Disease stabilisation and wider motor capacity in motor neurone disease

History

Motor neurone disease was diagnosed at the beginning of 2023, though the first motor symptoms had appeared earlier.

Electrophysiological studies showed widespread neurogenic involvement with chronic and ongoing denervation in the arms, legs and thoracic musculature. The most marked changes were initially in the legs.

Despite the treatment given, the disease continued to progress. By January 2025 neurological examination found marked generalised muscle hypotonia and wasting in all four limbs. Active movement in the legs was virtually absent, and only isolated movements of low power remained in the arms.

The motor and respiratory deficit continued to increase thereafter.

Before treatment

By the time of the programme the patient's condition was one of severe functional limitation.

The main problems were:

• marked tetraparesis, considerably more severe in the legs
• no active movement in the legs
• marked muscle wasting
• substantially restricted arm movement
• dysphagia, which had required a PEG for feeding
• dysarthria
• a weakened cough
• marked respiratory impairment requiring non-invasive ventilatory support

Immediately before the programme the rehabilitation specialists noted markedly reduced muscle bulk in the arms and legs and no active movement in the legs. The patient required round-the-clock non-invasive ventilation. Active movement was retained to a limited extent mainly in the arms and neck.

In this situation the main aim of treatment was above all to stop further functional deterioration, preserve the motor reserve that remained and try to widen active movement.

The programme

A personalised allogeneic cell and neuroregenerative programme was designed for the patient.

The protocol included several complementary directions:

• therapy with mesenchymal stromal cells
• use of regulatory T cells
• systemic and neurally targeted cell components
• concentrated exosome therapy
• intranasal peptide support
• two sessions of electrical neurostimulation

The exact doses, sequence and technical details of the procedures formed part of an individual internal protocol.

Course after treatment

One of the most important results of the follow-up was stabilisation.

The steady deterioration seen previously was no longer observed. More than that, the specialists who worked with the patient regularly in rehabilitation began to record a widening of his motor capacity.

Motor function

Positive change was already recorded in December:

• strength and the number of active movements of the fingers of the left hand increased
• movements of individual fingers and of the wrist appeared that had been absent before
• active movement at the left elbow and shoulder grew stronger
• minimal active movement of the toes of the left foot appeared

The improvement continued thereafter.

By January the specialists noted a further widening of active movement:

• strength and coordination of the left hand, wrist, elbow and shoulder girdle improved
• movement appeared and grew stronger in the right arm
• active movement appeared in the left leg, including movement at the hip and in the toes

It is particularly important that at the same time there was no further decline in muscle bulk.

Respiratory function

Positive change was noted in breathing as well.

Whereas before treatment the patient required round-the-clock non-invasive ventilation, it later became possible for him to breathe unaided for short periods – up to an hour.

The volume achieved with a breathing trainer also rose, to 300 ml.