An electronic implant surgically placed into the spine of a woman has allowed her to walk again, after a debilitating neurodegenerative disease caused her to fall unconscious every time she stood up. The incredible system has previously allowed three paralyzed men to regain movement in their legs and shows huge promise for patients with neurodegenerative diseases for which there are currently no cures.
The results were published in the New England Journal of Medicine.
The patient that received the implant has a condition called multiple system atrophy-parkinsonian type (MSA-P), a rare condition that presents with Parkinson’s-like symptoms but which also causes widespread damage to nerves around the body. As a result, patients often have trouble regulating blood pressure, heart rate, and sweating.
In this case, one significant symptom of MSA-P was the loss of sympathetic neurons in the patient’s body, causing blood pressure to dramatically drop when standing up (called orthostatic hypotension). Many of us will have felt a very mild form of orthostatic hypotension after standing up too quickly and suddenly becoming lightheaded and dizzy. However, in this case, the woman’s nervous system was too damaged to regulate blood pressure at all and she would blackout immediately after standing, preventing any form of upright movement.
The researchers, a collaboration of different hospitals in Switzerland, implanted an electronic device consisting of electrodes and an electrical-impulse generator directly into the spinal cord. Previously used as a way to treat chronic pain, the chip was instead designed to detect changes in the woman’s posture and react accordingly, instructing arteries to constrict and helping her body maintain blood pressure.
The device worked, and the woman could stand once more after being unable for 18 months prior. Furthermore, she is now in physical therapy to hopefully regain the ability to walk.
"We’ve already seen how this type of therapy can be applied to patients with a spinal-cord injury. But now, we can explore applications in treating deficiencies resulting from neurodegeneration. This is the first time we’ve been able to improve blood-pressure regulation in people suffering from MSA," Grégoire Courtine, EPFL professor in neuroscience and co-author of the paper, said in a statement.
"This technology was initially intended for pain relief, not for this kind of application. Going forward, we and our company Onward Medical plan to develop a system targeted specifically to orthostatic hypotension that can help people around the world struggling with this disorder."