Swiss teams have managed to reduce in a patient of abrupt blood pressure drops responsible for syncopes, thanks to a stimulation of the spinal cord.
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Straighten a few minutes only, then make a syncope. This was Nirina, 48 years old, achieved since 2017 a multisystem atrophy of Parkinson type. This rare neurodegenerative disease (which is estimated that it affects one in 10,000 to 50,000) generates, among other disabling symptoms, so-called “orthostatic” hypotension, namely a sharp drop in blood pressure that occurs when the ‘We move from the sitting or lying position to the standing position. For a year and a half, Nirina could not live any otherly only, until he implanted an electronic system on the spinal cord allowing him to rise, but also to see a few hundred meters.
This advance, it is owed to Jocelyne Bloch, Professor at the University of Lausanne (UNIL) and Neurosurgene at the Vaudois University Hospital (UNIL-CHUV), and Gregory Courtine, Professor of Neuroscience at the Ecole Polytechnique Federal of Lausanne (EPFL) and to the UNIL, as well as their teams of the research center Neurorestore. the Es Results of this case study have been published on April 6 in the New England Journal of Medicine magazine. They follow A previous work published In Nature in 2021, which had already demonstrated the possibility of treating orthostatic hypotension in tetraplegic patients through the establishment of a similar implant. This is the first time that such an intervention is carried out on a person with neurodegenerative pathology.
“We have applied exactly the same principle as the one we put in place for individuals affected by traumatic injury, explains Jocelyne Bloch. The goal is to use electrical stimulations at the spinal cord level in order to Target neuronal circuits that regulate blood pressure and reactivate the baroreflex. “This is a naturally triggered reflex during blood pressure changes, for example when one gets up and the blood flow decreases at the level of The head and increases in the legs. “In case of arterial hypotension, we all have a sensor at the heart and carotid, which will immediately indicate that the pressure is too low, details the professor. This baroreceptor will then send the order to the sympathetic system to contract The arteries, which will bring up the pressure. “
rare cases
Nirina affecting disease causes a loss of sympathetic neurons specialized in the regulation of blood pressure and therefore an alteration of the baroreflex, which resists, in its case, to drug approaches. Coupled to a voltage sensor, the device used in this patient – electrodes and an electrical stimulation generator generally used in the processing of chronic pain – detects abnormal voltage declines and then send a series of pulses to a specific place of The spinal cord, which makes it possible to immediately increase the blood pressure at the desired level and thus restore the natural hemodynamic system of the body.
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