2023-11-06 18:00:03
Neuroscientists and neurosurgeons from the Federal Polytechnic School of Lausanne (EPFL), the University Hospital of Lausanne (both in Switzerland), and the University of Bordeaux (France) have designed and implanted a neuroprosthesis aimed at improving the gait of patients with Parkinson’s.
In a study published in Nature Medicinethe researchers detail the development process of this implant, from which a first patient with this neurodegenerative disease has benefited and “has allowed him to walk comfortably, with confidence and without falling,” according to the authors.
The study details the details of the implant, from which a first patient has benefited, and which “has allowed him to walk comfortably, with confidence and without falling.”
The team, led by neuroscientist Grégoire Courtine and the neurosurgeon Jocelyne Blochfrom the EPFL, has been researching for years to help people with paralysis problems walk again, after introducing them electronic implants in the spinal cord.
In the present work, they have applied their findings to improve the quality of the gait of Marc, a 62-year-old patient from Bordeaux, who has had Parkinson’s for almost three decades. In 2004, he was treated with dopamine and deep brain stimulation, aimed at improving tremors and rigidity, Courtine and Bloch recall.
However, more recently, he developed severe gait disorders that did not respond to dopamine or brain stimulation. “I practically couldn’t walk anymore without falling frequently, several times a day,” says Marc.
Previous findings applied to Parkinson’s
“The idea of developing a neuroprosthesis that electrically stimulates the spinal cord, with the aim of correcting locomotor disorders in patients with Parkinson’s, is the result of several years of research on the treatment of paralysis due to spinal cord injuries,” Courtine says.
Unlike conventional treatments against this disease, which target brain regions directly affected by the loss of dopamine-producing neurons, This neuroprosthesis is implanted in the area of the spinal cord responsible for activate leg muscles when walkingwhich, apparently, is not directly affected by Parkinson’s.
It is impressive to see how by selectively electrically stimulating the spinal cord we can correct the gait disorders caused by Parkinson’s disease.
Jocelyne Bloch, neurosurgeon (EPFL)
“It is impressive to see how by selectively electrically stimulating the spinal cord, as we have previously done with patients with paraplegia, we can correct the gait disorders caused by Parkinson’s disease,” says Bloch.
The EPFL researchers recognize that the implantation of this neuroprosthesis in the patient would not have been possible without the collaboration of the doctor Erwan Bezardneuroscientist at the French National Institute for Health and Medicine Research (Inserm), affiliated with the University of Bordeaux.
Bezard, they point out, “has dedicated his career to the knowledge of neurodegenerative diseases. His experience in preclinical models of Parkinson’s disease “It was essential to correctly produce the technological and conceptual developments necessary for clinical application in humans.”
“I’m not even afraid of stairs anymore.”
Marc’s intervention was carried out two years ago at the Lausanne University Hospital. There he was implanted with the device, composed of a electrode field, placed in the part of the spinal cord that controls walking, and an electrical impulse generator implanted under the skin of your abdomen.
Thanks to one specific programming of spinal cord stimulations that adapts in real time to his movements, Marc has seen his walking problems quickly subside, the authors highlight.
I turn stimulation on in the morning and off at night. This allows me to walk better and stabilize myself. Every Sunday I go to the lake and walk about 6 kilometers. Is incredible!
Marc, Parkinson’s patient
After several weeks of rehabilitation with the neuroprosthesis, he can now walk almost normally. He currently uses his device about eight hours a day, and only turns it off when he is sitting for a long time or when he is sleeping.
“I turn stimulation on in the morning and off at night. This allows me to walk better and stabilize myself. Right now, I’m not even afraid of stairs anymore. Every Sunday I go to the lake and walk about six kilometers. “It’s amazing!” she comments.
Development of a commercial version
Researchers believe that this neuroprosthetic system opens new possibilities for treat gait disorders suffered by many people affected by Parkinson’s disease, but so far the treatment concept has only proven effective in one person, with an implant that has yet to be optimized for large-scale use.
At the moment the treatment has only proven effective in one person, with an implant that still needs to be optimized for large-scale use, researchers say
In collaboration with the company ONWARD MedicalGrégoire Courtine and Jocelyne Bloch are working on the development of a commercial version of the neuroprosthesis, which includes all the functionalities necessary for optimal daily use.
“Our ambition is to provide general access to this technology to significantly improve the quality of life of Parkinson’s patients around the world,” underline Courtine and Bloch.
Additionally, thanks to the donation of one million dollars from the Michael J. Fox Foundation for Parkinson’s Researchthe center for research and innovation in bioengineering NeuroRestorecreated by Courtine and Bloch, will conduct clinical trials in six new patients next year.
These essays aim not only validate the developed technology in collaboration with ONWARD, but also identify the patient profiles most likely to benefit from this treatment.
Reference:
G. Courtine, J. Bloch et al. “A spinal cord neuroprosthesis for locomotor deficits due to Parkinson’s disease”. Nature Medicine (2023)
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