In 2017, Michel Roccati suffered a motorcycle accident that left his lower body completely paralyzed. In 2020, he walked again, thanks to an innovative new spinal cord implant.
The implant sends electrical pulses to your muscles, mimicking the action of your brain, and could one day help people with severe spinal injuries stand up, walk and exercise.
It is based on long-running research that uses electrical pulses to improve the quality of life for people with spinal cord injuries, including a 2018 study by the same team that helped people with partial paralysis of the lower of the body to walk again.
“It was a very emotional experience,” Roccati told reporters about the first time the electrical pulses were activated and he took a step.
He was one of three patients involved in the study, published Monday in the journal Nature Medicine, all of whom were unable to move their lower bodies after accidents.
All three were able to take measurements shortly after the six-centimeter implant was inserted and their pulses adjusted.
“These electrodes were longer and larger than the ones we had previously implanted, and we were able to access more muscles thanks to this new technology,” said Jocelyne Bloch, a neurosurgeon at Lausanne University Hospital who helped lead the trial.
Those initial steps, while impressive to the researchers and their patients, were difficult and required handrails and significant upper-body strength.
But patients could start rehabilitation right away, and within four months, Roccati could walk with only a frame for balance.
“Not that it’s an immediate miracle, far from it,” said Gregoire Courtine, a neuroscientist at the Swiss Federal Institute of Technology who led the research with Bloch.
But with practice, Roccati can now stand for several hours and walk almost a kilometer. The Italian described being able to look clients in the eye, have a drink at a standing table and shower standing up thanks to the implant.
He and others in the trial were also able to climb stairs, swim and canoe.
‘I see the improvement’
Improvements depend on electrical stimulation, which is activated by a computer worn by the patient that triggers a pattern of pulses.
Two of the patients can now activate their muscles slightly without electrical pulses, but only minimally.
By comparison, some patients with partial paralysis of the lower body treated in an earlier study can move their previously immobile legs and stand without stimulation.
All three men in the new trial suffered injuries at least a year before the implant, and Bloch hopes to test the technology sooner after an accident.
“What we all think is that if you try it earlier it will have more effect,” he said.
There are challenges: In early recovery, a patient’s ability is still changing, making it difficult to establish a baseline from which to measure progress, and ongoing medical treatment and pain could get in the way of rehabilitation.
Until now, the implants are only suitable for those with an injury above the lower thoracic spinal cord, the section that runs from the base of the neck to the abdomen, because six centimeters of healthy spinal cord are needed.
The idea of using electrical pulses to treat paralysis grew out of technology used to regulate pain, and the researchers said they see possibilities for other applications.
They have also shown that it can regulate low blood pressure in patients with spinal cord injury and plan to publish a study on its use for severe Parkinson’s disease soon.
The team cautioned that much remains to be done before the implant is available for treatment outside of clinical trials, but said they receive about five messages a day from patients seeking help.
Next, they plan to miniaturize the computer that monitors the pulses so that it can be implanted in patients and controlled with a smartphone.
They hope this will be possible this year and have plans for large-scale trials with 50 to 100 patients in the United States and later in Europe.
Roccati said he activates the implant daily at home and continues to get stronger.
“I see the improvement every day,” he said.
“I feel better when I use it.”
TheGuardian