Electronic implant reactivates spinal-cord nerves of a patient with neurodegenerative disease
A patient suffering from a debilitating neurodegenerative disease was able to get up and walk again after being bedridden for over a year, thanks to an innovative system developed by a team of scientists at the NeuroRestore research center headed by Jocelyne Bloch, a neurosurgeon at Lausanne University Hospital (CHUV) and Professor at University of Lausanne UNIL, and Grégoire Courtine, an EPFL professor in neuroscience. Their system includes electronics implanted directly on the spinal cord to reactivate the neurons that regulate blood pressure, thereby preventing the patient from losing consciousness every time she is in an upright position.
The implant had already been used to treat low blood pressure in tetraplegic patients, but this was the first time it was applied to this kind of neurodegenerative disease, substantially improving the patient’s quality of life.
The study, titled «Implanted System for Orthostatic Hypotension in Multiple System Atrophy,» was published in The New England Journal of Medicine on 7th April 2022. The patient in the study suffers from multiple system atrophy-parkinsonian type (MSA-P), a neurodegenerative disease that afflicts several
parts of the nervous system, including the sympathetic nervous system. After being bedridden for 18 months, the patient can now walk up to 250 meters.
MSA-P leads to the loss of sympathetic neurons that regulate blood pressure, which tends therefore to drop dramatically as soon as patients are in an upright position – a problem known as orthostatic hypotension – in some cases causing them to faint. This makes them more likely to fall, limits their ability to stand and walk around, and can eventually shorten life expectancy. Patients’ quality of life is reduced considerably since they must remain in a reclined position to avoid passing out.
The scientists’ implant consists of electrodes connected to an electrical-impulse generator that’s commonly used to treat chronic pain. After implanting their device directly on the patient’s spinal cord, the scientists found an improvement in the body’s capacity to regulate blood pressure, enabling the patient to remain conscious for longer periods in an upright position and to begin physical therapy to walk again.
For Jocelyne Bloch, this advance paves the way to important clinical breakthroughs in treating degenerative diseases: «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 adds: «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.»
Press kit (images, videos) :
https://go.epfl.ch/MSAimplant2022
Contact information :
CHUV Press office: medias@chuv.ch, +41 79 556 60 00
EPFL Press office : Emmanuel Barraud, +41 21 693 21 90
http://www.nejm.org/doi/full/10.1056/NEJMoa2112809
About Lausanne University Hospital (CHUV)
CHUV is one of Switzerland’s five university hospitals, alongside Geneva, Bern, Basel and Zurich. It is tasked with three basic missions by the public authorities, namely care, teaching and research. It provides care in all areas of medicine, including physical disorders and psychiatric illnesses, medical and surgical disciplines, outpatient and inpatient treatment.
In 2020, CHUV’s 11,942 employees cared for 48,227 inpatients, accounting for over 456,974 days of hospitalisation. It dealt with 75,457 emergencies, provided 1,346,973 outpatient consultations and welcomed 3,180 new babies into the world. Its annual budget is 1.782 billion Swiss francs.
CHUV works closely with the Faculty of Biology and Medicine of the University of Lausanne to provide undergraduate, postgraduate and continuing education for doctors. It also works with other higher education institutions in the Lake Geneva area (including EPFL, ISREC, the Ludwig Institute for Cancer Research and the University of Geneva), with the University Hospitals of Geneva and other hospitals, health care providers and institutions, such as the Federation of Vaud Hospitals and the Vaud Society of Medicine.
Since 2019, CHUV has been ranked as one of the best hospitals in the world according to Newsweek magazine.
About EPFL EPFL, one of the two Swiss Federal Institutes of Technology, based in Lausanne, is Europe’s most cosmopolitan technical university with students, professors and staff from over 120 nations. A dynamic environment, open to Switzerland and the world, EPFL is centered on its three missions: teaching, research and technology transfer. EPFL works together with an extensive network of partners including other universities and institutes of technology, developing and emerging countries, secondary schools and colleges, industry and economy, political circles and the general public, to bring about real impact for society.
About .NeuroRestore .NeuroRestore is an R&D platform based in French-speaking Switzerland that develops approaches for restoring neurological function in patients suffering from paraplegia, tetraplegia, Parkinson’s disease or the consequences of stroke. It is headed by Grégoire Courtine, a neuroscientist at Ecole polytechnique fédéral de Lausanne (EPFL), and Jocelyne Bloch, a neurosurgeon at Lausanne University Hospital (CHUV). .NeuroRestore, founded in 2018, brings together engineers, doctors and scientists from EPFL, CHUV and the University of Lausanne, with the support of the Defitech Foundation. It draws on this pooled expertise to develop neurotherapies that can help patients recover motor function. Its innovative and personalized treatments are tested through research protocols and then made available to hospitals and patients. .NeuroRestore is also committed to training the next generation of health-care professionals and engineers on the use of these novel therapeutic approaches.