A patient severely disabled by Parkinson’s disease can now walk almost normally thanks to an electrode system attached to his spinal cord. This is the new achievement of a team of researchers in Lausanne who have already succeeded in getting paralyzed people to walk again.
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“Now (…) I can walk from one point to another without having to worry about how to get there,” summarizes this French patient, Marc, 62, to AFP. “I can go for a walk alone, go shopping. Do what I want.”
AFP
The sixty-year-old, who does not want to give his last name, has been suffering from Parkinson’s disease in a very advanced stage for around thirty years. He could only walk with great difficulty.
This is the case in almost all patients when the disease has progressed significantly. They are particularly affected by “freezing,” a sudden blockage that often leads to falls.
We almost do not know how to treat these symptoms, which leaves patients seriously disabled and ultimately doomed to remain bedridden or in a wheelchair.
Marc’s case is therefore exceptional and the result of a medical masterpiece, more detailed on Monday in the journal “Nature Medicine”. A Swiss research team implanted a complex electrode system, a “neuroprosthesis,” into the spinal cord.
AFP
Result: This neuroprosthesis “reduced walking disorders, balance problems and freezing”, summarizes this work supervised by the surgeon Jocelyne Bloch and the neuroscientist Grégoire Courtine at the CHUV of Lausanne with the support of the Swiss Federal Polytechnic.
The duo is already known for one of the great medical achievements of recent years: their team enabled several paraplegics who had previously lost movement in their legs due to accidents to walk again.
“Tour de Force”
This time they are fighting Parkinson’s disease in collaboration with a third man, a specialist in this pathology: the neurobiologist Erwan Bézard, researcher at INSERM, who first tested this prosthesis on monkeys for several years.
The principle is the same as for paralyzed people. Electrodes are placed at key points in the spinal cord to override brain function.
The accident caused the paralyzed patients to lose contact between their brains and part of their spinal cord. In Marc’s patients and Parkinson’s patients in general, this contact still exists, but it is the brain itself that is functioning poorly due to the progressive disappearance of the neurons that produce a neurotransmitter, dopamine.
AFP
In order to function, Professors Bloch and Courtine’s system does not simply have to send electrical stimuli. It must be able to take over the role of the brain and generate these stimuli at the right time so that the movement corresponds to the patient’s intentions.
“The idea is that we measure the residual movements, that is, the intention to walk, with small sensors attached to the legs,” Grégoire Courtine explained to AFP. “Thanks to this, we know whether the person wants to do an oscillation phase or stop and can adjust the stimulation accordingly.”
With Marc the result is there. The patient can largely return to normal walking, even if this requires great concentration. But can we already talk about a medical revolution that would benefit many Parkinson’s patients?
It is not possible to make a statement for an individual patient, especially since the symptoms of the disease can vary greatly. The team led by Ms. Bloch and Mr. Courtine will therefore continue the experiment on a group of six Parkinson’s patients.
It also remains to be seen whether such an innovation, which is likely to come at a very high cost, can benefit the greatest number of people, while the two scientists have founded a “startup” – Onward – to work on its commercialization. To justify public reimbursement, therapeutic progress must be confirmed as significant.
But Marc’s case already represents a “tour de force” demonstrating the “feasibility” of such an approach, according to other neurologists who commented on the study in the same issue of Nature Medicine.