[{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":"\u003Cdiv id=\u0022republish_modal_form\u0022\u003E\u003Cform class=\u0022modal-form-example-modal-form ecl-form\u0022 data-drupal-selector=\u0022modal-form-example-modal-form\u0022 action=\u0022\/en\/article\/modal\/7152\u0022 method=\u0022post\u0022 id=\u0022modal-form-example-modal-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cp\u003EHorizon articles can be republished for free under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.\u003C\/p\u003E\n \u003Cp\u003EYou must give appropriate credit. We ask you to do this by:\u003Cbr \/\u003E\n 1) Using the original journalist\u0027s byline\u003Cbr \/\u003E\n 2) Linking back to our original story\u003Cbr \/\u003E\n 3) Using the following text in the footer: This article was originally published in \u003Ca href=\u0027#\u0027\u003EHorizon, the EU Research and Innovation magazine\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003ESee our full republication guidelines \u003Ca href=\u0027\/horizon-magazine\/republish-our-stories\u0027\u003Ehere\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003EHTML for this article, including the attribution and page view counter, is below:\u003C\/p\u003E\u003Cdiv class=\u0022js-form-item form-item js-form-type-textarea form-item-body-content js-form-item-body-content ecl-form-group ecl-form-group--text-area form-no-label ecl-u-mv-m\u0022\u003E\n \n\u003Cdiv\u003E\n \u003Ctextarea data-drupal-selector=\u0022edit-body-content\u0022 aria-describedby=\u0022edit-body-content--description\u0022 id=\u0022edit-body-content\u0022 name=\u0022body_content\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea ecl-text-area\u0022\u003E\u003Ch2\u003EParkinson\u2019s disease: Stimulation of brain, feet may help people overcome freezing episodes\u003C\/h2\u003E\u003Cp\u003EDuring a freezing episode, a patient feels like their feet are stuck to the ground for a few seconds or more while they are trying to take a step. \u2018You can be walking or trying to stand up from a chair and your body does not respond anymore to your commands,\u2019 said Francesco Cecchini, co-founder and CEO of Gondola Medical Technologies in Switzerland. \u2018Patients can very often fall following a freezing episode.\u2019\u003C\/p\u003E\u003Cp\u003EFurthermore, when other people are around, the inability to move is more likely to occur and can be more intense. In Sanvito\u2019s case, having colleagues stare at him during a meeting would result in a more extreme episode.\u003C\/p\u003E\u003Cp\u003E\u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4140195\/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003EMore than half of people with advanced Parkinson\u2019s disease experience freezing of gait\u003C\/a\u003E but existing treatments don\u2019t work for everyone and have limitations. Medication helped Sanvito, for example, but the effect would wear off so he had to plan his work agenda around his pill schedule.\u003C\/p\u003E\u003Cp\u003EIn some cases, physiotherapy can also alleviate the symptom, especially if combined with cues such as stepping sideways first or timing steps to a rhythmic beat. And deep brain stimulation (DBS) \u2013 a procedure where two electrodes are implanted in the brain and stimulated with electrical impulses \u2013 can provide relief but requires major surgery and can cause discomfort.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EBetter treatments for freezing of gait are therefore needed. Dr AmirAli Farokhniaee, a post-doctoral fellow in the neuromuscular systems lab at University College Dublin in Ireland, and his colleagues are focussing on improving DBS as part of the \u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/rcn\/197101\/factsheet\/en\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003EDBS Model project\u003C\/a\u003E\u0026nbsp;led by Professor Madeleine Lowery.\u0026nbsp;\u2018It can work for rigidity of gait but I think we can still make it better because there is a percentage of people that don\u2019t get all the therapeutic benefits,\u2019 said Dr Farokhniaee.\u003C\/p\u003E\u003Cp\u003EThe team also wants to make the therapy less invasive. Initially, this could be by using shorter electrodes that don\u2019t penetrate as deeply inside the brain. They would also like to see if adding pauses between pulses instead of constant stimulation could be more comfortable for patients while having the same effect.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EBrain mechanisms\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EFreezing of gait is hard to address since the brain mechanisms responsible for it remain unclear. Several brain regions, such as some related to motion and anxiety, seem to be involved, as well as failing brain networks. For example, it has recently been found that when healthy individuals walk, communication between the subthalamic nucleus and cortex \u2013 two key areas that play a role in locomotion \u2013 are synchronised. But during freezing of gait, \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6598629\/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Ethe activity is decoupled\u003C\/a\u003E.\u003C\/p\u003E\u003Cp\u003EFurthermore, how DBS works and why it gives patients relief isn\u2019t fully understood. \u2018It\u2019s like a technician who changes a resistor in a circuit, and he doesn\u0027t really know what happens in the electric circuitry but it\u0027s working,\u2019 said Dr Farokhniaee.\u003C\/p\u003E\u003Cp\u003EThe therapy typically stimulates the subthalamic nucleus, where the misfiring of neurons is linked to problems with movement experienced by Parkinson\u2019s patients. However, identifying additional areas involved in freezing of gait and other symptoms could lead to new targets.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cfigure role=\u0022group\u0022 class=\u0022@alignleft@\u0022\u003E\n\u003Cimg alt=\u0022A portable device that stimulates two areas of the foot could help prevent freezing of gait episodes. Image credit: Gondola MedTech SA\u0022 height=\u00221200\u0022 src=\u0022\/research-and-innovation\/sites\/default\/files\/hm\/IMCEUpload\/web-DSC06501.jpg\u0022 title=\u0022A portable device that stimulates two areas of the foot could help prevent freezing of gait episodes. Image credit: Gondola MedTech SA\u0022 width=\u00222000\u0022\u003E\n\u003Cfigcaption class=\u0022tw-italic tw-mb-4\u0022\u003EA portable device that stimulates two areas of the foot could help prevent freezing of gait episodes. Image credit: Gondola MedTech SA\u003C\/figcaption\u003E\n\u003C\/figure\u003E\n\u003C\/p\u003E\u003Cp\u003EThe team\u2019s first step is therefore to try and uncover how DBS is affecting the brain by creating computer simulations. They are mimicking the therapy on models of different parts of the brain to see how their activity or functions change. \u2018This is one of the very basic things that we have to do,\u2019 said Dr Farokhniaee. \u2018With the simulations, we can improve current methods of deep brain stimulation.\u2019\u003C\/p\u003E\u003Cp\u003EMeanwhile, in Switzerland, Cecchini and his colleagues are testing whether\u0026nbsp;stimulating an entirely different\u0026nbsp;part of the body - the feet - could improve communication between body and brain to\u0026nbsp;treat\u0026nbsp;freezing of gait.\u003C\/p\u003E\u003Cp\u003ECecchini and his colleagues have developed a portable device, called \u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/rcn\/218923\/factsheet\/en\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003EGondola\u003C\/a\u003E, that can be used at home. When attached to a patient\u2019s feet, it physically stimulates two areas on each foot \u2013 the top of the big toe and the metatarsal joint further down \u2013 for about two minutes. \u2018In most cases, the benefits are immediate and last up to three to four days following the treatment,\u2019 said Cecchini.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EConnectivity\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EThe device modifies how movement is processed by the brain and spinal cord by increasing messages sent from nerves in the body. By doing fMRI brain scans of Parkinson\u2019s sufferers, Cecchini and his colleagues have also shown that the stimulation increases connectivity between the cerebellum, basal ganglia and frontal motor cortex, three key areas involved in movement. \u2018(The treatment) is the first of its kind,\u2019 said Cecchini. \u2018It\u0027s really unique as far as results and effectiveness.\u2019\u003C\/p\u003E\u003Cp\u003ESanvito, for example, came across the Gondola device by chance and noticed immediate improvements after trying it. \u2018It allowed me to get back to normality, without needing to increase the dosage of my medications,\u2019 he said.\u003C\/p\u003E\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003E\u2018You can be walking or trying to stand up from a chair and your body does not respond anymore to your commands.\u2019\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EFrancesco Cecchini, co-founder and CEO, Gondola Medical Technologies, Switzerland\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\u003Cp\u003ECecchini and his team are currently working on improving the device so that it can be linked to a phone app. It will be able to monitor patients and remind them to repeat the treatment if freezing of gait is starting to recur. It will also be able to remotely tweak stimulation settings, which need to be adjusted once or twice a year.\u003C\/p\u003E\u003Cp\u003EThe team is now exploring how the device could be used to help stroke patients too. The condition, which occurs when blood supply to the brain is interrupted, affects about 15 million people a year worldwide. About 60% of sufferers will have long-term disabilities as a result, such as difficulty walking and balance problems.\u003C\/p\u003E\u003Cp\u003EThe Gondola device could, however, provide a quick fix, using the exact same treatment used for freezing of gait. \u2018From what we have seen so far, patients who have had a stroke respond very well to our treatment,\u2019 said Cecchini. \u2018It\u2019s very exciting because we are really providing people with an improvement to their life.\u2019\u003C\/p\u003E\u003Cp\u003E\u003Cem\u003EThe research in this article was funded by the EU. 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