Media release

From: Springer Nature

Neuroprosthesis reduces gait impairments due to Parkinson’s disease

Targeted epidural stimulation of the spinal cord with an implanted neuroprosthesis improved the walking and balance abilities of an individual with severe movement deficits due to chronic Parkinson’s disease, reports a study published in Nature Medicine. The findings highlight the potential of using neuroprosthetic devices to treat movement deficits in people with Parkinson’s disease.

Around 90% of people with advanced Parkinson’s disease experience locomotor deficits that include gait impairments, balance problems and freezing-of-gait episodes. These deficits reduce quality of life, increase the severity of related conditions, and currently available therapies are ineffective. Targeted epidural electrical stimulation (EES) of the lumbosacral spinal cord modulates the activity of neurons that control locomotor movements and has recently been shown to restore standing and walking functions in people with paralysis due to spinal cord injury. 

Grégoire Courtine and colleagues developed a neuroprosthesis based on EES to restore the natural activation of leg neurons that are disrupted during walking in people with Parkinson’s disease. After extensive validation of this neuroprosthesis in non-human primate models, the authors initiated a first-in-human trial of this approach in a 62-year-old man who had a 30-year history of Parkinson’s disease and exhibited severe locomotor deficits despite pharmacological and deep-brain-stimulation treatments. A personalized anatomical map of spinal cord regions to be targeted by EES was first generated, which guided the precise surgical implantation of the neuroprosthesis. Wireless sensors worn by the participant were then used to detect locomotor intentions and triggered EES to activate leg neurons to generate natural walking movements. The study results show that the neuroprosthesis improved walking and balance deficits in the participant, who further reported a substantial improvement in his quality of life (the participant has now been using the neuroprosthesis for nearly two years, for about eight hours per day).

These preliminary results suggest that targeted EES may be a potential therapeutic option for the treatment of locomotor deficits that are common in people with Parkinson’s disease. However, this was a proof-of-concept study with a single participant, and further studies in larger clinical trials are needed to validate the efficacy of this approach.