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Article Dans Une Revue Nature Medicine Année : 2023

A spinal cord neuroprosthesis for locomotor deficits due to Parkinson’s disease

Tomislav Milekovic
Shiqi Sun
Matthew G Perich
Robin Demesmaeker
Giuseppe Schiavone
David Borton
Simon Borgognon
Auke Ijspeert
Marco Capogrosso
Leonie Asboth
Philip A Starr
Silvestro Micera
Jocelyne Bloch
G Courtine

Résumé

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.
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Dates et versions

hal-04279036 , version 1 (10-11-2023)

Identifiants

Citer

Tomislav Milekovic, Eduardo Martin Moraud, Nicolo Macellari, Charlotte Moerman, Flavio Raschellà, et al.. A spinal cord neuroprosthesis for locomotor deficits due to Parkinson’s disease. Nature Medicine, 2023, ⟨10.1038/s41591-023-02584-1⟩. ⟨hal-04279036⟩
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