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A man with Parkinson's who was unable to walk without falling is enjoying Sunday strolls again thanks to a spine implant

Nov 6, 2023, 23:23 IST
Insider
Marc Gautier can now walk down a flight of stairs on his own. Neurorestore
  • A man who has had Parkinson's for 30 years could hardly walk on his own and had to stay home.
  • Scientists implanted a device in his spine that stimulates his leg muscles with electrical impulses.
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A man diagnosed with Parkinson's disease almost 30 years ago who could barely walk on his own can now climb stairs and go out independently again thanks to a potentially revolutionary device implanted in his spinal cord.

Marc Gautier, 62, from a small town near Bordeaux, France, has lived with Parkinson's since he was 36, and was forced to stop working as an architect three years ago when his mobility got so bad that he was falling down five to six times a day, meaning he often had to stay at home.

"I practically could not walk anymore without falling frequently, several times a day. In some situations, such as entering a lift, I'd trample on the spot, as though I was frozen there," Gautier said in a press release.

Two years since the device was surgically implanted, however, he can once again do many things he used to enjoy.

"Every Sunday I go to the lake, and I walk around six kilometers. It's incredible," he said.

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The implant stimulates sensory fibers connected to muscles

Parkinson's is a degenerative disease where people don't have enough dopamine — a neurotransmitter responsible for many bodily functions — in their brain, which can lead to physical symptoms including rigidity and tremors.

Parkinson's is most common in older people and men, with symptoms typically appearing in those over 50, but it can occur in people under 40, too.

Treatments typically include taking dopamine and deep brain stimulation, where electrodes implanted in the brain produce electrical impulses that affect brain activity. These are usually effective but can stop working as the patient's condition worsens over time.

Around 90% of people with advanced Parkinson's experience walking problems, such as gait impairments, balance problems, and freezing-of-gait episodes, which reduce their quality of life, study co-author Jocelyne Bloch, director of the NeuroRestore treatment center that researches implantable neurotechnologies, and senior attending neurosurgeon at University Hospital of Lausanne, Switzerland, said in a press video.

Scientists from Switzerland and France worked to develop the new treatment by designing and implanting a device, known as a neuroprosthesis, into Gautier's spinal cord.

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In healthy people without Parkinson's, muscles move after being stimulated by sensory fibers. In Gautier's case, the fibers in his legs were weakened by Parkinson's, meaning the sensory feedback loop was not strong enough to make them move properly, co-author Grégoire Courtine, professor of neuroscience at the Swiss Federal Institute of Technology in Lausanne, told a press conference. The implant works by stimulating the weakened sensory fibers attached to the leg muscles.

"So if you imagine the stretch reflex, you go to the doctor, there's a tendon with the hammer, you hit the tendon and then you have a reflex. That's exactly this pathway that we are mobilizing with the stimulation," he said. Gautier can turn the stimulation on and off himself, the authors said.

"Instead of focusing on the region of the brain that's deprived of dopamine, we thought that we could focus on the spinal cord, that ultimately is responsible for the activation of leg muscle in order to walk," Courtine said.

The team published their findings in Nature Medicine on Monday.

Gautier's walking improved almost immediately

After the device was implanted, Gautier quickly saw his walking start to improve, according to the study, and following several weeks of rehabilitation, it had nearly returned to normal.

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He currently uses his neuroprosthetic for around eight hours a day, only turning it off when sitting down for a long period or sleeping, according to the press release.

The study's authors are excited about the possibility of turning this proof of concept into a widely available therapy to treat mobility problems in people with Parkinson's, they told a press conference.

"I really believe that these results open realistic perspectives to develop a treatment that alleviates gait deficits due to Parkinson's disease and therefore look forward to testing this new therapy in six additional patients," Bloch said.

The authors said further testing would happen within the next 18 months, but if successful, the treatment would not be commercially available for at least five to ten years.

David Dexter, director of research at Parkinson's UK, who was not involved in the study, told Insider: "This research is still at a very early stage and requires much more development and testing before it can be made available to people with Parkinson's, however, this is a significant and exciting step forward and we hope to see this research progress quickly."

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Eduardo Fernández, director of the Institute of Bioengineering at the Miguel Hernandez University of Elche, Spain, who was also not involved in the research, said in a statement that Parkinson's patients with mobility issues can often respond poorly to standard treatments that focus primarily on the areas of the brain directly affected by the loss of dopamine-producing neurons. He described the new approach as "very innovative" because it involves areas of the nervous system not affected by the disease.

"The future is hopeful, but it is necessary to advance little by little and not to create false expectations that could damage the credibility of this research," he said.

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