A 63-year-old man who has been living with Parkinson’s disease for nearly three decades is able to leave the house alone again thanks to a spinal cord implant that has helped to improve his walking.
Marc Gauthier was forced to stop working as an architect three years ago when his condition made it very difficult for him to walk.
He would fall five to six times a day, and not be able to climb stairs because of issues with his mobility.
But neuroscientists and neurosurgeons have designed a neuroprosthetic – spine implant – that has allowed Mr Gauthier to walk comfortably, confidently and without falling.
I’m not even afraid of the stairs anymore. Every Sunday I go to the lake, and I walk around six kilometres. It’s incredible— Marc Gauthier
It works by electrically stimulating the spinal cord in a targeted manner.
Mr Gauthier, who is the first person to have the implant, said he was “very happy” when it worked, adding: “After the therapy, the surgery I was able to go out alone again.
“There were things I could redo, some easier, some more difficult, but I could redo many things I couldn’t before.
“For example, walking into a store would be very difficult, impossible, before, because of the freezing of gait that will often happen in those environments.
“And now it just doesn’t happen anymore – I don’t have freezing anymore.”
He also joked that his wife was very happy with the results as they meant that he could leave the house and she could get some time alone at home.
Dopamine and then the deep brain stimulation that Mr Gauthier, from Pessac in France, received in 2004 dealt with his tremors and stiffness.
It is impressive to see how by electrically stimulating the spinal cord in a targeted manner, in the same way as we have done with paraplegic patients, we can correct walking disorders caused by Parkinson’s disease— Jocelyne Bloch, neurosurgeon
But more recently, he developed serious walking disorders which did not respond to the treatment.
Unlike conventional treatments for Parkinson’s, which target the regions of the brain directly affected by the loss of dopamine-producing neurons, the implant targets the area of the spine responsible for activating leg muscles while walking.
Jocelyne Bloch is a neurosurgeon and professor at the CHUV University Hospital Lausanne, Switzerland, and co-director of the NeuroRestore centre with Gregoire Courtine, of the Swiss Federal Institute of Technology.
She said: “It is impressive to see how by electrically stimulating the spinal cord in a targeted manner, in the same way as we have done with paraplegic patients, we can correct walking disorders caused by Parkinson’s disease.”
During a surgery two years ago, Mr Gauthier was fitted with a new neuroprosthetic made up of an implant placed against the spinal cord, which controls walking, and an electrical impulse generator implanted under the skin of his abdomen.
It uses targeted programming of spinal cord stimulations which adapt in real time to his movements.
After several weeks of rehabilitation Mr Gauthier is now able to walk almost normally.
I turn on the stimulation in the morning and turn it off in the evening— Marc Gauthier
He currently uses his neuroprosthetic for around eight hours a day, only turning it off when he is sitting down for a long period of time or when he is sleeping.
Mr Gauthier said: “I turn on the stimulation in the morning and turn it off in the evening.”
He added: “I’m not even afraid of the stairs anymore. Every Sunday I go to the lake, and I walk around six kilometres. It’s incredible.”
Researchers say the implant opens up new possibilities to deal with walking disorders that many people suffering from Parkinson’s diseases are affected by, but that it has only been tested in one person and further trials are needed.
Thanks to funding from the Michael J Fox Foundation for Parkinson’s Research, the NeuroRestore centre is going to carry out clinical tests on six new patients next year.
Around 90% of people with advanced Parkinson’s disease experience locomotor deficits that include gait impairments, balance problems and freezing-of-gait episodes.
These deficits reduce quality of life and increase the severity of related conditions, and currently available therapies are ineffective.
The findings are published in Nature Medicine.
