for young patients, a different dream is even more prominent. Regaining the ability to have sex is one of the number one priority for paraplegic patients, researchers have found.

The two solutions for this need that are available right now are both painful and expensive. Injecting a serum into the penis with a syringe shortly before having sex is a mood killer. Implanting a gel pad that regularly causes infections and can cost up to USD 25’000 doesn’t sound very attractive either, but the demand for these treatments is there. And Viagra cannot help when nerves are damaged, which often happens during routine surgeries such as prostate removals. Every year, doctors remove cancerous prostates of around 400’000 mainly older patients in the US and EU. Adding up all of these cases, Viagra can’t cure the impotence of more than 22 million men in the Western world alone.

A novel technology promises help. Scientists at Comphya, another EPFL spin-off with offices right next to GTX, offer patients a nerve stimulator allowing them to “have a natural erection by pushing a button,” as Rodrigo Fraga-Silva explains. The 37-year old neuroscientist heads the company and currently prepares the pilot clinical trials which are about to start in the US and Europe in 2021.
His research team had their main breakthrough when they localized the nerves leading to the penis. “In monkeys and mice, you can easily see the nerves. In humans, they just look like the tissue around them. That’s why nobody has found them so far,” he says. Comphya connects electrodes to the nerves and gives the patient a wireless activation button. “Pushing the button excites the nerves and builds up an erection. Pushing it again switches it off – all natural,” Rodrigo explains.

Comphya’s scientists are now preparing a biocompatibility study and a pre-clinical study and work with a large med-tech production partner to assemble the first devices. These are necessary steps to be able to start a clinical study that will be undertaken with the goal to get regulatory approval from the FDA for Comphya’s device. This approval process will take time, but it seems that at least some relief for paraplegics is on the horizon.