Groundbreaking spinal cord implant significantly improves mobility for Parkinson's patients: A groundbreaking study
Revolutionary spinal cord implant transforms the life of Parkinson's patient Marc Gauthier, living with the disease for 30 years, can now effortlessly perform daily activities once hindered by stiffness and freezing An exciting breakthrough!
Marc Gauthier is no longer paralyzed when he enters an elevator. He can now walk three miles by the lakeside without needing to take breaks. Getting up from a chair is no longer a struggle for him. Despite living with Parkinson's disease for nearly 30 years, these daily activities have become easier for Gauthier.
"Walking through a store used to be incredibly difficult, almost impossible, because I would frequently experience freezing of gait in those environments. But now, it no longer happens. The freezing has completely stopped," said Gauthier during a news briefing, speaking in French, which was then translated to English.
In a recent study, Gauthier underwent surgical implantation of an innovative neuroprosthesis for the spinal cord. Designed to address walking impairments in individuals with Parkinson's disease, this experimental procedure has progressively restored his ability to walk with confidence.
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The neuroprosthesis described in a study published in the journal Nature Medicine on Monday focuses on specific regions of the spinal cord associated with walking, effectively addressing the challenges of gait and balance deficits in Parkinson's disease. Dr. Eduardo Moraud, a researcher at Lausanne University Hospital in Switzerland and an author of the study, emphasized the heterogeneity and variability of these deficits across patients, affecting not only walking but also symmetry, balance, and posture.
"The neuroprosthetic approach developed here revolutionizes the treatment of Parkinson's disease, offering personalized solutions to address specific problems faced by individual patients," stated Moraud. "This cutting-edge technique operates in real time and seamlessly complements existing therapies."
Parkinson's disease, a degenerative brain disorder, results in the deterioration of certain brain regions. Impairment or loss of nerve cells in the basal ganglia area, responsible for movement control, leads to symptoms related to walking. These cells normally produce dopamine, and their dysfunction hinders a person's motor abilities, including movement, walking, and balance. Approximately 90% of Parkinson's patients experience locomotor deficits. While a cure for Parkinson's disease is currently unavailable, certain treatments like deep brain stimulation or medications to boost dopamine levels can alleviate symptoms.
Marc Gauthier, 63, who has Parkinson's disease, was treated with a spinal cord neuroprosthesis for his locomotor symptoms.
Gilles Weber from CHUV
Gauthier, a father of two, received a Parkinson's diagnosis at the age of 36. Initially, he underwent dopamine replacement therapy and later opted for deep brain stimulation in 2004 to alleviate tremors and stiffness. However, as the disease advanced, he experienced severe walking impairments that did not improve with either treatment. Gauthier frequently experienced stiffness in his body and endured an average of four falls per day, leading him to discontinue his career as an architect.
Gauthier initially rejected the invitation to take part in the study evaluating the experimental neuroprosthesis for the spinal cord due to the time commitment. However, he later reconsidered, took a leap of faith, and agreed to participate.
Stimulating the spinal cord
To create the implant, scientists from various countries including France and Switzerland, as well as other research institutions globally, utilized visualization and mapping techniques. Their goal was to identify specific areas in the lower spinal cord that the neuroprosthesis should focus on with electrical stimulation. The aim of this stimulation is to alleviate gait impairments and balance issues in patients with Parkinson's disease.
Moraud explained, "Our focus is on the spinal cord, particularly the region responsible for coordinating leg movements."
The scientists pinpointed six areas of high activity for promoting walking. Subsequently, they inserted a set of electrodes along the lower section of Gauthier's spinal cord to specifically target these regions. These electrodes were connected to a neural stimulator positioned beneath the skin in the abdominal area. This stimulator was programmed to administer electrical stimulation to the spinal cord.
Brain showing Parkinsons disease
Peter Dazeley/Photodisc/Getty Images/FILE
Neurosurgeon Dr. Jocelyn Bloch, a study author and professor at Lausanne University Hospital, highlighted the discreet nature of the connection between the electrode and stimulator, concealed under the skin, which allows remote control over the device.
The surgery took place at Lausanne University Hospital approximately two years ago. Following a few months of rehabilitation with the neuroprosthetic stimulation, Gauthier has successfully regained the capacity to walk autonomously through the use of the implant. Additionally, he now has the choice to utilize sensors on his legs that further enhance the stimulation. By synchronizing epidural electrical stimulation to his movements, the signals received from these wearable sensors can reinforce and optimize his overall mobility.
In their study, the researchers stated that the neuroprosthesis, which relies on epidural electrical stimulation, has proven effective in enhancing stride length, improving balance, and reducing gait freezing. Gauthier now utilizes the neuroprosthetic for approximately eight hours per day. He activates the stimulator in the morning and deactivates it when he is sedentary or asleep for extended periods. Gauthier mentioned during the news briefing that he experiences a slight tingling sensation in his legs due to the stimulation. However, this does not bother him, and he joked that his wife is delighted that he can now venture outdoors independently, giving her the opportunity to enjoy some peaceful time at home.
However, it should be noted that this is not a complete cure for the condition. The researchers anticipate that the progression of his Parkinson's disease will continue.
"While this spinal cord stimulation does yield some positive results, we are still faced with the challenge of managing increasingly severe symptoms," Bloch explained. "Nevertheless, through this therapy, we can offer him a modest improvement in his quality of life."
An exciting development
According to Dr. Svjetlana Miocinovic, a neurologist specializing in Parkinson's disease and associate professor at Emory University School of Medicine, this proof-of-concept study is both "exciting" and "impressive."
"This is an exciting development as better treatments for gait and balance impairment in PD are desperately needed," said Miocinovic, who was not involved in the new research.
Michael J. Fox is interviewed by Jane Pauley on CBS "Sunday Morning."
From CBS Sunday Morning/YouTube
Michael J. Fox refers to Parkinson's disease as a relentless thief, as revealed in a recent candid interview. He emphasized the significance of establishing that the observed improvement in gait in this study is indeed a result of spinal stimulation, by comparing it to sham stimulation. Furthermore, proving that this benefit can be replicated in other Parkinson's patients and effectively implemented in clinical practice is essential. The technology also needs to be simplified for the convenience of healthcare providers and patients.
According to David Dexter, director of research at Parkinsons UK, this technology should be tested in a larger sample size of people with Parkinson's disease. It is essential to include individuals who have not previously undergone deep brain stimulation as a therapy. In a statement distributed by the UK-based Science Media Centre, Dexter emphasized the need for clinical trials to assess the potential benefits, side effects, and risks of this experimental therapy. He highlighted that although the technology has only been tested in one Parkinson's patient who already had deep brain stimulation, it is crucial to expand the scope of testing to gain a better understanding of its effectiveness in a broader population.
"This procedure is considered invasive, but it has the potential to revolutionize the treatment of advanced Parkinson's by restoring movement when conventional drugs are no longer effective," he mentioned. "Although this research is still in its preliminary stages and requires extensive further development and testing, it represents a significant and promising advancement. We anticipate rapid progress in this research and its eventual availability to individuals with Parkinson's." Subscribe to CNN Health's weekly newsletter now.
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According to Moraud, a second patient has already begun the therapy process, as stated in the news briefing. Additionally, the researchers plan to conduct clinical tests on six more patients with Parkinson's disease next year. This research is being supported by a generous $1 million donation from the Michael J. Fox Foundation. Bloch and Grégoire Courtine, an author of the study and professor of neuroscience at Lausanne University Hospital, are collaborating with ONWARD Medical, a Netherlands-based medical technology company, to develop a commercial version of the neuroprosthesis.
Courtine stated during the news briefing that the plan is to proceed with a larger scale clinical trial to effectively validate the therapy, following the initial phase. He further mentioned that this ongoing research will require a significant amount of time, estimating a minimum of five years for its development and testing.
