Three people who had suffered a complete spinal cord injury and were paraplegics can now walk thanks to an implant that stimulates the area of the spinal cord that controls the muscles of the trunk and legs. It works from an application that incorporates artificial intelligence
Michel Roccati, a patient suffering from paraplegia, walks through the Complex of the Federal Polytechnic School of Lausanne after receiving a spinal cord implant. EFE/Federal Polytechnic School of Lausanne/EDITORIAL USE ONLY
This technique, which uses ‘electrode paddles’ designed specifically for spinal cord injuries, has been developed by a Swiss team of researchers, which is part of an ongoing clinical trial showing that stimulation treatments specially designed for each patient , rather than more general ones, result in “higher efficiency and more diverse motor activities” even in the most severe spinal cord injuries.
As published on Monday in the journal Nature Medicine, Grégoire Courtine and Jocelyne Bloch, responsible for the experiment, confirm that electrical stimulation of the spinal cord is currently a promising therapeutic option to restore motor function in people with spinal cord injury.
But they point out that, until now, continuous electrical stimulation therapies have mostly been employed using “adapted” neurotechnologies, which were originally designed to treat pain.
From the Polytechnic Federal School of Lausanne (EPFL), which is part of the platform on which this scientific advance has been achieved, the neuroscientist Grégoire Courtine said that the new soft implants placed under the vertebrae in contact with the spinal cord “are capable of modulating the neurons that regulate the activity of precise muscle groups”.
“In this way -he added- we can activate the spinal cord as the brain would naturally do to stand up, walk, cycle or swim.”
three volunteers
Courtine and Bloch and their teams designed a new electrode palette that reaches all the nerves associated with leg and trunk movements, which they tested on three male volunteers aged 29-41.
The team also combined this technology with “a personalized computational framework, which allowed the electrode palette to be precisely positioned for each of the patients and to personalize the activity stimulation programs,” they explain.
An “optimized approach” to spinal cord stimulation restored the ability to walk independently and other motor activities, such as cycling and swimming, in a single day in the three patients, who have complete paralysis of the legs.
On this occasion, the key has been “to insert a longer and wider implant, with electrodes placed in such a way as to make them correspond precisely with the nerve roots of the spinal cord that allow us to access the neurons that control the muscles,” he explained. Bloch, at a press conference in which he showed the method and the results obtained.
Michel Roccatti
One of the first to receive this implant was patient Michel Roccati, an Italian who had a motorcycle accident four years ago and was left completely paraplegic, but who can now get up and walk with a walker in which two small remote controls are inserted.
A tablet sends the stimulation commands to a pacemaker located in Michel’s abdomen and from which the stimuli are transmitted to the spinal cord implant so that Michel gets up.
In a video provided by the EPFL, the patient is seen showing how this system works: a pressure on the button on the right side of his walker plus his will to activate his muscles make it possible for his left leg to flex and then rest a few centimeters more ahead. When activating the button on the left, it is the right leg that takes a step in turn and thus begins to walk.
This system has also allowed him to go up and down stairs.
“I use it daily for a couple of hours to walk outside and also in my house, so now it’s part of my daily life,” Michel recounted at the same press conference, who said that his next goal, which he hopes to achieve in a few months is to walk a kilometer in Lausanne, the city where he lives.
In the question and answer session of the press conference organized by the journal Nature Medicine, Bloch explained that the interventions to the patients who participated in the research were carried out at least one year after the injury was suffered, a period in which it is considered that his situation is stable and a maximum in recovery has been reached.
Age influences but does not exclude
With the data collected, it is believed that the sooner this technology is used after the injury, the better results can be obtained, said the surgeon at the University Hospitals of Lausanne.
He also commented that age has an influence on the result after receiving the implant: “In general, a younger patient is in better condition and is also more motivated, but we have seen patients up to fifty years of age who have responded well, as well that age is a factor that influences, but does not exclude.
Michel, the patient who agreed to offer his testimony, confirmed that with the use of this technology he is able to feel the contraction of specific muscles in his legs and abdomen when he receives stimulation.
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