2023-11-06 16:16:33
Severely disabled by his Parkinson’s disease, a patient can now walk almost normally thanks to a system of electrodes attached to his spinal cord. This is the new feat of a team of researchers in Lausanne, who had already succeeded in getting paralytics to walk once more.
“Now, (…) I can walk from one point to another without worrying regarding how I’m going to get there,” summarizes this French patient, Marc, 62, to AFP. “I can go for a walk, go shopping alone. Go do what I want.”
AFP
This sixty-year-old, who does not wish to give his last name, has been suffering from Parkinson’s disease for around thirty years, at a very advanced stage. He was no longer able to walk except with great difficulty.
This is the case for almost all patients when the disease has progressed significantly. They are particularly affected by “freezing”, a sudden blockage which often causes a fall.
We almost do not know how to treat these symptoms which end up seriously handicapping patients, ultimately condemned to remain bedridden or in a wheelchair.
Marc’s case is therefore exceptional and the result of a medical feat, detailed Monday in the journal “Nature Medicine”. A Swiss team of researchers implanted a complex system of electrodes, a “neuroprosthesis”, on the spinal cord.
AFP
Result: this neuroprosthesis “reduced walking disorders, balance problems and freezing”, summarizes this work supervised by surgeon Jocelyne Bloch and neuroscientist Grégoire Courtine within the CHUV of Lausanne, with the support of the Federal Polytechnic.
The duo is already known for one of the great medical exploits of recent years: their team made several paraplegics who had previously been deprived of all leg movement following accidents walk once more.
“Tour de force”
This time, they are tackling Parkinson’s disease in collaboration with a third man, a specialist in this pathology: the neurobiogist Erwan Bézard, researcher at INSERM, who first tested this prosthesis for several years on monkeys.
The principle is the same as for paralytics. Electrodes are placed at crucial points in the spinal cord to override the action of the brain.
In the case of the paralytics, their accident had interrupted contact between the brain and part of the spinal cord. In patient Marc and Parkinson’s patients in general, this contact still exists, but it is the brain itself which functions poorly due to the progressive disappearance of the neurons generating a neurotransmitter, dopamine.
AFP
To work, Professors Bloch and Courtine’s system must therefore not simply send electrical stimulations. It must be able to assume the role of the brain by generating these stimulations at the right time so that the movement corresponds to the patient’s intentions.
“The idea is that we are going to measure the residual movements, therefore the intention of walking, with small sensors which are located on the legs,” Grégoire Courtine explained to AFP. “Thanks to this, we know if the person wants to do an oscillation phase or stop, and we will therefore adjust the stimulation accordingly.”
At Marc, the result is there. The patient has largely regained the normal use of walking, even if this requires great concentration. But, beyond that, can we already talk regarding a medical revolution that would benefit many Parkinson’s patients?
It is impossible to tell from a single patient, especially since the manifestations of the disease can be very variable. The team of 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, probably at a very high cost, will be able to benefit the greatest number of people, while the two scientists have launched a “startup” – Onward – to work on its commercialization. To justify public reimbursement, the therapeutic advance must be confirmed as major.
But Marc’s case already constitutes a “tour de force” which demonstrates the “feasibility” of such an approach, according to other neurologists who commented on the study in the same issue of Nature Medicine.
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