Grégoire CourtineHelp paralysed people walk again
For all human history, a seriously injured spine has meant permanent loss of the ability to walk. Now, in an advance that would have seemed miraculous until very recently, a French medical scientist based in Switzerland is helping paralysed patients to walk again.
Grégoire Courtine is developing an electronic “bridge” that can reconnect the patient’s brain with the lumbar spinal cord after injury. Supported by wireless technology, the system records the brain signals controlling movement to drive electrical stimulation of the lower spinal cord.
This targeted stimulation of the lumbar spinal cord can generate leg movements coinciding with the natural motor intention signals from the brain.
The neuroprosthetic bridge could restore immediate voluntary control over leg muscles allowing intensive gait rehabilitation. In turn, this will encourage the re-growth of neurons in the spinal cord, ultimately inducing long-lasting recovery over paralysed leg muscles, reducing the need for the bridge itself.
“Movement has always been very important for me because of my love of sport,” explains Courtine, who is an avid rock climber and extreme sports fan. “This is why I decided to study how the brain controls movement.” He became inspired through his work at the Christopher & Dana Reeve Foundation in the United States and in particular by meeting a young man in Zurich who had lost the ability to walk.
“I could really relate to him because I was the same age, I was also very much involved with sports, and it was heartbreaking to see him lose this capacity that was so important in my own life. That moment, that confrontation with a person in a wheelchair, really compelled me to invest the rest of my scientific career in trying to find a treatment for people with spinal cord injury.” Courtine has already proved his spinal bridge can work. Using the system, he has helped nine long-term paraplegic men to stand and walk short distances on crutches. The patients can turn the bridge on and off using a personalized voice control, although they have no voluntary control over the signals it sends.
The concept of such a bridge has been validated in comprehensive preclinical work. As a next step and proof of concept, Courtine will conduct a clinical trial involving four patients who have been paralysed for more than a year, with the goal of better understanding the relationship between brain signals and spinal cord stimulation.
His brain-spine bridge will be surgically implanted into these four patients and electrical stimulation patterns tailored for each individual, who will then gradually learn to walk again using body-weight support from a suspended harness.
This experiment will establish the technological and conceptual framework for the development of a fully implantable brain-spine interface that may one day become a common medical treatment for those whose legs have been paralysed by spinal injury, improving the lives of thousands of people.