Tomislav Milekovic†, Eduardo Martin Moraud†, Nicolo Macellari*, Charlotte Moerman*, Flavio Raschellà*, Shiqi Sun*, Matthew G. Perich*, Camille Varescon, Robin Demesmaeker,Alice Bruel, Léa N. Bole-Feysot, Giuseppe Schiavone, Elvira Pirondini, Cheng YunLong, LiHao, Andrea Galvez, Sergio Daniel Hernandez-Charpak, Gregory Dumont, Jimmy Ravier, Camille G. Le Goff-Mignardot, Jean-Baptiste Mignardot, Gaia Carparelli, Cathal Harte, Nicolas Hankov, Viviana Aureli, Anne Watrin, Hendrik Lambert, David Borton, Jean Laurens, Isabelle Vollenweider, Simon Borgognon, François Bourre, Michel Goillandeau, WaiKin D Ko, Laurent Petit, Qin Li, Rik Buschman, Nicholas Buse, Maria Yaroshinsky, Jean-BaptisteLedoux, Fabio Becce, Mayté Castro Jimenez, Julien F. Bally, Timothy Denison, DominiqueGuehl, Auke Ijspeert, Marco Capogrosso, Jordan Squair, Leonie Asboth, Philip A.Starr, Doris D. Wang, Stéphanie P. Lacour, Silvestro Micera, Chuan Qin, Jocelyne Bloch, Erwan Bezard and G. Courtine
Abstract
People with late-stage Parkinson’s disease (PD) often suffer from debilitating locomotor deficits that are resistant to currently available therapies.To alleviate these deficits, we developed a neuroprosthesis operating in closed loop that targets the dorsal root entry zones innervating lumbosacral segments to reproduce the natural spatiotemporal activation of the lumbosacral spinal cord during walking. We first developed this neuroprosthesis in a non-human primate model that replicates locomotor deficits due to PD. This neuroprosthesis not only alleviated locomotor deficits, but also restored skilled walking in this model. We then implanted the neuroprosthesis in a 62-year-old male with a 30-year history of PD who presented with severe gait impairments and frequent falls that were medically refractory to currently available therapies. We found that the neuroprosthesis interacted synergistically with deep brain stimulation of the subthalamic nucleus and dopaminergic replacement therapies to alleviate asymmetry and promote longer steps, improve balance and reduce freezing of gait. This neuroprosthesis opens new perspectives to reduce the severity of locomotor deficits in people with PD.
Link to the article: https://www.nature.com/articles/s41591-023-02584-1