2023-11-07 スイス連邦工科大学ローザンヌ校(EPFL)
◆新しい神経プロステーシスは、脊髄を電気的に刺激して、パーキンソン病患者の歩行障害を改善することを可能にし、電気刺激は脊髄をターゲットにし、脳のドーパミン産生ニューロンの損失に直接影響を受けない歩行を担当する領域に働きかけます。
◆患者は装置を体内に埋め込み、歩行障害が改善し、歩行がほぼ正常に戻りました。この技術はまだ試験段階ですが、将来的には多くのパーキンソン病患者に利用可能になる可能性があります。
<関連情報>
- https://actu.epfl.ch/news/parkinson-s-disease-a-neuroprosthetic-to-correct-w/
- https://www.nature.com/articles/s41591-023-02604-0
パーキンソン病における歩行の固定解除のための脊髄刺激
Spinal stimulation for unfreezing gait in Parkinson’s disease
Aviv Mizrahi-Kliger & Karunesh Ganguly
Nature Medicine Published:06 November 2023
DOI:https://doi.org/10.1038/s41591-023-02604-0
Epidural electrical stimulation of the spinal cord alleviated freezing-of-gait and other postural impairments in a patient with Parkinson’s disease, potentially addressing an unmet need and offering an exciting new avenue for therapy.
Impairments in posture, balance and gait are hallmark symptoms of Parkinson’s disease (PD). They become increasingly prevalent as the disease progresses; they affect the majority of patients with late-stage PD and dominate the clinical presentation at 15 years after diagnosis1. These axial symptoms increase the risk of falling and reduce both mobility and independence, and eventually contribute to higher rates of hospital admissions and reduced survival. The effect of freezing-of-gait is especially debilitating as these episodes manifest in a sudden and unpredictable inability to start or continue walking forward — resulting in falls and injuries2. Treatment with levodopa (a dopamine replacement agent) addresses some of the motor symptoms of the disease early on, but its effect on gait and balance impairments is inconsistent3. Similarly, the effect of deep brain stimulation of the subthalamic nucleus on the axial symptoms of the disease is heterogeneous4, which motivates the search for new avenues of therapy.
