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>>> World-first: Deep brain stimulation enables paralyzed patient to walk again


Interesting Engineering

by Mrigakshi Dixit

December 3, 2024


https://www.yahoo.com/news/world-first-deep-brain-stimulation-141138940.html


A ski accident left 54-year-old Wolfgang Jäger paralyzed in 2006. He has been confined to a wheelchair since sustaining a spinal cord injury.

But thanks to a new treatment, he is slowly regaining his mobility - through the ability of walking short distances.

Jäger participated in the clinical trial for spinal cord injuries (SCI) conducted by EPFL and Lausanne University Hospital (CHUV).

In this clinical trial, the participants received deep brain stimulation (DBS) in the surprising region of the brain called the lateral hypothalamus (LH).

This region was long thought to be involved only in basic functions like arousal and feeding. But it has now been revealed linked to controlling the movement of legs and even motor recovery.

Surprisingly, the results showcased notable improvement in lower limb function in trial individuals with partial SCI.

The treatment enhanced the participants’ walking abilities without the need for any aid.

“Last year on vacation, it was no problem to walk a couple of steps down and back to the sea using the stimulation,” Jäger shared.

“I can also reach things in my cupboards in the kitchen,” he added.

Revives remaining nerve fibers in the brain

DBS is a neurosurgical technique used to treat movement disorders like Parkinson's disease. It involves implanting electrodes to modulate neural activity for motor control.

This new approach involves using DBS on the lateral hypothalamus to treat partial paralysis.

By stimulating this area with DBS, researchers have been able to awaken dormant neural pathways.

The effects of DBS were both immediate and long-lasting. For instance, the treatment immediately improved walking ability during rehabilitation. Moreover, it resulted in sustained improvements in motor function.

The treatment promoted the reorganization of “residual nerve fibers,” which survive after the injury. This resulted in lasting neurological improvements.

“We found how to tap into a small region of the brain that was not known to be involved in the production of walking in order to engage these residual connections and augment neurological recovery in people with spinal cord injury,” said Grégoire Courtine, professor of neuroscience at EPFL, Lausanne University Hospital (CHUV).

For the surgery, detailed brain scans of the patients were first conducted. The scans enabled accurate placement of small electrodes into the brain region.

After this, stimulations were performed while the patient was fully conscious. During stimulation, the patients provided real-time feedback.

For instance, the first patient immediately reported feeling her legs, and increased stimulation prompted her to say, "I feel the urge to walk!"

“This real-time feedback confirmed we had targeted the correct region, even if this region had never been associated with the control of the legs in humans,” said Jocelyne Bloch, neurosurgeon and professor at the Lausanne University Hospital (CHUV), in the press release.

Researchers developed a multi-step approach to identify the role of the lateral hypothalamus in walking recovery.

They started by mapping the entire brain to understand its function in walking. Moreover, experiments on animal models revealed specific neural circuits involved in recovery. Finally, they translated these findings into clinical trials on two human participants.

These results open the door to new treatments for SCI recovery.

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