Paralysed men have been able to stand, walk and even swim again thanks to new technology that restores movement within hours.
Implants controlled by artificial intelligence stimulated the area of the spinal cord that activates the torso and leg muscles, allowing three patients with complete paralysis to walk again.
Extensive training is needed to get comfortable using the device, but patients select the desired activity on a tablet-like device which sends a message to a pacemaker-like device.
Researchers say they now have the understanding and technology to talk to the spinal cord, and are going to use this to address as many conditions as possible, including stimulation of the bladder, and arms and hands.
Gregoire Courtine, who co-led the study, said further research on how this technology could be used for other types of neurological conditions, such as severe Parkinson’s disease, is due to be published imminently.
Michel Roccati, an Italian man who became paralysed after a motorcycle accident four years earlier, had the implants placed in August 2020.
After 10 recovery days he was able to start using the technology.
He said: “After one day I was able to walk – the body was supported, but on just the first day I was able to see my legs moving and it was very emotional.”
When the stimulation is turned on Roccati is now able to stand for two hours and walk almost 1 kilometre straight without stopping.
Control torso movements
Prof Courtine, of the Swiss Federal Institute of Technology, said: “All three patients were able to stand, walk, pedal, swim and control their torso movements in just one day, after their implants were activated.
“That’s thanks to the specific stimulation programmes we wrote for each type of activity.
“Patients can select the desired activity on the tablet, and the corresponding protocols are relayed to the pacemaker in the abdomen.”
He added: “The next step is a mini computer implanted in the body that communicates in real time with an external iPhone.”
Researchers say that while progress achievable in a single day is astonishing, the gains after several months are even more impressive.
A drink at a bar
The three men – aged between 29 and 41 – followed a training regimen based on the stimulation programmes and were able to regain muscle mass, move around more independently, and take part in social activities such as having a drink standing at a bar.
Because the technology is miniaturised, the patients can perform their training exercises outdoors and not only inside a lab.
In 2018 the researchers reported that David Mzee, who had been left paralysed after a sports accident, got up from his wheelchair and began to walk with the help of a walker.
This was the first proof that Prof Courtine and Jocelyne Bloch’s system could work effectively in patients.
The current research involves electrodes being implanted on the spinal cord, but they are larger than the one that was previously used, and more muscles could be accessed.
This meant the researchers could access not only precisely the leg muscles but also the trunk muscles which they say was very new.
For men and women
Neurosurgeon Dr Bloch, of Lausanne University Hospital, said: “It was not perfect at the very beginning, but they could train very early to have a more fluid way and fluid gait, and not only being able to walk in the laboratory, they were also able to walk outside the laboratory and do more steps.”
The researchers said they expect the technology to work in both men and women, and that while age may influence how well patients respond to the therapy there is no reason to exclude older people who are paralysed.
However, there has to be enough healthy spinal cord (6cm) for the electrodes to be implanted, and so this may exclude some people who do not have this.
The new design involves an electrode paddle that targets all nerves associated with leg and trunk movements in the spinal cord.
The team combined this technology with a personalised application which allowed precise positioning of the electrode paddle for each patient.
The findings are published in Nature Medicine.