People with advanced Parkinson’s disease (PD) often present with locomotor deficits that do not respond to current therapies. Targeted epidural electrical stimulation (EES) of the lumbrosacral spinal cord can restore standing, walking, and other movements impaired by spinal cord injury. Milekovic, Moraud and colleagues adapted this approach to treat locomotor deficits in advanced PD. Their closed-loop, EES-based neuroprosthesis alleviated gait impairments and balance problems in a non-human primate model of late-stage PD, and greater benefits were seen when the device was combined with deep brain stimulation (DBS), the primary neurosurgical intervention used in PD. This approach also improved gait and balance in a person with a 30-year history of PD, who was also receiving DBS and dopamine replacement therapy. This work joins several other remarkable discoveries in motor and speech neuroprostheses this year, and we look forward to future neuroengineering developments that can help to restore lost functions.
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