Spinal implant: Man with advanced Parkinson’s walks without falling over
Life has brightened for Parkinson's patient Marc Gauthier. Photo: Gilles Weber/CHUV
Marc Gauthier, 63, was diagnosed with Parkinson’s disease nearly 30 years ago. He was still a young man.
Time passed with the gradual loss of control over his body. The disease has been at an advanced stage for some time.
For Gauthier, from Bordeaux, this meant falling over five or six times a day when walking – caused by what’s known as ‘freezing of gait’.
This is a complex disorder that affects about 90 per cent of people with advanced-stage Parkinson’s. When ‘freezing of gait’ occurs, you get stuck in place and temporarily struggle to move your feet forward.
It’s akin to having a noose thrown around the ankles and drawn tight: You tip forward and fall.
“I would fall five to six times per day,” Gauthier, a former architect and mayor, said at a press briefing.
“I would often stay home as well, and was forced to stop working three years ago. For example, walking into a store was impossible before, because of the freezing of gait that would happen in those environments. And now it doesn’t happen anymore.”
Two years ago, Gauthier began a highly experimental intervention that resulted in a “rebirth”.
His legs no longer let him down. Every Sunday he travels to a lake and walks six kilometres without stopping or falling over. He is no longer frightened of stairs. He manages to get out of a chair without a struggle.
The experimental implant
Gauthier is the first person to receive an experimental device that delivers electrical stimulation to the spinal cord in order to improve mobility, as reported in Nature Medicine.
Researchers at the Swiss Federal Institute of Technology in Lausanne (EPFL) implanted the neuroprosthesis in his lower back, over the lumbosacral spinal cord.
There, the stimulation activates the network of neurons running between his spinal cord and the leg muscles.
Gauthier now walks confidently, without falling or freezing. Photo: Gilles Weber/CHUV
This team has previously, successfully applied the strategy in people with paralysis from spinal cord injury. They reasoned “that it could be adapted to Parkinson’s”.
To personalise the stimulation for Marc Gauthier, “the researchers gathered data on his walking deficits and patterns by placing sensors on his feet and legs”.
They then configured the stimulation to compensate for any dysfunction – such as “weak knee extension or a problem contracting the muscles in the buttocks”.
“Our specialty is in our understanding of how to stimulate the spinal cord in order to be very precise in the way we adjust leg movement,” says Grégoire Courtine, a neuroscientist at the EPFL who developed the technique.
“The novelty of this study is to leverage this understanding and technology in Parkinson’s.”
What happens next?
According to an article in Nature, the effects of the treatment have lasted for two years.
“There are no therapies to address the severe gait problems that occur at a later stage of Parkinson’s, so it’s impressive to see him walking,” says Jocelyne Bloch, a neurosurgeon at the EPFL and a lead author of the paper.
The Parkinson’s community is ever watchful for new treatments and hints of a breakthrough. They’ll be looking closely to see what happens next.
But there is a long road ahead before it becomes a standard or even widely adopted treatment.
The next step will be a randomised, controlled trial. Let’s hope that happens sooner than later.