Press release
Lausanne, 7 février 2022

New implant offers promise for the paralyzed

A system developed by Grégoire Courtine and Jocelyne Bloch now enables patients with a complete spinal cord injury to stand, walk and even perform recreational activities like swimming, cycling and canoeing.

« The first few steps were incredible – a dream come true! » © Alain Herzog, EPFL

The images made headlines around the world in late 2018. David Mzee, who had been left paralyzed by a partial spinal cord injury suffered in a sports accident, got up from his wheelchair and began to walk with the help of a walker. This was the first proof that Courtine and Bloch’s system – which uses electrical stimulation to reactivate spinal neurons – could work effectively in patients.

Fast forward three years, and a new milestone has just been reached. The research team led by both Courtine, a professor at EPFL, and Bloch, a professor and neurosurgeon at CHUV, has enhanced their system with more sophisticated implants controlled by artificial-intelligence software. These implants can stimulate the region of the spinal cord that activates the trunk and leg muscles. Thanks to this new technology, three patients with complete spinal cord injury were able to walk again outside the lab. «Our stimulation algorithms are still based on imitating nature,” says Courtine. «And our new, soft implanted leads are designed to be placed underneath the vertebrae, directly on the spinal cord. They can modulate the neurons regulating specific muscle groups. By controlling these implants, we can activate the spinal cord like the brain would do naturally to have the patient stand, walk, swim or ride a bike, for example.»

Activating motor sequences at the push of a button
On a cold, snowy day last December, Michel Roccati – an Italian man who became paralyzed after a motorcycle accident four years earlier – braved the icy wind to try out the system outdoors, in central Lausanne. He had recently undergone the surgical procedure in which Bloch placed the new, implanted lead on his spinal cord. Scientists from the Courtine and Bloch’s .NeuroRestore research center were with him, helping to prepare the demonstration. They attached two small remote controls to Michel’s walker and connected them wirelessly to a tablet that forwards the signals to a pacemaker in Michel’s abdomen. The pacemaker in turn relays the signals to the implanted spinal lead that stimulates specific neurons, causing Michel to move. When he was ready, Michel grasped the walker and set off. He pressed the button on the right side of the walker with the firm intention of taking a step forward with his left leg. His left foot rose like magic and fell to the ground a few centimeters ahead. He then did the same thing with the button on his left side, and his right foot moved forward. He was walking! «The first few steps were incredible – a dream come true! » he says. «I’ve been through some pretty intense training in the past few months, and I’ve set myself a series of goals. For instance, I can now go up and down stairs, and I hope to be able to walk one kilometer by this spring. » Two other patients have also successfully tested the new system, which is described in an article appearing today in Nature Medicine. «Our breakthrough here is the longer, wider implanted leads with electrodes arranged in a way that corresponds exactly to the spinal nerve roots,» says Bloch. «That gives us precise control over the neurons regulating specific muscles. Ultimately, it allows for greater selectivity and accuracy in controlling the motor sequences for a given activity.»

One day is all it takes
Extensive training is obviously necessary for patients to get comfortable using the device. But the pace and scope of rehabilitation is amazing. «All three patients were able to stand, walk, pedal, swim and control their torso movements in just one day, after their implants were activated!» says Courtine. « That’s thanks to the specific stimulation programs we wrote for each type of activity. Patients can select the desired activity on the tablet, and the corresponding protocols are relayed to the pacemaker in the abdomen.»

While the progress achievable in a single day is astonishing, the gains after several months are even more impressive. The three patients followed a training regimen based on the stimulation programs and were able to regain muscle mass, move around more independently, and take part in social activities like having a drink standing at a bar. What’s more, because the technology is miniaturized, the patients can perform their training exercises outdoors and not only inside a lab.

«This study further demonstrates the benefits of our approach,» says Courtine. « We’re now working with ONWARD Medical, which recently listed on Euronext, to turn our discoveries into genuine treatments that can improve the lives of thousands of people around the world.»

 

Contact information
For medical information, please fill the form on NeuroRestore
EPFL Press office : Emmanuel Barraud, +41 21 693 21 90
CHUV Press office: medias(at)chuv.ch
ONWARD Medical: Dave Marver, CEO, +41 78 208 36 04

About .NeuroRestore
.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.

About ONWARD
ONWARD is a medical technology company creating innovative therapies to restore movement, independence, and health in people with spinal cord injury. ONWARD’s work builds on more than a decade of basic science and preclinical research conducted at the world’s leading neuroscience laboratories. ONWARD’s ARC Therapy, which can be delivered by implantable (ARCIM) or external (ARCEX) systems, is designed to deliver targeted, programmed stimulation of the spinal cord to restore movement and other functions in people with spinal cord injury, ultimately improving their quality of life. ONWARD has received three Breakthrough Device Designations from the FDA encompassing both ARCIM and ARCEX. The company’s first FDA pivotal trial, called Up-LIFT, completed enrollment in December 2021 with 65 subjects worldwide. ONWARD’s technology is protected by over 310 issued or pending patents globally. ONWARD is headquartered at the High Tech Campus in Eindhoven, the Netherlands. It maintains a significant team in Lausanne, Switzerland and has a growing U.S. presence in Boston, Massachusetts, USA. For additional information about the company, please visit ONWD.com. To access our 2022 Financial Calendar, please visit IR.ONWD.com

About Lausanne University Hospital (CHUV)

CHUV is one of Switzerland’s five university hospitals, alongside Geneva, Bern, Basel and Zurich. It is tasked with three basic missions by the public authorities, namely care, teaching and research. It provides care in all areas of medicine, including physical disorders and psychiatric illnesses, medical and surgical disciplines, outpatient and inpatient treatment.

In 2021, CHUV’s 12,228 employees cared for 51,205 inpatients, accounting for over 500,374 days of hospitalisation. It dealt with 80,261 emergencies, provided 1,451,300 outpatient consultations and welcomed 3,177 new babies into the world. Its annual budget is 1.832 billion Swiss francs.

CHUV works closely with the Faculty of Biology and Medicine of the University of Lausanne to provide undergraduate, postgraduate and continuing education for doctors. It also works with other higher education institutions in the Lake Geneva area (including EPFL, ISREC, the Ludwig Institute for Cancer Research and the University of Geneva), with the University Hospitals of Geneva and other hospitals, health care providers and institutions, such as the Federation of Vaud Hospitals and the Vaud Society of Medicine.

Since 2019, CHUV has been ranked as one of the best hospitals in the world according to Newsweek magazine.