Researchers from the École Polytechnique Fédérale de Lausanne (EPFL) and Lausanne University Hospital (CHUV), led by Professors Grégoire Courtine and Jocelyne Bloch, have pioneered a novel approach to treating spinal cord injuries (SCI) by applying deep brain stimulation (DBS) to the lateral hypothalamus (LH). This innovative method has significantly improved lower limb movement recovery in two individuals with partial SCI, enhancing their autonomy and quality of life.
DBS is a neurosurgical technique that involves implanting electrodes into specific brain regions to modulate neural activity. Traditionally, it has been used to treat movement disorders like Parkinson’s disease by targeting areas responsible for motor control. However, applying DBS to the LH to address partial paralysis is unprecedented. By focusing on the LH, the researchers tapped into an unexpected neural pathway, facilitating motor recovery.
In the study published in Nature Medicine, DBS not only showed immediate improvements in walking during rehabilitation but also led to long-term enhancements that persisted even when the stimulation was turned off. These findings suggest that the treatment promotes the reorganization of residual nerve fibers, contributing to sustained neurological improvements.
The success of this therapy hinged on combining fundamental neuroscience with precise neurosurgical techniques. Detailed brain scans guided the accurate placement of electrodes into the brain, performed by Professor Bloch at CHUV while the patient was fully awake. Real-time feedback during the procedure confirmed the correct targeting of the LH, a region not previously associated with leg control in humans.
Identifying the LH as a key player in motor recovery after paralysis marks a significant scientific discovery, as this region has traditionally been linked to functions like arousal and feeding. This breakthrough emerged from developing a novel multi-step methodology that began with whole-brain anatomical and functional mapping to establish the LH’s role in walking. Subsequent experiments in preclinical models identified the precise circuits involved in recovery, ultimately leading to clinical trials in human participants.
These remarkable results pave the way for new therapeutic applications to augment recovery from SCI. Future research will explore integrating DBS with other technologies, such as spinal implants that have already shown potential in restoring movement after SCI. Integrating brain and spinal stimulation offers a more comprehensive recovery strategy for patients with spinal cord injuries.
(Image by Joyce Hankins from Unsplash)
DAAD-Gastprofessorin at Julius-Maximilians-Universität Würzburg