Aaron A. Phillips, Aasta P. Gandhi, Nicolas Hankov, Sergio D. Hernandez-Charpak, Julien Rimok, Anthony V. Incognito, Anouk E. J. Nijland, Marina D’Ercole, Anne Watrin, Maxime Berney, Aikaterini Damianaki, Grégory Dumont, Nicolò Macellari, Laura De Herde, Nadine Intering, Donovan Smith, Ryan Miller, Meagan N. Smith, Jordan Lee, Edeny Baaklini, Jean-Baptiste Ledoux, Javier G. Ordonnez, Taylor Newton, Ettore Flavio Meliadò, Léa Duguet, Charlotte Jacquet, Léa Bole-Feysot, Markus Rieger, Kristen Gelenitis, Yoann Dumeny, Miroslav Caban, Damien Ganty, Edoardo Paoles, Thomas Baumgartner, Clinical Study Team*, Onward Team*, Cathal Harte, Charles David Sasportes, Paul Romo, Tristan Vouga, Jemina Fasola, Jimmy Ravier, Matthieu Gautier, Frédéric Merlos, Rik Buschman, Tomislav Milekovic, Andreas Rowald, Stefano Mandija, Cornelis A. T. van den Berg, Niels Kuster, Esra Neufeld, Etienne Pralong, Lorenz Hirt, Stefano Carda, Fabio Becce, Etienne Aleton, Kyle Rogan, Patrick Schoettker, Grégoire Wuerzner, Nelleke Langerak, Noël L. W. Keijsers, Brian K. Kwon, James D. Guest, Erika Ross, John Murphy, Erkan Kurt, Steve Casha, Fady Girgis, Ilse van Nes, Kelly A. Larkin-Kaiser, Robin Demesmaeker, Léonie Asboth, Jordan W. Squair, Jocelyne Bloch & Grégoire Courtine, An implantable system to restore hemodynamic stability after spinal cord injury, Nature Medicine (2025)
Abstract
A spinal cord injury (SCI) triggers immediate and persistent hemodynamic instability that jeopardizes neurological recovery and diminishes quality of life. Through analysis of 1,479 participants, we documented the substantial clinical burden of chronic hypotensive complications following SCI—revealing the inadequacy of conventional conservative treatments. To address this unmet need, we engineered an implantable system leveraging biomimetic epidural electrical stimulation (EES) of the spinal cord, which instantly induced strong pressor responses. This approach durably reduced the severity of hypotensive episodes in individuals with SCI, eliminated reliance on conservative therapies, enhanced quality of life, and restored greater independence in daily activities. A critical insight emerged from direct comparisons in the same participants: EES must precisely target the last three thoracic spinal segments—not the lumbosacral region—to safely and effectively regulate blood pressure. Demonstrated in 14 participants, these results pave the way for a pivotal trial to rigorously evaluate EES as a transformative solution for the overlooked, treatment-resistant hypotensive complications of SCI.
Link to the article : https://www.nature.com/articles/s41591-025-03614-w