(October, 2024) Annalisa Heiss came to Miami as a 16-year-old to enroll in a peripheral nerve injury clinical trial after a car accident and returned as a college student in the Henry G. Steinbrenner Scholars Program.
In 2019, Annalisa Heiss was in a car accident in her home state of Georgia. It left the then 16-year-old with a significant injury to her leg from a wooden pole that had punctured her groin.
For many months, “it was painful because my knee wasn’t functioning,” Annalisa said. “I had to lock my leg to walk with sort of a limp. The leg fatigued a lot. Because it affected a nerve, I experienced tingling and numbness.”
Her physical therapist recommended a clinical trial in Miami.
Eager to recover and regain her quality of life, Annalisa and her parents made the trip to South Florida to learn more about the research study. She was evaluated by Allan Levi, M.D., Ph.D., a renowned spine and peripheral nerve injury surgeon and professor and chair of neurological surgery at the University of Miami Miller School of Medicine. Dr. Levi is the trial’s principle investigator.
“Annalisa had a lot of soft-tissue injury and was left partially paralyzed in the quadriceps muscle of one leg. In Georgia, she received physical therapy for strengthening, but the muscle wasn’t going to recover without nerve repair. Her nerve was fully transected, so the nerve ends couldn’t regrow together,” said Dr. Levi, also the Robert M. Buck Distinguished Chair in Neurological Surgery.
Dr. Levi and other researchers with The Miami Project, a Center of Excellence at the Miller School, are developing new treatments for traumatic spinal cord and brain injury, peripheral nerve injury and neurodegenerative disorders. Their clinical research study evaluates the safety and efficacy of injecting a patient’s own Schwann cells, along with nerve autograft, following a severe injury to a major nerve.
Annalisa met the criteria to enroll in the trial, which includes having a large-diameter peripheral nerve injury with a large gap — an injury that cannot be successfully repaired with traditional techniques.
Before her accident, Annalisa was an athlete in high school. “I ran track and played softball and basketball,” she said. “Now I’m in college in Georgia, studying biochemistry. While I can’t play competitively at the collegiate level because of this injury, I do play just for fun. I can play basketball and run. I can walk, lift heavy and do a lot of active things. I’ve made very close to a complete recovery — maybe a 95% recovery — and I’m very happy with it.”
The experimental treatment and expert care she received from The Miami Project marked the beginning of her interest in studying medicine, engaging in medical research and conducting life-changing surgical interventions.
“We began with a biopsy of a sensory nerve to grow Annalisa’s Schwann cells,” Dr. Levi said. “After her cells cooked in our laboratory for a few weeks, she returned for the repair, consisting of the nerve grafts plus her own Schwann cells.”
Dr. Levi and The Miami Project team took part of Annalisa’s sural nerve from her right leg to graft into the femoral nerve on her left leg.
Annalisa started to experience some motor improvement about 12 to 14 months post-repair. She continued to improve over time as more axons regenerated and the nerves regrew to the muscle.
“One day, my motor function just came back without me really noticing it. Then I noticed my knee extension coming back. Most of my motor function returned after two years,” Annalisa said. “When I was going into the surgery, I didn’t expect much progress from it because my physical therapist had warned me that most people who suffer with nerve transections like this just don’t have any motor function because it’s very hard to get it back. But once a little of my motor function returned, my motivation to start working on it in physical therapy came back, and that brought along a lot of progress.”
What makes her story so interesting, Dr. Levi said, is not only her treatment and recovery but also her medical school ambitions.
“I’m so pleased that the experience inspired Annalisa’s interest in medical school,” he said. “Five years after her participation in our trial, she returned as a research intern with The Miami Project’s Scholars Program.”
Annalisa spent 10 weeks this past summer participating in the Henry G. Steinbrenner Scholars Program, which empowers undergraduate student scholars to actively participate in every step of the research cycle to answer the questions that drive their summer projects.
“The scholars program was a nice way to introduce me to the research side of medicine because I’ve always been the patient,” Annalisa said. “I worked directly under Dr. James Guest in his lab. It was great to see the researcher and clinician side and learn how they run clinical trials like the one I was in.”
David W. McMillan, Ph.D., director of education and outreach with The Miami Project and research assistant professor of neurological surgery at the Miller School, oversees the program. He said that Annalisa returning to the Miller School as a summer scholar was a “full-circle return” to the experience that launched her journey.
“In her interview, Annalisa clearly articulated how her positive experience receiving a peripheral nerve surgery, combined with an experimental therapeutic from our neurosurgical team, inspired her desire to pursue a career in medicine,” Dr. McMillan said. “As an educator, I see the greatest potential when academic achievement and lived experience align in such a way.”
In Dr. Guest’s lab, Annalisa conducted neuromodulation research as part of a pivotal clinical trial that will likely result in the licensing of a transcutaneous spinal cord stimulation (tSCS) device for upper extremity, arm and hand movement in paralyzed people.
“Annalisa’s research expanded on this research,” Dr. McMillan said, “measuring signals from the brain via transcranial electroencephalography during tSCS paired with a hand-grasping task. Her results confirmed that, during tSCS grasping, coordination was improved — results we expected — and added the finding that brain signals during tSCS plus grasp were stronger than during grasp alone. This finding suggests that the improved grasp coordination with tSCS is not just due to output from the cord to the muscles, but also involves the brain.”
“The scholars program opened my eyes to the types of fields that are available to researchers,” Annalisa said. “In high school, I didn’t have any interest in medicine. But my doctors, physical therapist and the clinicians who treated me, their attitude about their careers and toward medicine itself, is what really brought me closer to studying medicine myself. Now, my plan is to get into medical school, and I’m pretty sure I want to go into some type of surgery.”
By Dana Kantrowitz