Game-changing Parkinson’s implant ‘REBIRTHS’ patients by helping them walk normally again without freezing and falling
Spinal cord stimulation could help people with Parkinson’s to walk normally again, without freezing and falling.
Around 153,000 people in Britain live with Parkinson’s disease, and one in 37 people will be diagnosed with it in their lifetime.
Starting with slowness of movement and stiffness, this causes walking problems in about 90 percent of people. Comedian Billy Connolly, who has Parkinson’s, described last month how ‘fed up’ he is at losing his balance, falling and needing a walking stick to get around.
However, there is now hope through spinal cord stimulation, which can activate movements in the legs.
Marc Gauthier, 63, who has suffered from Parkinson’s disease for 28 years, fell five to six times a day, had poor balance, often froze in one place when he tried to walk, and was afraid of climbing stairs.
Marc Gauthier was forced to stop working as an architect three years ago because his condition made it very difficult for him to walk
Neuroscientists and neurosurgeons have designed a neuroprosthesis – a spinal implant – that allows Mr Gauthier to walk comfortably, confidently and without falling
How does the implant work?
Conventional treatments for Parkinson’s disease target the areas of the brain directly affected by the loss of dopamine-producing neurons.
But the implant targets the area of the spine responsible for activating the leg muscles when walking.
It electrically stimulates the spine in a targeted manner and thus corrects gait disorders caused by Parkinson’s, researchers say.
Surgery is required to place the implant against the spinal cord, which controls walking, while an electrical impulse generator is placed under the skin of the abdomen.
It uses targeted programming of spinal cord stimulations that adapt to movements in real time.
Researchers say the implant opens up new possibilities to tackle the gait disorders that many people with Parkinson’s disease suffer from, but that it has only been tested in one person and further studies are needed.
Now he almost never freezes, he has regained the independence to leave the house alone and can walk more than five kilometers without stopping.
The father-of-two, a former architect and mayor who lives with his wife near Bordeaux in France, described the treatment, which he was the first in the world to undergo, as a “rebirth”.
After using the stimulation eight hours a day for almost two years, he said, “I turn the stimulation on in the morning and off at night. This allows me to walk and stabilize better.
‘At this point I’m not even afraid of the stairs anymore.
‘Every Sunday I go to the lake and walk about four miles. It’s unbelievable.’
When Mr. Gauthier had his spinal cord stimulated, most of the steps he took appeared to resemble the gait of healthy people without Parkinson’s disease, the study in Nature Medicine reports, although the movements were still not completely normal.
Problems with walking occur in Parkinson’s when certain brain cells in the basal ganglia, the area of the brain that controls movement, no longer work properly or die.
Although some brain signals still reach the spinal cord to control the muscles in the legs, these signals are not normal and cause problems such as freezing and loss of balance.
Precise stimulation of the spinal cord can help by sending a stronger signal to the leg muscles, compensating for the brain problem.
For Mr. Gauthier, researchers adjusted the stimulation to correct his crooked gait caused by a weaker right leg and help him take longer, more stable steps.
Like many people with Parkinson’s, he would freeze on the spot and feel glued to the floor, for example when he tried to get into an elevator and walk to the narrow doorway, but that no longer happens.
He currently uses his neuroprosthesis for approximately eight hours a day and only turns it off when sitting or sleeping for extended periods of time. In the photo: Mr. Gauthier walks independently (top) without assistance thanks to the implant and with assistance (bottom) when it is turned off
Scientists gave the 63-year-old an implant with electrodes, placed at a precise location between two vertebrae in his back, over the top six centimeters of his spinal cord, and connected to a device that generates electrical pulses, delivered under his skin in the abdominal area is implanted.
The device, which was first tried in primates, is turned on and off using a remote control or smartwatch, with sensors worn in the shoes determining what type of muscle stimulation is needed for everyday tasks such as climbing stairs, and the stimulation is delivered in response. amended.
It is said to work better than deep brain stimulation and medications in addressing gait problems in real time, after tailoring it to an individual’s walking style.
The technology is already showing improvements in a second person and will be trialled in a further six people next year, with $1 million in funding from the Michael J. Fox Foundation for Parkinson’s Research, which was founded by the Back to the Future actor . in 2000 after being diagnosed with Parkinson’s at age 29.
It targets the nerve cells responsible for activating the leg muscles when walking, and has previously been used to help spinal cord injury patients regain movement.
Mr Gauthier, an avid guitarist and gardener, received deep brain stimulation for other Parkinson’s symptoms 20 years ago and said: ‘Two years ago I experienced a second rebirth when I received spinal cord stimulation.
‘I can now walk with much more confidence and my daily life has improved enormously.’
Researchers now want to understand whether their technology works for everyone with Parkinson’s disease, and say it will require at least another five years of development and testing.
David Dexter, research director at the charity Parkinson’s UK, said: ‘This study is a major potential advance and an exciting step forward.
‘It involves a spinal implant, which is invasive, but it could be a breakthrough technology to help restore movement in people with advanced Parkinson’s, where the medications no longer work properly.
‘We now need to see it tested in many more people with the condition, to explore the potential benefits and risks.’
Professor Jocelyne Bloch, member of the research team from CHUV Lausanne University Hospital in Switzerland, said: ‘It is impressive to see how by electrically stimulating the spinal cord in a targeted way, in the same way as we have done with patients with spinal cord injury , we can correct gait disorders caused by Parkinson’s disease.’