Spinal Implant Helps Man With Advanced Parkinson’s to Walk Without Falling
Marc Gautier enjoys taking a three-mile stroll on Sundays along the lake. The 62-year-old resident of a small town near Bordeaux, France, previously had difficulty walking because he has been living with Parkinson’s disease for nearly 30 years. Now, he can climb stairs, take an elevator, stand up and out of a chair, and walk alone in a store.
Gautier’s ability to walk on his own is nothing short of miraculous, and it is all due to a groundbreaking study that helped him regain mobility.
Gautier stopped working as an architect three years ago because his mobility was so impaired that he had trouble walking and would fall five to six times a day. Like many people with Parkinson’s disease, Gautier experienced “freezing,” a sudden but temporary, inability to move, which places them at risk for falling.
As part of the study, an experimental device known as a neuroprosthesis was implanted into Gautier’s spinal cord two years ago. After the surgery, Gautier’s walking started to improve. And, after several weeks of rehabilitation, Gautier’s walking had nearly returned to normal.
“Walking in a store would be really difficult, impossible before, because of the freezing of gait that would often happen in those environments,” Gautier said in a news briefing reported by CNN. “And now, it just doesn’t happen anymore. I don’t have freezing anymore.”
About The Study
Scientists from Switzerland and France, led by surgeon Jocelyne Bloch and neuroscientist Gregoire Courtine, implanted the neuroprosthesis, a complex system of electrodes, at crucial points in Gautier’s spinal cord.
Bloch and Courtine had previously introduced the use of spinal cord implants that allowed paraplegic patients to walk again. The team’s latest research, published in the Nature Medicine journal in November,
works along the same principle.
People who do not have Parkinson’s move after being stimulated by sensory fibers. Parkinson’s disease, however, weakens the fibers in the legs, and this leads to problems with mobility. The implanted neuroprosthesis is designed to stimulate the weakened sensory fibers attached to the leg muscles, Courtine, a professor of neuroscience at the Swiss Federal Institute of Technology in Lausanne, Switzerland, explained at the press briefing.
Overall, the neuroprosthesis helps to “promote longer steps, improve balance and reduce freezing of gait,” the researchers wrote in their study.
Gautier can turn the stimulation on and off himself, the authors said. Gautier uses his neuroprosthetic for about eight hours a day, only turning it off when sitting down for an extended period or sleeping.
What is Parkinson’s Disease?
Researchers say there is still much to learn about Parkinson’s disease, a neurodegenerative disorder that affects 10 million people worldwide. Most people develop Parkinson’s after age 60. However, about 5-10 percent experience onset before age 50. Early-onset forms of Parkinson’s are often, but not always, inherited, and some forms have been linked to specific alterations in genes, according to the National Institute on Aging.
Parkinson’s affects predominately the dopamine-producing neurons in the substantia nigra, the part of the brain that controls movement. These neurons gradually die and cause problems with mobility. Scientists have found Parkinson’s symptoms develop in patients with an 80 percent or more significant loss of the neurons that produce dopamine.
While there are many Parkinson’s symptoms, physical movement is primarily affected by the main symptoms that include:
• Tremors in the hands, arms, legs, jaw, or head. Tremors occur at rest.
• Muscle stiffness
• Slowness of movement
• Impaired balance and coordination, sometimes leading to falls
Besides movement-related or motor symptoms, people with Parkinson’s also have non-motor symptoms, such as:
• Difficulty swallowing, chewing, and speaking
• Hallucinations and sleep disorders
• Skin problems
• Urinary problems or constipation
Parkinson’s is usually treated with drugs that replace or mimic dopamine. Deep brain stimulation (DBS) is also used as a treatment. DBS involves implanting electrodes in the brain to produce electrical impulses that affect brain activity. These treatments are effective but can stop working as the disease worsens. Currently, there is no treatment available that can slow down the disease.
Research Team Plans To Expand Their Experiment
Encouraged by the success of Gautier’s results, the Swiss research team will now test the new device on six additional Parkinson’s patients to determine how the device might benefit others since the disease affects people in different ways.
While the study’s authors are pleased with the results, David Dexter, director of research at Parkinson’s UK, who was not involved in the study, agreed that further testing should be done on more people.
In a written statement distributed by the Science Media Centre, based in the United Kingdom, Dexter said, “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.”
The cost of the invasive implant could be high, potentially limiting the number of patients who might benefit from the treatment. Because of this possibility, Bloch and Courtine launched a startup business called “Onward” to look at future marketing. At the press briefing, the researchers said they hope to make this therapy widely available to treat mobility problems in people with Parkinson’s.
“I really believe that these results open realistic perspectives to develop a treatment that alleviates gait deficits due to Parkinson’s disease,” Bloch said.
Although this latest implant shows much promise, it is not a cure for Parkinson’s, and the research team believes the disease will progress in Gautier.
“With this spinal cord stimulation, we still have an effect, but we have to fight against worse and more severe symptoms,” Bloch said. “But we can still give him, with the therapy, a bit of quality of life.”
In the meantime, Gautier said he is planning a trip to Brazil now that his mobility has improved. However, Gautier said he still has to concentrate when he walks, especially when climbing stairs.