Swiss scientists from the Swiss Federal Technology Institute of Lausanne (EPFL) and Lausanne University Hospital have discovered the region of the brain responsible for recovering motor skills and have stimulated it to improve recovery in two patients. According to a study published in Nature Medicine, two patients with partial spinal cord injuries have gained more autonomy while walking thanks to an innovative electrostimulation therapy applied to a very specific brain region.  One of them can even go upstairs and downstairs without help. The clinical breakthrough is the completion of a study started in mice that identified a region of the brain traditionally linked to arousal and feeding as key in rehabilitating this type of injury. It has been shown that stimulating it improves patient recovery.

Two trial patients gain autonomy

Wolfgang Jäger, a 54-year-old Swiss who has been using a wheelchair since 2006 due to a ski accident, participated in the very limited clinical trial. He emphasizes the autonomy he has gained from the intervention: “”Last year on vacation, it was no problem to walk a couple of steps down and back to the sea using the stimulation. It’s a wonderful feeling not to have to depend on others all the time,” he describes. The other patient, who prefers to remain anonymous, could not walk without the help of prosthetics and a machine to take off weight. After the intervention and rehabilitation process, she can move independently with only the aid of a walker.

Brain maps first found in rodents

The Swiss team that made the discovery began by creating three-dimensional maps of the brain activity of various mice recovering from spinal cord injuries and developed a therapeutic approach that improves the quality of life for human patients.

The rodents’ brain maps allowed the identification of a brain region called the lateral hypothalamus, which serves as the operations centre from which the recovery of leg mobility occurs after a spinal cord injury. The finding was surprising, the researchers explain, because it is a region that had never been associated with leg movement.

After confirming in healthy individuals that the lateral hypothalamus is also involved in human motor skills, the scientists applied their findings to the recovery of two patients with spinal cord injuries who had not benefited much from rehabilitation. To do this, they implanted two electrodes in their brains, directly in the key region, and used them to stimulate their neurons.

Immediate health improvement

The results were immediate. Both patients instantly felt sensations in their previously numb extremities. “I feel my legs,” said one of them on the operating table (the surgery was performed while the patients were fully awake). The activity in the leg muscles increased immediately.

“This real-time feedback confirmed we had targeted the correct region, even if this region had never been associated with the control of the legs in humans. At this moment, I knew that we were witnessing an important discovery,” explains Jocelyn Bloch, neuroscientist and neurosurgeon at the University Hospital of Lausanne.

“This research demonstrates that the brain is needed to recover from paralysis,” adds Grégoire Courtine, professor of neuroscience at the Swiss Federal Technology Institute of Lausanne and co-director of the NeuroRestore centre.

According to the scientists, the next step is to validate these results with a larger group of patients. The Swiss team’s proposal has been successful, and neither of the two participants in the clinical trial suffered any serious side effects after the intervention. However, it will still be necessary to extend testing to more people to validate the safety and effectiveness of the treatment.