Spinal device helps man with Parkinson’s walk without freezing
The implanted device delivers electrical stimulation to nerve cells in the spine
An implanted device that delivers electrical stimulation to nerve cells in the spine helped reduce gait freezing in a man with Parkinson’s disease, improving his ability to walk. Gait freezing occurs when a person stops walking without meaning to, which can lead to falls.
The device’s development was described in Nature Medicine, in “A spinal cord neuroprosthesis for locomotor deficits due to Parkinson’s disease.”
“I would fall five to six times per day. 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,” Marc Gauthier said in Nature.
Most people with Parkinson’s, especially those in the disease’s more advanced stages, will have problems walking, difficulty with balance, or gait freezing.
Medications and deep brain stimulation (DBS), a surgical intervention where a device is implanted to deliver electrical stimulation to specific brain regions, may help improve walking for some Parkinson’s patients, but many continue to have problems despite available therapies.
Unfreezing gait in Parkinson’s
Scientists here developed a device to help normalize walking by targeting the nerve cells in the lower spine directly responsible for controlling leg movements.
“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. The novelty of this study is to leverage this understanding and technology in Parkinson’s,” said Grégoire Courtine, PhD, a neuroscientist at the Swiss Federal Institute of Technology in Lausanne (EPFL) and co-author of the study.
The scientists first worked to understand how the activity of nerves in the spinal cord of monkeys with Parkinson’s-like disease differs from healthy monkeys while walking. Then, they developed a device to deliver electrical stimulation that would help normalize electrical activity.
In order to sync the device’s stimulations with the monkey’s movements, the researchers used a sensor implanted into their motor cortex, the part of the brain chiefly responsible for controlling movement.
The system let monkeys with Parkinson’s-like disease walk essentially normally and the effects improved when they were given DBS, suggesting the two approaches may work together.
The researchers then adapted the technology to treat Gauthier, who received an implant in his lower back over the spinal cord. To coordinate electrical signals delivered by the implant, the researchers used motion sensors he could wear, which could determine the needed electrical stimulation by tracking his movements. These sensors couldn’t be used in the monkeys because they wouldn’t tolerate wearing them, the researchers said.
The device led to notable improvements in Gauthier’s walking ability. A computer-based analysis of his gait with it suggested he was walking in a way similar to a person without Parkinson’s.
“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,” said Jocelyne Bloch, a neurosurgeon at the EPFL and a lead author of the study.
Before getting the device, Gauthier “exhibited frequent freezing-of-gait episodes,” said the researchers, who noted with the device these episodes “nearly vanished.”
Gauthier has been using the device daily for nearly two years and is able to walk more than “several kilometers without any additional assistance,” wrote the researchers, who are running a clinical trial called STIMO-PARK (NCT04956770) that’s collecting data on Gauthier and another participant’s use of the device. The trial is expected to run through early 2026.
A pair of researchers at the University of California, San Francisco, writing in an editorial that was published alongside the study, said further research is needed to test the technique in more patients, but noted early data was promising. “It will be exciting to see how this approach translates to a larger group of patients with freezing-of-gait in the setting of advanced” Parkinson’s, they said.