A paraplegic regains control of walking thanks to two technologies

For the first time, a paraplegic person has been able to regain natural control of walking by thinking, thanks to the coupling of two technologies that restore communication between the brain and spinal cord.

Dutchman Gert-Jan walking in Lausanne, May 23, 2023. © FABRICE COFFRINI/AFP

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I regained freedom " says Gert-Jan, who does not wish to give his last name. Suffering from a spinal cord injury in the cervical vertebrae following a bicycle accident a decade ago, this 40-year-old Dutchman can now stand, move on various terrains and even climb stairs.

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Initially, he was unable to put one foot in front of the other. "reported the Swiss surgeon Jocelyne Bloch, professor at the University Hospital of Vaud, presenting a study published Wednesday in the scientific journal Nature. Before him, other patients who could no longer move their legs benefited from advances allowing them to walk again. But for the first time, this man can again control by thought the movement of his legs and the rhythm of his steps, says the study.

Two technologies implanted in the body

This feat is made possible by the combination of two technologies implanted in the brain and spinal cord, explains Guillaume Charvet, researcher at the CEA (French Alternative Energies and Atomic Energy Commission), a stakeholder in the project. This result is the result of more than ten years of research by teams in France and Switzerland. The spinal cord, contained by the spine, prolongs the brain and controls many movements. The latter can therefore be irretrievably lost if contact with the brain is damaged.

To change the situation, electrodes developed by the CEA were implanted in the paralyzed patient, above the region of the brain that is responsible for leg movements. This device makes it possible to decode the electrical signals generated by the brain when we think about walking. At the same time, a neurostimulator connected to an electrode field was positioned on the region of the spinal cord that controls the movement of the legs.

Thanks to algorithms based on artificial intelligence methods, movement intentions are decoded in real time from brain recordings. These intentions are then converted into electrical stimulation sequences of the spinal cord, which in turn activate the leg muscles to achieve the desired movement.

The data is transmitted via a portable system placed on a walker or in a small backpack, allowing the patient to dispense with outside help. Until now, the installation of a single implant electronically stimulating the spinal cord has allowed paraplegic patients to walk again. But the control of this march was not natural.

More trials to come

Operated twice for the placement of the two implants, the Dutchman evokes "a long journey" to manage to stand again and walk several minutes in a row. Another important advance: after six months of training, he seems to have recovered some of his sensory and motor faculties, even though the system is disabled. "These results suggest that establishing a link between the brain and spinal cord would promote a reorganization of neural circuits at the lesion level," explains Guillaume Charvet of the CEA.

The teams are now preparing to launch a trial to restore, with the same technology, the function of the arms and hands. They also hope to apply it to other clinical indications, such as paralysis caused by a stroke.

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With AFP)

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