Deep Brain Stimulation Helps Partially Paralyzed Individuals Walk Again
Wolfgang Jäger, a 54-year-old from Austria, found himself confined to a wheelchair after a 2006 skiing accident left him with a spinal cord injury. After participating in a clinical trial, he experienced something extraordinary: regained mobility. “Last year while on vacation, I could walk a couple of steps down to the sea and back, using the stimulation,” Jäger shared, describing the newfound freedom provided by deep brain stimulation (DBS).
This cutting-edge treatment, spearheaded by Professors Grégoire Courtine and Jocelyne Bloch at EPFL and Lausanne University Hospital (CHUV), targets a surprise region in the brain: the lateral hypothalamus (LH). This unexpected location had never before been associated with walking control. The discovery, resulting from years of fundamental research and refined surgical techniques, marks a major milestone in the field of spinal cord injury treatment.
DBS traditionally involves implanting electrodes in specific brain regions to modulate neural activity. While commonly used for movement disorders like Parkinson’s disease, its use in treating partial paralysis is novel. By focusing on the LH, researchers tapped into a previously unidentified neural pathway crucial for motor recovery.
The study, published in
Nature Medicine
, revealed both immediate and long-lasting benefits. DBS helped patients walk more effectively during physical therapy, with the improvements persisting even when the stimulation was off. These remarkable outcomes suggest that DBS not only enhances walking during therapy but also fosters a long-term reorganization of remaining nerve fibers, allowing for sustained neurological gains.
“This research shows that the brain is vital for recovering from paralysis,” explains Courtine, professor of neuroscience at EPFL and co-director of the .NeuroRestore center. “Though the brain can’t completely utilize the existing neuronal pathways after a spinal cord injury, we have identified a way to activate this forgotten circuitry,” he adds. This involves engaging a small, previously unknown region in the brain with precise stimulation, enabling patients to regain lost motor function, potentially changing how we approach SCI recovery.
Pushing the Boundaries with DBS
This groundbreaking approach combines groundbreaking neuroscience with refined surgical precision. Researchers relied on detailed brain scans to guide the precise placement of electrodes during surgery. Remarkably, these procedures were performed while patients were fully awake, allowing for real-time feedback. Meat-Bloch, the other co-director of the .NeuroRestore center, describes a pivotal moment: “Once we activated the electrode, the first patient immediately reported feeling movement in their legs. When we increased the stimulation, she exclaimed, ‘I feel the urge to walk!'” This immediate feedback validated their work, confirming they were targeting the right area. This unexpected region, never before linked to locomotion, had been mistakenly overlooked prior to this discovery.
While the LH is traditionally associated with functions like arousal and feeding, this recently discovered
function
in walking is significant.
‘:’The identification of the LH in motor recovery after paralysis is a major scientific breakthrough, says Jordan Squair, a lead author of the study.
To pinpoint the LH’s role, the team employed a novel, multi-faceted approach. They initially mapped the brain to identify its role in walking, followed by preclinical studies to pinpoint the exact neural circuits involved in recovery. These findings paved the way for human trials, proving the effectiveness of this novel approach.
This research sheds light on the remarkable plasticity of the brain
allowing for adaptation and regeneration even after significant injury.
Targeting the Past, Designing the Future
The potential of this discovery extends beyond DBS alone. The team envisions future
How does stimulating the LH bypass damage caused by a spinal cord injury to promote walking recovery?
## A New Dawn for Spinal Cord Injury Patients
**Welcome back to the show! Today, we’re exploring groundbreaking research that offers hope for individuals living with spinal cord injuries.** Joining us is Professor Grégoire Courtine, a leading neuroscientist and co-director of the NeuroRestore center at EPFL and Lausanne University Hospital, who is spearheading this revolutionary treatment.
**Professor Courtine, your team’s recent work using deep brain stimulation (DBS) has shown incredible promise in helping partially paralyzed individuals walk again. Can you tell us more about this exciting discovery?**
**Courtine:** Absolutely. We’ve been focusing on deep brain stimulation, a technique traditionally used for movement disorders like Parkinson’s disease. Our research has identified a surprising new target for DBS: the lateral hypothalamus, or LH. This region, previously not associated with walking control, holds the key to unlocking motor recovery after spinal cord injury.
**That’s fascinating! How does targeting the LH aid in walking recovery?**
**Courtine:** Think of it as activating a dormant pathway in the brain. While a spinal cord injury disrupts communication between the brain and the body, we’ve discovered that the LH can bypass this damage and stimulate remaining nerve fibers. This leads to both immediate improvements during physical therapy and surprisingly, long-lasting benefits even when the stimulation is off.
**We have a powerful testimonial from Wolfgang Jäger, a patient who participated in your clinical trial. He shared an incredible story about regaining the ability to walk down to the sea. What does this tell us about the impact of this treatment?**
**Courtine:** Wolfgang’s story exemplifies the transformative power of this therapy. It shows that DBS doesn’t simply enhance movement during therapy; it fosters a remarkable reorganization of the nervous system, leading to sustained neurological gains. It allows patients to regain a level of independence they thought was lost forever.
**This research is indeed groundbreaking. What’s next for you and your team?**
**Courtine:** Our goal is to make this treatment accessible to a wider population of spinal cord injury patients. We’re continuing to refine our techniques and conduct further clinical trials to fully understand the long-term effects and optimize its application. This discovery has the potential to revolutionize spinal cord injury treatment and offer renewed hope for millions worldwide.
**Thank you, Professor Courtine, for sharing this groundbreaking research with us. We wish you and your team continued success in your pursuit of restoring mobility to those affected by spinal cord injuries. **
** [[1](https://neurosciencenews.com/brain-stimulation-sci-walking-28150/) ]**
