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A study published in Nature Medicine looks at neuroprosthesis to improve mobility of people living with Parkinson’s Disease.
Prof David Dexter Director of Research, Parkinson’s UK, said:
“This study is significant because it represents a major potential advance in how technology could help over movement deficits in people with Parkinson’s in the future.
“The volunteer already had Deep Brain Stimulation – a surgical therapy for Parkinson’s which involves having electrical stimulation in the brain using carefully placed electrodes. The volunteer then underwent a procedure to have electrodes implanted in their spinal cord. When these spinal electrodes were turned on the freezing of gait normally observed in the volunteer almost disappeared, and these positive effects were seen when his DBS simulator was on or off.
“This has so far only been tried in one individual with Parkinson’s who already had Deep Brain Stimulation. We now need to see this be tested in many more people with the condition, including those without DBS, in clinical trials to further explore the potential benefits and side effects/risks of this experimental new therapy.
“This is quite an invasive procedure but could be a game changing technology to help restore movement in people with advanced Parkinson’s where the drugs are no longer working well.
“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.”
A comment from our friends at SMC Spain, below:
Eduardo Fernández, director of the Institute of Bioengineering at the Miguel Hernandez University of Elche (Spain) and director of the Biomedical Neuroengineering group at the Center for Biomedical Research Network on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), says:
“People with advanced Parkinson’s disease often face mobility problems that can have a significant impact on their quality of life and decrease their autonomy. This problem affects approximately 90% of sufferers and includes muscle stiffness, slowness of movement, freezing of gait, problems starting and stopping movement, and postural instability. These disorders often respond poorly to standard therapies that focus primarily on the areas of the brain directly affected by the loss of dopamine-producing neurons. Therefore, we need to develop new therapeutic strategies that can help solve these problems.
“This study introduces a very innovative therapeutic strategy that does not target the brain areas most affected in Parkinson’s disease, but other areas of the nervous system that are not affected by this pathology. Specifically, it targets the lumbosacral region of the spinal cord, which is ultimately involved in the control of the leg muscles and in the generation of the act of walking. To this end, they propose to use both deep brain stimulation, which is commonly used in many patients with Parkinson’s disease, and the modulation of the activity of motor neurons located in this lumbosacral area of the spinal cord, using epidural electrical stimulation. Thanks to this, a 62-year-old man, who was affected for more than 30 years by Parkinson’s disease, has experienced a marked reduction in his mobility problems and has also experienced improvements in his balance and in his tendency to freeze gait, resulting in a significant improvement in his quality of life.
“The study is very well designed and of high quality. The authors first developed the technology in an animal model of Parkinson’s disease, and then validated it in a person with advanced Parkinson’s disease. The results suggest that, with the right technology, it is possible to detect a person’s movement intention and establish bidirectional communication with the nervous system, and that artificial electrical stimulation of nerve cell populations in the spinal cord may be effective in alleviating motor deficits that occur in some neurodegenerative brain diseases. However, it should be noted that this research has been performed in a single patient, so further studies are still needed to confirm the effectiveness of this therapeutic approach in a larger number of individuals, and to identify those patients who may benefit most from this type of neuroprosthesis.
“We hope that advances in neurotechnology, electronics, neuroscience and biomedical engineering will contribute to the development of a new generation of motor neuroprostheses, capable of modulating or adjusting the optimal parameters of electrical stimulation with greater precision, which may help restore some lost functions in many patients with severe neurological diseases. 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.”
‘A spinal cord neuroprosthesis for locomotor deficits due to Parkinson’s disease’ by Tomislav Milekovic et al. was published in Nature Medicine at 16:00 UK time on Monday 6th November.
DOI: https://doi.org/10.1038/s41591-023-02584-1
Declared interests
Eduardo Fernández: Declares having no conflict of interest.
For all other experts, no reply to our request for DOIs was received.