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Case Reports
. 2023 Nov;29(11):2854-2865.
doi: 10.1038/s41591-023-02584-1. Epub 2023 Nov 6.

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

Tomislav Milekovic #  1   2   3   4   5 , Eduardo Martin Moraud #  2   3   4 , Nicolo Macellari #  1   2   3   4 , Charlotte Moerman #  2   3   4 , Flavio Raschellà #  1   6 , Shiqi Sun #  1   2   3   4 , Matthew G Perich #  5 , Camille Varescon  1   2   3   4 , Robin Demesmaeker  1   2   3   4 , Alice Bruel  7 , Léa N Bole-Feysot  1   2   3   4 , Giuseppe Schiavone  1   8 , Elvira Pirondini  2   3   9   10 , Cheng YunLong  11   12   13 , Li Hao  11   12   13 , Andrea Galvez  1   2   3   4 , Sergio Daniel Hernandez-Charpak  1   2   3   4 , Gregory Dumont  1   2   3   4 , Jimmy Ravier  1   2   3   4 , Camille G Le Goff-Mignardot  1   2   3   4 , Jean-Baptiste Mignardot  1   2   3   4 , Gaia Carparelli  1   2   3   4 , Cathal Harte  1   2   3   4 , Nicolas Hankov  1   2   3   4 , Viviana Aureli  1   2   3   4 , Anne Watrin  14 , Hendrik Lambert  14 , David Borton  1   2   3   4   15 , Jean Laurens  1   16 , Isabelle Vollenweider  1   2   3   4 , Simon Borgognon  1   2   3   4 , François Bourre  17   18 , Michel Goillandeau  17   18 , Wai Kin D Ko  11   12   13 , Laurent Petit  17   18 , Qin Li  11   12   13 , Rik Buschman  19 , Nicholas Buse  19 , Maria Yaroshinsky  20 , Jean-Baptiste Ledoux  21 , Fabio Becce  21 , Mayté Castro Jimenez  22 , Julien F Bally  22 , Timothy Denison  23 , Dominique Guehl  17   18 , Auke Ijspeert  7 , Marco Capogrosso  1   2   3   4   9 , Jordan W Squair  1   2   3   4 , Leonie Asboth  1   2   3   4 , Philip A Starr  20 , Doris D Wang  20 , Stéphanie P Lacour  6   8 , Silvestro Micera  6   24 , Chuan Qin  12 , Jocelyne Bloch  25   26   27   28 , Erwan Bezard  29   30   31   32   33 , G Courtine  34   35   36   37
Affiliations
Case Reports

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

Tomislav Milekovic et al. Nat Med. 2023 Nov.

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.

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