The onset of Parkinson’s disease has a number of debilitating outcomes. One of those is a gradual decline in the ability to walk freely. The progressive loss of dopamine-producing neurons that accompanies Parkinson’s leads to difficulties with walking, balance and a ‘freezing’ gait.
Now, though, there is hope of minimising – perhaps even eliminating – walking difficulties associated with Parkinson’s, thanks to a breakthrough trial. Details of the trial were published this week in Nature.
The Parkinson’s shuffle
It was about 20 years ago that I first noticed it in Nick. Nick was by no means young, but he’d been in good health in the five years I’d known him since moving in next door. Nick would often walk up to the local milk bar. Never quickly but, after all, he was probably well into his 80s.
One day, though, I noticed a change in Nick’s gait. Before long it had evolved into a ‘shuffle’. He’d take short steps as he headed up to the corner shop. Each foot would only just leave the footpath with each step he took.
“His knees must be giving him a lot of trouble,” I thought. But I soon found out that Nick’s shuffle was a telltale sign of Parkinson’s disease. In time, even a shuffle was too much for Nick, and much of his last few years were spent in a wheelchair.
The shuffle usually aligns with the first of five defined stages of the disease, each progressively worse.
Stage five is the most advanced and debilitating. Stiffness in the legs can make it impossible to stand or walk. The person is usually either bedridden or confined to a wheelchair unless aided, and around-the-clock care is required.
Restoring the signal
The neurons lost as a result of Parkinson’s are central to sending signals from the spine to the leg muscles. But a first-time trial of a spinal implant that aims to restore that signalling has produced very promising results.
The ‘guinea pig’ for the trial was a Frenchman named Marc, a 63-year-old from Bordeaux. Diagnosed with Parkinson’s over 20 years ago, Marc had developed severe mobility problems, including balance problems and the freezing gait. Since receiving an implant, Marc has been able to walk more normally and has regained his independence.
Having previously found himself “trampling on the spot” when trying to move forward, Marc has experienced a dramatic recovery. “Right now, I’m not even afraid of the stairs anymore,” he told The Guardian newspaper. “Every Sunday I go to the lake, and I walk around six kilometres. It’s incredible.”
Previous treatments, such as the drug Levodopa, can improve symptoms but are unable to completely restore normal movement. Such treatments have targeted the affected areas of the brain.
However, the spinal implant “targeted the region of the lumbosacral spinal cord that ultimately produces walking”. That area is not directly affected by Parkinson’s. In effect, the trial implant bypasses Parkinson’s disease and stimulates the muscles in a new way.
That’s extremely promising news for Parkinson’s sufferers, but much work remains to be done. The study’s authors say a full clinical trial is the next step. In reality, it will be several years before the spinal cord implant reaches the wider population.
Nevertheless, this is an important first step towards a new Parkinson’s treatment, even if it is only a ‘shuffling’ one.
Do you know someone who suffers from Parkinson’s? How has their mobility been affected? Let us know in the comments section below.