Gregoire Courtine, a professor of neuroscience at the Swiss Federal Institute of Technology, alongside Marc Gauthier, 63, the first patient with a neuroprosthetic designed to stimulate his spinal cord to correct walking disorders due to Parkinson's disease, and Jocelyne Bloch, a neurosurgeon and professor at Lausanne University Hospital, along with Eduardo Martin Moraud, head of Parkinson research at NeuroRestore, presented their findings to the media in Lausanne, Switzerland, on November 2, 2023. — Reuters file
On Monday, scientists announced that electrically stimulating a specific region in the brain could aid individuals with spinal cord injuries in walking more easily, with one patient sharing how the method helped him overcome his fear of stairs. This new technique targets people with spinal cord injuries where the connection between the brain and spinal cord is not completely severed, and where some leg movement remains. Wolfgang Jaeger, one of the two patients in an early trial, noted that the technique made a significant difference in his mobility. "Now, when I see a staircase with just a few steps, I know I can manage it on my own," the 54-year-old said in a video accompanying a new study published in the journal Nature Medicine.
The research was led by a Swiss team that has made several recent breakthroughs, including using electrical stimulation of the spinal cord to enable several paralyzed patients to walk again. This time, the researchers aimed to identify the brain region most responsible for recovery from spinal cord injuries. Utilizing 3D imaging techniques to map the brain activity of mice with such injuries, the team developed a "brain-wide atlas." They were surprised to discover that the targeted region was the lateral hypothalamus, typically known for regulating arousal, feeding, and motivation. A specific group of neurons in this area "seems to play a role in the recovery of walking after spinal cord injury," explained neuroscientist Gregoire Courtine at Switzerland's Ecole Polytechnique Federale de Lausanne.
Next, the team enhanced the signal from these neurons using deep brain stimulation, a procedure commonly used to treat movement issues in Parkinson's patients. This involves implanting electrodes in the brain region, connected to a device in the patient's chest. When activated, the device sends electrical pulses to the brain. Initially tested on rats and mice, the study found that this method immediately improved walking. The first human participant in the 2022 Swiss trial, a woman with an incomplete spinal cord injury, reported feeling her legs when the device was turned on for the first time. As the electrical current was increased, she felt the urge to walk, according to neurosurgeon Jocelyne Bloch.
The patients could activate their devices as needed and underwent months of rehabilitation and strength training. The woman aimed to walk independently without a walker, while Jaeger aimed to climb stairs on his own. Both achieved their goals, Bloch noted. Jaeger, from the Swiss municipality of Kappel, shared his experience of facing eight steps down to the sea during a holiday. With the device on, "walking up and down the stairs was no problem," he said. "It's a great feeling not to have to rely on others all the time." Over time, he became faster and could walk longer even with the device off.
Further research is necessary, and this technique may not benefit all patients, Courtine emphasized. Since it relies on boosting the brain's signal to the spinal cord, its effectiveness depends on the initial signal strength. While deep brain stimulation is now fairly common, some individuals are uncomfortable with brain surgery. The researchers believe that future recovery from such injuries might best involve stimulating both the spinal cord and the lateral hypothalamus.
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