Most of our readers will know that we are on a mission to develop the world’s first disease-modifying therapies for Parkinson’s: therapies that can stop or slow (or potentially even reverse) the insidious progression of the disease. Such therapies are desperately needed because existing treatments, which address the symptoms but not the progression, will inevitably become less effective over time. But, of course, it is always great to see the development of new technologies that can help patients manage their symptoms better. Examples of this include the development of deep brain stimulation (DBS) leading to its approval for use in people with Parkinson’s in the late 1990s, and the more recent development of infusion therapies such as the DUODOPA® intestinal gel.
Now, a newly published study1 in the prestigious journal Nature Medicine reports how a spinal cord neuroprosthesis providing electrical spinal stimulation restored walking ability in a 62-year-old man who had had Parkinson’s for 30 years, and who had severe gait impairments and frequent falls despite medications and DBS. The authors of the paper described how the neuroprosthesis “restored skilled walking” in the patient. The device, which was first tested in a chemically induced non-human primate model of Parkinson’s, targets the six major nerves controlling the leg muscles and control of walking in the lumbosacral region of the spinal cord. The surgery to implant the device was performed in Lausanne, Switzerland.
It should be noted that this is a highly invasive procedure, and that extensive fine-tuning of the implanted device was required to achieve optimal results (namely, aligning and coordinating the timing of activation of motor neurons during walking). The results are also from a single patient only, and it is uncertain how effective the device would be in a larger cohort of people with Parkinson’s. However, the study does represent a significant advance in showing how technology can be used to help people with Parkinson’s who are experiencing severe impairments of gait and balance.
Marc, who received the implanted neuroprosthesis, said that before the device was installed, he would fall five or six times per day. Now, he says he can go out for a walk alone, which he could not do before. Larger studies are certainly needed before this device could be made more widely available, but it is just another reason for hope for those with advanced-stage Parkinson’s who are suffering major gait impairments and frequent falls despite other treatments.
1 Milekovic, T., Moraud, E.M., Macellari, N. et al. A spinal cord neuroprosthesis for locomotor deficits due to Parkinson’s disease. Nat Med (2023). https://doi.org/10.1038/s41591-023-02584-1
Marc is a 62-year-old man with a 30-year history of Parkinson’s. The experimental treatment notably improved his ability to walk normally.
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