Could people with Parkinson’s disease soon regain smooth walking? This is what we hope from the results of a study published in the journal Nature Medicine. Neuroscientists from Inserm, CNRS and the University of Bordeaux, as well as Swiss researchers and neurosurgeons, have developed a neuroprosthesis intended to correct the walking disorders present in 90% of people with an advanced stage of this disease . The results of the test carried out on a first patient are promising.
To compensate for falls and the phenomenon of freezing, when the feet remain glued to the ground while walking, the team has developed a neuroprosthesis. This accessory is made up of two parts. On one side is a field of electrodes placed against the region of the spinal cord that controls walking. On the other, an electrical pulse generator implanted under the skin of the abdomen. By electronically stimulating the area of the spinal cord responsible for activating the leg muscles, this prosthesis allows the patient to precisely control a limb or part of their body.
Return to almost normal walking
“Previous attempts to stimulate the spinal cord failed because they stimulated the locomotor centers as a whole,” explain Grégoire Courtine and Jocelyne Bloch, co-directors of NeuroRestore, the research center based in Switzerland. In this case, it is a stimulation which superimposes on the natural functioning of the neurons of the spinal cord by stimulating, with spatiotemporal coordination, the different muscle groups responsible for walking. »
The researchers developed and tested the neuroprosthesis on a non-human primate model, reproducing the locomotor deficits linked to Parkinson’s disease. The results were conclusive. Not only did the device make it possible to reduce locomotor deficits, but it also helped the primate to restore its walking capacity by reducing the phenomena of freezing.
Development of a commercial version
This promising test paved the way for clinical development to test the device in a patient. Marc, 62 years old, almost thirty of whom had the disease, was the first patient tested. Two years ago, the man from Bordeaux went to the Vaud university hospital in Lausanne to be fitted with the new neuroprosthesis. Thanks to the targeted programming of spinal cord stimulations which adapt in real time to his movements, Marc quickly saw his walking problems fade away. After a few weeks of rehabilitation with the implant, he regained almost normal walking.
This first promising result therefore offers new hope in the treatment of gait disorders due to Parkinson’s disease, the latter often resistant to currently available treatments. “However, at this stage, this therapeutic concept has demonstrated its effectiveness in a single person, with an implant which must still be optimized for large-scale deployment,” explains Inserm.
New clinical trials on a larger number of patients are due to start next year.