Discovery of a brain area for walking recovery

Lausanne scientists have identified a brain region crucial for the recovery of walking in mice suffering from spinal cord injuries. This unexpected discovery led to brain stimulation therapy in humans.

Scientists from the Federal Polytechnic School of Lausanne (EPFL), the Vaud University Hospital Center (CHUV) and the University of Lausanne (UNIL) led by Grégoire Courtine and Jocelyne Bloch have taken a new step in the treatment of lesions of the spinal cord, said a press release from these institutions on Monday.

By applying deep brain stimulation (DBS) to a brain region little known to be involved in walking, the lateral hypothalamus (HL), the team improved recovery of lower limb movements in two people with spinal cord injuries partial, greatly promoting their autonomy and well-being.

Reorganization of nerve fibers

DBS is a well-established neurosurgical technique that involves implanting electrodes in specific regions of the brain to modulate neuronal activity. Traditionally, it was primarily used to treat movement disorders such as Parkinson’s disease.

The application of DBS to the lateral hypothalamus to treat partial paralysis is an innovative approach. The study published in the journal Nature Medicine found that DBS produced not only immediate results in improving walking during rehabilitation, but also long-term improvements that persisted even when stimulation was stopped.

These results suggest that the treatment promoted a reorganization of residual nerve fibers that contributes to lasting neurological improvements.

“I feel my legs”

“Once the electrode was in place and the stimulation carried out, the first patient immediately said: ‘I feel my legs,’” says neurosurgeon Jocelyne Bloch, professor at CHUV, UNIL and EPFL, and co -director of the .Neurorestore center with Grégoire Courtine.

“When we increased the stimulation, she said, ‘I want to walk.’ This real-time feedback confirmed that we had targeted the right region, although it has never been associated with leg control in humans,” adds the researcher, quoted in the press release.

The identification of the lateral hypothalamus as a key player in motor recovery after paralysis constitutes in itself an important scientific discovery, given that this region is traditionally only associated with functions such as arousal and food.

Brain mapping

This advance is the result of a multi-step methodology, which began with anatomical and functional mapping of the whole brain to establish the role of this region in walking, followed by experiments on preclinical models to identify the circuits precise involved in recovery.

Finally, these results led to clinical trials on humans. Future research will focus on integrating DBS with other technologies, such as spinal cord implants, which have already demonstrated potential in restoring movement after spinal cord injury.

“The integration of our two approaches – brain and spinal stimulation – will offer a more comprehensive recovery strategy for patients suffering from spinal cord injuries,” concludes Grégoire Courtine.

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