Parkinson’s patient walks again with spinal implant – 11/06/2023 – Balance and Health

A 62-year-old man with mobility difficulties due to Parkinson’s disease was able to regain movement in his legs and walk normally after a spinal cord implant.

The patient, Marc, lives in Bordeaux, France, and was diagnosed with Parkinson’s 28 years ago. He underwent medication and other therapies to help reduce symptoms associated with the loss of neurons linked to locomotion and balance, but to no avail.

As the disease progressed, Marc needed other treatments, such as deep brain stimulation, which consists of implanting some electrodes in the brain and electrically stimulating affected areas with low production of the neurotransmitter dopamine.

However, he continued to present symptoms such as “freezing of gait”, where, for a period of varying duration, despite the intention to walk, the feet and leg muscles “do not obey” commands. brain.

Thus, the implants were placed to receive so-called epidural electrical stimulation (EES) and be able to resume walking naturally. The device turns on when he is moving and turns off at bedtime.

Marc was the first human patient treated following a preclinical trial using nine animal models (Rhesus monkeys) with Parkinson’s disease in the laboratory. The results were published this Monday (6) in the scientific journal Nature Medicine.

The research is in collaboration with Jocelyn Bloch and Eduardo Morad, from Neurosurgery at the University Hospital of Lausanne (Switzerland); neuroscientist Grégoire Courtine, from the Federal Polytechnic School of Lausanne and other researchers from both institutes. The scientists are part of the NeuroRestore program, founded in 2018 and supported by the Defitech Foundation.

According to the authors, EES is a safe, minimally invasive therapy that has been approved for use since the 1990s in patients who have suffered spinal cord injuries and thus experience paralysis.

The EES directly stimulates the spinal cord nerves linked to the muscles of the lower limbs, generating impulses. Unlike robotic exoskeletons, it is the patient’s own leg that will perform the locomotion function. As the system connects to different regions of the limb, walking is as natural as possible.

In addition to the impulses in the spine, the movements were monitored by a brain MRI to see the areas of the brain activated with the movement.

According to Bloch, many of the patients she treated had “freezing” walking, which can lead to frequent falls. “In response to spinal cord stimulation, we saw for the first time significant improvements in the type of locomotor decline seen in Parkinson’s patients,” she says.

So far, a single treated patient represents the so-called “proof of concept”, but other participants must be included in clinical trials to, after this stage, approve the therapy for large-scale use.

Scientists are moving towards carrying out tests on six other patients, says Courtine. “The therapy is based on the type of spinal stimulation already used for patients with spinal injuries due to accidents adapted for Parkinson’s. A natural next step is to increase the number of individuals to be able to reproduce a treatment that can be applied to other patients”, he points out. she.

If it depends on improving the quality of life of patients, there is great hope with the new therapy. According to Marc, he was “reborn a second time” with spinal implants. “I had my first rebirth 20 years ago when I had deep brain stimulation, but unfortunately I had a deterioration in symptoms in recent years, which caused many falls. Two years ago, spinal stimulation significantly improved my daily life” , he says.

According to Eduardo Morad, a neurologist engineer, the technology has the advantage of being adaptable. “There is no single formula. Some people may improve with medication, others with brain stimulation and others with spinal implants. There is also no rule that only those who have already undergone brain stimulation can receive the implant. And, most importantly, it is a complementary therapy”, he states.

“Marc already has advanced Parkinson’s, and so far we have seen a significant improvement in his condition. This is very encouraging”, concludes Morad.

The researchers’ expectation is to submit a request for authorization for the clinical trial by April of next year and, if possible, start treatment by the end of 2024.

The team received support of US$1 million (about R$5.1 million) from the Michael J. Fox Foundation, the largest philanthropic fund for Parkinson’s research, created by the “Back to the Future” actor, who lives with the disease.