Three paraplegics can walk again thanks to a promising Swiss implant – rts.ch

The image had gone around the world at the end of 2018. David Mzee, a patient paraplegic in a sports accident that caused partial damage to his spinal cord, left his wheelchair to start walking with the help of a a walker. Reactivation of the spinal cord with electrical stimulation gave the first evidence of its relevance.

David MZee crosses the start line during the sixth edition of the Wings for Life World Run in Zug on May 5, 2019. [Romina Amato / Red Bull Content Pool – AFP]>> Read also: Paraplegic walks with electrical stimulation

Three years later, a new step was taken by the teams of Grégoire Courtine, neuroscientist at the Ecole polytechnique fédérale de Lausanne (EPFL), and Jocelyne Bloch, neurosurgeon at the Center hospitalier universitaire vaudois (CHUV), who presented new results in review NatureMedicine.

Thanks to the development of implants optimized to stimulate the region of the spinal cord that controls the muscles of the trunk and legs and new software incorporating artificial intelligence, three patients who suffered a complete spinal cord injury are now able to walk outside the laboratory, the two Lausanne institutions said on Monday.

>> Listen to CQFD:

A long rehabilitation

“Our stimulation algorithms continue to imitate nature”, explains Grégoire Courtine. “The new flexible implants that we place under the vertebrae in contact with the spinal cord are able to modulate the neurons that regulate the activity of specific muscle groups. We can thus activate the spinal cord as the brain would naturally do to stand up, walking, cycling or swimming”, adds the researcher.

Michel Roccati, an Italian patient who suffers from complete paraplegia following a motorcycle accident 4 years earlier, received the new implant in 2020. “At the beginning, after the operation, I was already able to move the muscles. The very first steps were really incredible, unexpected,” he said during a press briefing organized by the publisher of the scientific journal.

An intensive training program will help develop mobility. “Every day, I walk about two hours. My training now aims to improve my way of walking, faster and more fluid”, testifies Michel Roccati in the 7:30 p.m. “At the moment I can do 500 meters. I should be able to do a kilometer this summer.”

“There is no miracle, everything is not perfect, and rehabilitation is an important element,” said Grégoire Courtine. There are also differences according to the type of lesion, the age or even the motivation of the patient.

An improved implant

“Key to these advances has been being able to insert a longer and wider implant, with electrodes arranged to precisely match the nerve roots in the spinal cord that allow us to access the neurons controlling the muscles,” says Jocelyne Bloch. This allows more selectivity and precision in controlling the motor sequences associated with each activity.

“In a single day after the activation of their implant, our three patients could stand up, walk, pedal, swim and control trunk movements”, adds Grégoire Courtine. This is thanks to stimulation programs specific to each type of activity, which can be selected on demand on a tablet, and then generated by a pacemaker implanted in the abdomen.

It was after a few months that the progress proved to be the most spectacular. A training program allowed patients to regain muscle mass, increase their autonomy of movement, and reconnect with certain social activities, such as sharing a drink standing up at a bar, for example.

Thanks to the miniaturization of equipment, these training sessions can take place outdoors and not just in a laboratory. However, they are still considered too complex and one of the next steps will be to connect the stimulator directly to a smartphone, noted Grégoire Courtine.

The goal is to have an easy-to-use technology with implementation as soon as possible after the injury, which promotes recovery. Personalized electronics are also being considered, according to the specialist. No side effects, pain or otherwise, were recorded, reports Jocelyne Bloch. The electrode should be implanted in the patient for life, while the pacemaker should be changed approximately every ten years.

>> The presentation video of this promising new implant:

A “new hope”

Invited at 7:30 p.m., the scientists behind the project were delighted with the progress that this implant represents. “We are raising new hope of having a treatment that applies to everyone,” said Jocelyne Bloch.

For this technology – which consists of stimulating the spinal cord in real time using a small computer implanted in the abdomen – to be used on a larger scale on other patients, clinical trials must first be carried out and validated on “at least 50 to 100 people”, explained Grégoire Courtine.

The neuroscientist estimates that the technology, if validated, should be available to the world within two years. The two specialists point out, however, that the implant requires stimulation to function, otherwise nothing happens in people suffering from complete paraplegia.

Improvements in motor skills were however observed in the three patients in the study after training, reports Jocelyne Bloch. “But it’s important to have the stimulation on to be able to move forward.”

>> See the full interview with Jocelyne Bloch and Grégoire Courtine in 7:30 p.m.:

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