Could this new implant change the lives of patients with spinal cord injuries?

Daniel Joggi, now in his seventies, has been a lifelong skiing enthusiast. But after an accident on a ski slope left him quadriplegic decades ago, he was forced to give up his passion.

Spinal cord injuries often interrupt the communication between the brain and neurons that regulate blood pressure in the spinal cord. While Joggi has a wheelchair that makes everyday activities easier, he couldn’t even drive until recently because his unstable blood pressure caused him to black out.

Doctors have relied on medication to control this problem, but results have varied – until now.

Neuroscientists in Switzerland have developed a simple implant to electrically stimulate neurons in the spinal cord, helping people with severe spinal cord injuries regulate blood pressure.

Thanks to the new implant, Joggi can now ski again on the mountains near his Swiss home using a specially adapted sit-ski.

The system works with a watch-like band on his wrist, which allows him to adjust signals sent to an implant in his abdomen, helping to regulate his blood pressure. He controls the strength of the electrical signals that are sent to his implant through his wristband, depending on how he feels.

"It works very easily, you just have to make sure that the battery doesn't go down," said Joggi.

The signal is passed wirelessly to a pulse generator implanted in his abdomen that targets a specific part of his spine.

"When [the hotspots on the spine] are stimulated, they make you stay a bit straighter and that helps me, for instance, when I'm skiing," he said.

Dangerous imbalances in blood pressure

Patients with spinal cord injuries often experience dangerous imbalances in blood pressure that can make daily tasks difficult, if not impossible. Many of them say this makes their lives unbearable.

"They have a meal and the blood is concentrated on the digestion and they feel so bad they need to rest, they cannot have any activity, they cannot work, they cannot engage in normal social activity after that,” said Dr Jocelyne Bloch, a neurosurgeon at the Swiss Federal Technology Institute of Lausanne (EPFL).

Apart from Joggi, Belgian student Julie Verlinden was among the 14 patients to receive the stimulator in a trial led by EPFL and the Lausanne University Hospital (CHUV).

Verlinden lost mobility and the capacity to control her blood pressure in a car accident in 2022, and said the injury has taken a big toll on her social life.

“When you feel very tired, your eyes are blurred the whole time, your ears are buzzing, you're fainting – going out, doing stuff with friends [and] family, participation in society is not your priority,” Verlinden said.

Verlinden says she felt the effect straight away after the surgery

"I remember waking up in the intensive care unit and the engineer of the programme switched the simulator on for the first time,” Verlinden said.

“[My blood pressure] spiked up to a regular level. And I immediately felt some sort of energy boost going through my body. I felt oxygen in my brain again circulating. It was like a sort of awakening out of a very, very, very long sleep," she added.

Larger trial on its way

Doctors say the surgery to implant the device carries a low risk.

“We do not put the electrodes in the spinal cord, but above the spinal cord, [making] a little window between two vertebrae and we slide the electrodes just behind the spinal cord,” Bloch said.

Before surgery, the trial participants underwent medical imaging scans so the research team could identify the best site for the implant. 

“With the technology, it's completely changed. They are back to a normal level of energy… They feel a way that they can start something again," Bloch said.

The research team said the US Food and Drug Administration (FDA) has granted the device a designation that allows it to be used in clinical trials to gather data on its safety and effectiveness before it is approved for commercial sale.

A larger-scale trial is on the way at centres in the United States and Europe.

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