A Frenchman, Marc, regained his ability to walk thanks to a neuroprosthesis, implanted near the spinal cord. Six other patients will be implanted by next year. A technique which could be extended, according to the researchers, to gait paralysis due to spinal cord lesions.
“We are going to develop technology for all the people who need it around the world”, announced Tuesday, November 7 on franceinfo Grégoire Courtine, professor of neuroscience at the École Polytechnique de Lausanne, co-author with Jocelyne Bloch, neurosurgeon at the Lausanne University Hospitals, of a major medical feat for patients suffering from Parkison’s disease. A Frenchman, Marc, regained his ability to walk thanks to a neuroprosthesis, implanted near the spinal cord, developed by the two Franco-Swiss researchers.
Neuroscientists and neurosurgeons published the results of this medical advance on Monday in the scientific journal Nature. “We will stimulate very precisely the region of the spinal cord which is responsible for leg motor skills,” explains Jocelyne Bloch, also a guest of franceinfo. “Marc has a small remote control that he places right in front of the region of the abdomen that contains the stimulator. He presses, the stimulation is turned on. The effects are immediate,” describes Grégoire Courtine. “In about five years, this technology could be available to everyone”he hopes.
franceinfo: What does this medical feat consist of?
Jocelyne Bloch: In Parkinson’s disease, many people develop walking disorders for which it is difficult to have traditional treatments such as dopamine or deep brain stimulation. And there, for the first time, we will stimulate very precisely the region of the spinal cord which is responsible for leg motor skills. We will improve the patient’s walking.
“The results are immediate.”
Jocelyne Bloch, neurosurgeonat franceinfo
We were immediately able to correct his defects and allow him to walk much better.
What is the function of a neuroprosthesis?
Grégoire Courtine: You have to imagine a field of electrodes which will be placed against this region of the spinal cord which controls the leg muscles. Lots of small electrodes connected to a kind of computer, like a pacemaker as big as a box of matches, housed in the abdomen, which will therefore communicate wirelessly with an intelligent computer which will send electrical impulses to correct gait. It’s a small system that will measure residual movements and stimulate them in the right place to strengthen muscle activity, that is to say, correct muscles that are not active enough due to Parkinson’s disease. It is the patient who activates it himself. It’s a tablet. He has a small remote control that he places right in front of the area of the abdomen that contains the stimulator. He presses, the stimulation is on. The effects are immediate. This is what Marc says: “It’s my little joy. I press the button. I feel good.”
This is a cutting-edge operation. How accurate is it?
Jocelyne Bloch: There are sixteen electrodes which are on a small silicone tab which is approximately six centimeters long. We will insert it between two vertebrae and then target each of the nerve roots which will be responsible for activating the muscles. The intervention itself is not a dangerous intervention. It has already been done to treat chronic pain, electrodes on the spinal cord. In our situation, precision is extremely important, because you have to be able to target all of these nerve roots which will then contract each of the muscles on both sides.
There are also implants in the treatment of Parkinson’s disease in the brain. Is it complementary?
Grégoire Courtine: Its very important. There is a strong synergy between deep brain stimulation, therefore implants in the brain, pharmacology, therefore dopamine, and then stimulation which will really solve the problems of walking specifically.
However, we can’t speak of healing for Marc?
Jocelyne Bloch: Unfortunately, Parkinson’s disease is a neurodegenerative disease that will progress. We are going to improve signs. Everything that happens with this step will improve, but the disease continues to progress. At the start of Parkinson’s disease, we don’t see much. We are treated very well with medication. Deep brain stimulation helps a lot. Little by little, we can see walking problems, but also sometimes cognitive declines. Movement improves life expectancy, because from the moment you are in your chair all the time because you fall every time you get up, other problems arise.
Is this technology generalizable?
Grégoire Courtine: Expectations need to be carefully calibrated. Marc is our first test pilot. It worked very well for Marc. Now it is necessary to confirm the same effects in other patients who suffer from Parkinson’s disease. And above all, we must develop technology that is suitable for daily use for people who suffer from Parkinson’s. We are doing this with a company called Onworld Medical which will develop technology so that it is available to all people who need it throughout the world.
When?
Grégoire Courtine: Starting next year, Jocelyne Bloch will implant six additional patients.
“We have support from the Michael J. Fox Foundation, the actor who made Back to the Future and who had Parkinson’s disease at a very young age.”
Grégoire Courtine, professor of neuroscienceat franceinfo
We are going to test this new technology from Onworld Medical. If it works well, there will be a pivotal trial, that is to say with 60 to 100 people. In about five years, this technology could be available to everyone. We must demonstrate one, safety, and two, the effectiveness of this technology for a large number of patients.
Can other diseases be affected by this type of technology?
Grégoire Courtine: Jocelyne and I are rather known for using the same technology to restore walking following paralysis due to spinal cord injuries. It is the same technology, in fact, that we will use for these two pathologies. And then, perhaps, in the future, for other neurodegenerative diseases like multiple sclerosis that interest us.