A new way to stimulate nerve cells in the spinal cord has helped improve balance and walking in one individual with Parkinson’s.
Cells deep within the brain that produce vital chemical messengers, including dopamine, to control things such as movement, memory and sleep are depleted over time in Parkinson’s. Current medication can help to boost levels of dopamine to control some of the symptoms, but the effectiveness of medication can reduce over time. Some people with Parkinson’s will therefore explore a surgical option called Deep Brain Stimulation (DBS).
DBS involves having fine wires inserted into specific areas of the brain which are connected to a pulse generator (a device like a heart pacemaker) which is placed under the skin around the chest or stomach area. When the pulse generator is switched on, the electrodes deliver high frequency stimulation to the targeted area. This stimulation changes some of the electrical signals in the brain that cause the symptoms of Parkinson’s.
This surgery can be life changing for some people. However, DBS has limitations and it quite often doesn’t help with symptoms of freezing or problems with balance and walking. This is where research into a new spinal implant could offer a new way to manage these symptoms.
Using spinal stimulation
Researchers have developed a way to directly stimulate nerve cells in the spinal cord responsible for controlling leg movement. They developed this in primates and have now successfully carried out the surgery and follow up in a 62-year-old with Parkinson’s. Marc has had Parkinson’s for 30 years. Medication and DBS were failing to control his movement and he was experiencing frequent falls and freezing episodes.
The procedure involved the spine being carefully imaged using scans to find the optimal site to implant the electrodes. The implantation was carried out under general anaesthetic. The electrodes were then able to deliver electrical pulses to activate and control leg movement. External sensors worn on the individual’s leg were able to sense the body’s intention to move, triggering the firing of the electrical impulse to the spine and providing feedback to control this movement.
This new surgical intervention, alongside extensive rehabilitation, allowed Marc to walk long distances again by improving the action of walking, reducing falls and freezing episodes. As well as these motor improvements, he also reported an improved quality of life.
What does this mean?
These latest results build upon previous success of spinal nerve stimulation in restoring leg function in some individuals with spinal cord injury. It now needs to be further investigated in more people with Parkinson’s to see if these positive results are repeated and the surgery is safe.
You can read the full scientific article in the Journal of Nature Medicine.
Professor David Dexter, Director of Research at Parkinson’s UK, said:
“This is quite an invasive procedure but could be a game changing technology to help restore movement in people with advanced Parkinson's where the drugs are no longer working well.
“The research is still at a very early stage and requires much more development and testing before it can be made available to people with Parkinson's, however, this is a significant and exciting step forward and we hope to see this research progress quickly.”