Researchers from EPFL and the Lausanne University Hospital (CHUV), led by Professors Grégoire Courtin and Jocelyn Bloch, have made significant advances in the treatment of spinal cord injuries (SCI). Scientists increased lower limb movement recovery in two people with partial SCI by delivering deep brain stimulation (DBS) to an unanticipated brain region – the lateral hypothalamus (LH), significantly increasing their autonomy and well-being. Read also | Covid-19 infection can cause vocal cord paralysis in teenagers, new study suggests
Wolfgang Jaeger, 54, of Kappel, Austria, has been in a wheelchair since 2006 after suffering a spinal cord injury in a skiing accident. Participating in a clinical trial, he experienced firsthand how deep brain stimulation can restore his mobility and independence. “Last year on vacation it was no problem to walk a couple of steps down and back to the sea using the stimulation,” shared Jagger, describing the new freedom DBS has given him. In addition to walking, the therapy improved daily tasks. “I can also reach things in my cupboards in the kitchen,” he added.
DBS is a well-established neurosurgical technique that involves implanting electrodes in specific areas of the brain to modulate neural activity. Traditionally, DBS has been used to treat movement disorders such as Parkinson’s disease and essential tremor by targeting areas of the brain responsible for motor control. However, applying DBS to the lateral hypothalamus to treat partial paralysis is a novel approach. Focusing on LH, researchers from. Neurorestore tapped into an unexpected neural pathway not previously considered for motor restoration.
Research results:
In a study published in Nature Medicine, DBS not only showed immediate results in increasing walking during rehabilitation, but patients also showed long-term improvements that persisted even when the stimulation was turned off. These findings suggest that the treatment promoted the reorganization of residual nerve fibers that contribute to sustained neurological improvements. Read also | Sleep paralysis: awake but can’t move? An expert on this dreaded sleep disorder
“This study demonstrates that the brain is required to recover from paralysis. Surprisingly, the brain cannot take full advantage of the projections of neurons that survive spinal cord injury. Here we have found a way to engage a small area of the brain that is known to not involved in walking to engage these residual connections and increase neurological recovery in people with spinal cord injury,” says Curtin, professor of neurology at EPFL, Lausanne University Hospital (CHUV) and UNIL and co-director of the .NeuroRestore Center.
The success of this DBS therapy has depended on two complementary approaches: discoveries through new methodologies in animal studies and the translation of these discoveries into precise surgical techniques in humans. For the surgery, the researchers used detailed brain scans to pinpoint the exact location of tiny electrodes in the brain, performed by Bloch in the CHUV while the patient was awake.
“Once the electrode was in place and we did the stimulation, the first patient immediately said, ‘I can feel my legs.’ As we increased the stimulation, she said, “I feel like walking!” This real-time feedback confirmed that we were targeting the right area, even though the area had never been associated with foot control in humans. At that moment I knew we were witnessing an important discovery for the anatomical organization of brain functions,” says Bloch, a neurosurgeon and professor at the University Hospital of Lausanne (CHUV), UNIL and EPFL, as well as co-director of the .NeuroRestore center. Read also | Prevent dementia 40 years ahead: Simple lifestyle changes to protect your brain
The identification of LH as a key player in motor recovery after paralysis is in itself an important scientific discovery, given that this area has traditionally been associated only with functions such as arousal and feeding. This breakthrough resulted from the development of a new multi-step methodology that began with anatomical and functional mapping of the whole brain to determine the role of this region in gait, followed by experimentation in preclinical models to establish the precise circuits involved in recovery. These results eventually led to human clinical trials.
“This was fundamental research by creating detailed brain maps that allowed us to identify the lateral hypothalamus in gait recovery. “Without this seminal work, we would not have discovered the unexpected role this region plays in restoring gait,” says Jordan Squire, lead author of the study.
The advanced imaging platform at the Wyss Center was instrumental in this study, providing high-resolution imaging capabilities that allowed the team to map the anatomical and functional activity of neurons in the brain, allowing identification of the lateral hypothalamus.
These remarkable results pave the way for new therapeutic applications to increase recovery after SCI. Future studies will explore the integration of DBS with other technologies, such as spinal implants, which have already demonstrated their potential in restoring movement after SCI. “Integrating our two approaches—brain and spinal cord stimulation—offers a more comprehensive recovery strategy for patients with spinal cord injuries,” Curtin says.
Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Always consult your doctor for any health concerns.
