Scientists decode the neural signals that encode walking in the brain
Patient with Parkinson's disease doing walking exercises in the presence of Dr. Eduardo Moraud Martin at the Walking Lab in the Nestlé building. Credit: CHUV 2021 | DEROZE Eric
Most patients with advanced Parkinson's disease develop disturbances of gait and balance, which severely affect their everyday mobility, independence, and quality of life. Using a last generation deep brain stimulation implant able to simultaneously stimulate and record the brain, we identified the neural activity patterns that correlate with normal and pathological gait. These results open new avenues for the development of adaptive neuromodulation therapies that can target gait deficits and prevent falls in real-time.
Deep brain stimulation of the subthalamic nucleus is a well-established neuromodulation therapy for the symptomatic treatment of motor deficits in Parkinson’s disease. For decades, this therapy has been optimized to alleviate symptoms such as tremor, bradykinesia (slowness of movements) and rigidity. However, deep brain stimulation often fails to improve, or can even aggravate gait deficits. To date, little is known about the neural activity patterns underlying gait deficits in Parkinson’s disease, which has restricted the development of neuromodulation therapies better targeting these impairments.
In this study, we leveraged a high-resolution gait platform established at CHUV to record the activity of the subthalamic nuclei, wirelessly and in real time, and to map it to whole-body movements and leg muscle activity while patients performed a series of walking tasks. We identified the neural activity patterns underlying basic walking, turning and freezing of gait. We then developed machine learning algorithms able to predict in real-time different aspects of walking, such as locomotor states, gait phases or effort modulations when avoiding obstacles, as well as pathological episodes such as freezing of gait.
These results open new avenues for the development of adaptive neuromodulation therapies that employ predictions of leg motor states in real time to target and prevent gait and balance deficits in people with Parkinson’s disease.
Link to the article: https://www.science.org/doi/10.1126/scitranslmed.abo1800
Contact information: Eduardo Martin Moraud [email protected]
.NeuroRestore is an R&D platform based in French-speaking Switzerland that develops approaches for restoring neurological function in patients suffering from paraplegia, tetraplegia, Parkinson’s disease or the consequences of stroke. It is headed by Grégoire Courtine, a neuroscientist at Ecole polytechnique fédéral de Lausanne (EPFL), and Jocelyne Bloch, a neurosurgeon at Lausanne University Hospital (CHUV). .NeuroRestore, founded in 2018, brings together engineers, doctors and scientists from EPFL, CHUV and the University of Lausanne, with the support of the Defitech Foundation. It draws on this pooled expertise to develop neurotherapies that can help patients recover motor function. Its innovative and personalized treatments are tested through research protocols and then made available to hospitals and patients. .NeuroRestore is also committed to training the next generation of health-care professionals and engineers on the use of these novel therapeutic approaches.
European Commission: H2020-MSCA-IF-2017 793419
Swiss National Science Foundation: PZ00P3_180018
Parkinson Schweiz foundation
Funds Gustaaf Hamburger of the Fondation Philanthropia
Defitech foundation
Yohann Thenaisie, Kyuhwa Lee, Charlotte Moerman, Stefano Scafa, Andrea Gálvez, Elvira Pirondini, Morgane Burri, Jimmy Ravier, Alessandro Puiatti, Ettore Accolla, Benoit Wicki, André Zacharia, Mayte Castro Jiménez, Julien F. Bally, Grégoire Courtine, Jocelyne Bloch, Eduardo Martin Moraud. Principles of gait encoding in the subthalamic nucleus of people with Parkinson’s disease. Science Translational Medicine 07 Sep 2022 Vol 14, Issue 661. DOI: 10.1126/scitranslmed.abo1800