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Marc Gauthier, a 62-year-old man with Parkinson’s disease that had affected his mobility and balance, causing him to walk with difficulty and frequently fall, has experienced significant improvement and can walk normally, with confidence and without falling thanks to a neuroprosthesis that electrically stimulates your spinal cord. This technology has been tested for the first time in a person after the success obtained in tests on non-human primates.
The patient had suffered from Parkinson’s for almost 30 years and other treatments had failed to improve his mobility problems. Now, after using the neuroprosthesis for two years and around eight hours a day, he has recovered his ability to walk. The neuroprosthesis that corrects gait disorders has been designed by Grégoire Courtine and a team of neuroscientists and neurosurgeons from the Federal Polytechnic School of Lausanne, Inserm and the University of Bordeaux, who have published the results of their work in the journal scientific Nature.
“People with advanced Parkinson’s disease often face mobility problems that can have a significant impact on their quality of life and decrease their autonomy. This problem affects approximately 90% of patients and includes muscle rigidity, slowness of movement, freezing of gait, problems starting and stopping movement, and postural instability. These disorders often respond poorly to standard therapies that focus primarily on the areas of the brain directly affected by the loss of dopamine-producing neurons. Therefore, it is necessary to develop new therapeutic strategies that can help solve these problems,” explained Eduardo Fernández, director of the Institute of Bioengineering at the Miguel Hernández University of Elche and director of the Biomedical Neuroengineering group at the Red de Biomedical Research Center. Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), in statements to SMC Spain.
How the neuroprosthesis that helps walking works
The neuroprosthesis is based on directed epidural electrical stimulation (EES) of the lumbosacral spinal cord and modulates the activity of the neurons that control locomotor movements, thus restoring the natural activation of the neurons in the legs that is interrupted when walking in people. with Parkinson’s disease. Previous research has shown that targeted epidural electrical stimulation restores standing and walking functions in people with paralysis caused by spinal cord injury.
After testing this neuroprosthesis in non-human primate models, the researchers conducted a first-in-human trial in a man who had not improved after undergoing different pharmacological and deep brain stimulation therapies. First, they generated a personalized anatomical map of the areas of the spinal cord that would be targeted by targeted epidural electrical stimulation, which guided the surgical implantation of the neuroprosthesis.
They then used wireless sensors worn by the patient to detect their movement intentions and activated stimulation to activate neurons in the legs to generate natural walking movements. The results of the study show that the neuroprosthesis improved gait and balance deficits in this person, who also reported a significant improvement in her quality of life.
“I turn stimulation on in the morning and off at night. This allows me to walk better and stabilize myself. Now I’m not even afraid of stairs anymore. Every Sunday I go to the lake and walk about 6 kilometers. “It’s incredible,” says the man on whom this system has been successfully tested.
“It is impressive to see how by electrically stimulating the spinal cord specifically, as we have done with paraplegic patients, we can correct the gait disorders caused by Parkinson’s disease,” says Jocelyne Bloch, neurosurgeon and professor at the University Hospital. of Lausanne (CHUV).
In the opinion of Eduardo Fernández, “this study introduces a very innovative therapeutic strategy that does not target the brain areas most affected in Parkinson’s disease, but rather other areas of the nervous system that in principle are not affected by this pathology. Specifically, it is the lumbosacral region of the spinal cord that ultimately participates in the control of the muscles of the legs and in generating the act of walking. To this end, they propose synchronizing deep brain stimulation, which is routinely used in many patients with Parkinson’s disease, with the modulation of the activity of the motor neurons located in this lumbosacral area of the spinal cord using epidural electrical stimulation.”
“Thanks to this,” he adds, “a 62-year-old person, affected for more than 30 years by Parkinson’s disease, has experienced a notable reduction in his mobility problems and has also experienced improvements in his balance and tendency to freeze.” of walking, which has resulted in a significant improvement in their quality of life.”
“However, it should be noted that this research was carried out on a single patient, so more studies are still necessary to confirm the effectiveness of this therapeutic approach in a larger number of individuals and to identify those patients who may benefit.” more of this type of neuroprosthesis,” concludes the expert.
In collaboration with ONWARD Medical, Grégoire Courtine and Jocelyne Bloch are working on the development of a commercial version of the neuroprosthesis, which includes all the necessary functionalities for optimal daily use. “Our ambition is to provide general access to this innovative technology to significantly improve the quality of life of Parkinson’s patients around the world,” they explain.
In addition, thanks to a generous donation of one million US dollars from the Michael J. Fox Foundation for Parkinson’s Research, the NeuroRestore center will conduct clinical trials in six new patients next year, which it is hoped will serve to validate the technology developed , but also to identify the patient profiles most likely to benefit from this innovative treatment.
