“Next step: learning how we can repair injured spinal cord”

Jordan Squair has long been driven by the goal of developing therapies to improve patients’ lives – an ambition that prompted him to enroll in medical school. As an MD/PhD student, his research focused on alleviating the consequences of spinal-cord injury. Then in 2018, Squair took an opportunity to see how his findings could be applied directly to patients by accepting a postdoc position at EPFL’s G-Lab UpCourtine, headed by Prof. Grégoire Courtine. That lab is working to develop systems that give paralyzed people the ability to walk again. In that role, Squair has helped design implants for spinal-cord stimulation and saw first-hand the surgeries carried out by Jocelyne Bloch, a Swiss neurosurgeon, to place implants inside an initial cohort of patients. “Seeing the implants work and watching patients’ lives get better day after day has been an incredible experience,” says Squair.

During his MD/PhD program in Vancouver, in his native Canada, Squair developed expertise in the mechanisms of blood-pressure control. These skills have been a valuable contribution to Courtine’s lab: while spinal-cord stimulation aims to restore motor function in people with paralysis, these individuals also suffer from a range of other symptoms that can have potentially dire consequences. One such symptom is a type of low blood pressure known as orthostatic hypotension. Patients suffering from orthostatic hypotension can experience lightheadedness or dizziness after moving even the smallest bit, and they sometimes need to remain bedridden.

At EPFL, Squair is looking at how spinal-cord stimulation via implants can be used to regulate blood pressure and ease these symptoms. The method has proven to be robust – it was tested initially on primates and later on a patient whose orthostatic hypotension was so severe that she couldn’t remain standing for more than a few minutes at a time. With the implant, the patient was able to stand up and walk hundreds of meters. “So far, she hasn’t had any more fainting episodes despite the progression of her condition,” says Squair.

He adds: “I chose to study medicine in order to improve patients’ lives and help them do things and enjoy experiences they wouldn’t be able to without our research. And the more patients who can benefit from our discoveries, the bigger impact we can have and the more meaningful our work will be.” As the recipient of an Ambizione grant from the Swiss National Science Foundation, Squair will be able to expand his impact both at Courtine’s lab and through the work he’s doing with ONWARD Medical, an EPFL spin-off that has developed a spinal-cord stimulation therapy to restore movement and autonomic functions in people with neurological disorders.

Squair points out that while neuroprosthetics can give patients a better quality of life, they can’t cure the underlying injury. “Now we want to focus on studying possible biological methods to repair the spinal cord,” he says. This will entail drawing on Squair’s knowledge of bioinformatics and gene therapy to examine how individual cells respond to spinal-cord injury. “Once we understand that, we plan to restore the cells to their initial state,” he says.