Not being able to walk more than a few meters or sleep normally are sufferings common in advanced cases of Parkinson’s disease, and two recent studies provide encouraging clues to combat them.
In its last stage, which usually takes years, the Parkinson immobilizes the patient in bed or in a wheelchair.
Orthostatic hypotension is one of the symptoms that explain this disability. When the person stands up, their blood pressure drops, their brain doesn’t get enough food, and they pass out after a few steps.
In the case of Parkinson’s disease and related pathologies, it is a nervous system dysfunction. Patients no longer benefit from the reflex that normally ensures the return of sufficient blood flow to the brain.
Published in early April in the New England Journal of Medicine (NEJM), a work opens an innovative track: implant electrodes in the spinal cord.
This experiment was overseen by the same researchers — surgeon Jocelyne Bloch and neuroscientist Grégoire Courtine — who recently made three people paralyzed by accidents walk.
The results, published in early 2022, they are the result of ten years of research.
This time a similar technology was used in a severely disabled patient. It was not a Parkinson’s disease itself, but a pathology with similar symptoms, including orthostatic hypotension.
In the case of injured paralytics, the electrode system looks for restore the link by which the brain controls the gesture. Here, the objective is to restore the reflex that allows the correct arrival of blood to the brain.
Before implanting this system, the patient walked only a few meters before passing out. Three months later, he was able to walk about 250 meters with the help of a walker, according to the report of the work carried out by researcher Jordan Squair.
“She is not cured, she will not run a marathon, but this surgery clearly improved her quality of life”Bloch summed up before AFP.
However, this is an isolated case and the experience will have to be repeated with other people to consider therapeutic use, particularly with Parkinson’s patients.
In the latter, it is not certain that this form of hypotension can be improved by simple stimulation of the reflex in question.
Improve sleep quality
Another serious disorder that affects Parkinson’s patients is insomnia.
Its causes are multiple: sometimes the patient is simply distressed by the disease, or may being awakened by uncontrolled movements. your dream too can be directly affected by a lack of dopamine, the hormone whose progressive disappearance explains Parkinson’s disease.
Treatments for insomnia, including melatonin, may not be the same for all Parkinson’s patients.
But a study published Thursday in the Lancet Neurology proposes using an infusion pump to deliver a drug, apomorphine.
It is the same system that some diabetics use to continuously inject insulin. But the study, led by neurologist Emmanuel Flamand Roze and led by his colleague Valérie Cochen de Cock, focused on pump use only at night.
“So they don’t have the stress of wearing it during the day,” he explained to AFP.
The results are quite encouraging. Compared with patients who received placebo, patients who benefited from this device reported an improvement in the quality of your sleep.
However, the study was only conducted on a small sample — about 40 participants — and larger work is required to confirm the device’s efficacy.