People with advanced Parkinson's disease often face mobility problems that can have a significant impact on their quality of life and decrease their autonomy. This problem affects approximately 90% of sufferers and includes muscle stiffness, slowness of movement, freezing of gait, problems starting and stopping movement, and postural instability. These disorders often respond poorly to standard therapies that focus primarily on the areas of the brain directly affected by the loss of dopamine-producing neurons. Therefore, we need to develop new therapeutic strategies that can help solve these problems.  

This study introduces a very innovative therapeutic strategy that does not target the brain areas most affected in Parkinson's disease, but other areas of the nervous system that are not affected by this pathology. Specifically, it targets the lumbosacral region of the spinal cord, which is ultimately involved in the control of the leg muscles and in the generation of the act of walking. To this end, they propose to use both deep brain stimulation, which is commonly used in many patients with Parkinson's disease, and the modulation of the activity of motor neurons located in this lumbosacral area of the spinal cord, using epidural electrical stimulation. Thanks to this, a 62-year-old man, who was affected for more than 30 years by Parkinson's disease, has experienced a marked reduction in his mobility problems and has also experienced improvements in his balance and in his tendency to freeze gait, resulting in a significant improvement in his quality of life.  

The study is very well designed and of high quality. The authors first developed the technology in an animal model of Parkinson's disease, and then validated it in a person with advanced Parkinson's disease. The results suggest that, with the right technology, it is possible to detect a person's movement intention and establish bidirectional communication with the nervous system, and that artificial electrical stimulation of nerve cell populations in the spinal cord may be effective in alleviating motor deficits that occur in some neurodegenerative brain diseases. However, it should be noted that this research has been performed in a single patient, so further studies are still needed to confirm the effectiveness of this therapeutic approach in a larger number of individuals, and to identify those patients who may benefit most from this type of neuroprosthesis.   

We hope that advances in neurotechnology, electronics, neuroscience and biomedical engineering will contribute to the development of a new generation of motor neuroprostheses, capable of modulating or adjusting the optimal parameters of electrical stimulation with greater precision, which may help restore some lost functions in many patients with severe neurological diseases. The future is hopeful, but it is necessary to advance little by little and not to create false expectations that could damage the credibility of this research.