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research article

A spinal cord neuroprosthesis for locomotor deficits due to Parkinson's disease

Milekovic, Tomislav  
•
Moraud, Eduardo Martin  
•
Macellari, Nicolo  
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November 6, 2023
Nature Medicine

People with late-stage Parkinson's disease (PD) often suffer from debilitating locomotor deficits that are resistant to currently available therapies. To alleviate these deficits, we developed a neuroprosthesis operating in closed loop that targets the dorsal root entry zones innervating lumbosacral segments to reproduce the natural spatiotemporal activation of the lumbosacral spinal cord during walking. We first developed this neuroprosthesis in a non-human primate model that replicates locomotor deficits due to PD. This neuroprosthesis not only alleviated locomotor deficits but also restored skilled walking in this model. We then implanted the neuroprosthesis in a 62-year-old male with a 30-year history of PD who presented with severe gait impairments and frequent falls that were medically refractory to currently available therapies. We found that the neuroprosthesis interacted synergistically with deep brain stimulation of the subthalamic nucleus and dopaminergic replacement therapies to alleviate asymmetry and promote longer steps, improve balance and reduce freezing of gait. This neuroprosthesis opens new perspectives to reduce the severity of locomotor deficits in people with PD.

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Type
research article
DOI
10.1038/s41591-023-02584-1
Web of Science ID

WOS:001096987200003

Author(s)
Milekovic, Tomislav  
Moraud, Eduardo Martin  
Macellari, Nicolo  
Moerman, Charlotte  
Raschella, Flavio  
Sun, Shiqi  
Perich, Matthew G.
Varescon, Camille
Demesmaeker, Robin Jonathan  
Bruel, Alice Julie  
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Date Issued

2023-11-06

Publisher

Nature Portfolio

Published in
Nature Medicine
Volume

29

Issue

11

Start page

2854

End page
Subjects

Life Sciences & Biomedicine

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Deep Brain-Stimulation

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Nigrostriatal Degeneration

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Induced Dyskinesia

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Gait Disorders

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Motor Symptoms

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Macaque Model

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Balance

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Muscle

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Neuromodulation

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Attenuation

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
TNE  
BIOROB  
FunderGrant Number

Funding was obtained from the Defitech Foundation, the Roger de Spoelberch Prize, ONWARD Medical, CAMS Innovation Fund for Medical Sciences grant 2021-1-I2M-034, National Natural Science Foundation of China grants 81941012 and 82161138027, PDWALK ERANET JP

Defitech Foundation

2021-1-I2M-034

CAMS Innovation Fund for Medical Sciences

81941012

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Available on Infoscience
February 19, 2024
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/204154
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