Researchers develop a neural prosthesis for the treatment of diabetes-related neuropathy

Wearable “smart sock” system uses electrical impulses to restore sensory perception.

Researchers have developed a new treatment for diabetic neuropathy, with recent tests showing promising results.

The non-invasive neuroprosthesis system, which can be worn like a normal sock, uses targeted electrical impulses to restore the disrupted information to the nerves and return previously lost sensory perception.

Diabetic neuropathy is a common complication of diabetes, and previous interventions have aimed to alleviate the symptoms.

The loss of sensation in the feet caused by diabetic neuropathy can lead to chronic pain and ulcers, and in severe cases amputations, severely affecting the quality of life of people with neuropathy.

The system was developed by an international research team led by Stanisa Raspopovic from MedUni Vienna's Center for Medical Physics and Biomedical Engineering and first authors Noemi Gozzi and Lauren Chee from ETH Zurich, together with Zurich and Balgrist University Hospitals.

Results of the study, recently published in Nature Communications, report the NeuroStep system was tested on 14 patients with diabetic neuropathy.

The nerve damage of the condition affects around half of people with diabetes as a result of permanently high blood glucose levels and is currently only treated symptomatically.

Researchers focussed their attention on electrical nerve stimulation for the study in order to “get to the root of the problem”.

Professor Raspopovic described the technological steps to develop the “smart sock” with integrated electrodes: “In previous research into the potential use of this method for neuropathies, the electrical impulses were applied at different positions and with various configurations, finally resulting in the optimal location at the ankle level, with a personalised technological solution.

"Our study results give us reason to hope that NeuroStep will not only improve patients' quality of life, but also break a vicious circle.”

This technology is used to stimulate the still partially functional nerve tracts through the skin and to restore the impaired sensation. This is done using a personalised calibration procedure that adapts the stimulation to the patient's individual degree of nerve damage.

The wearable system works in closed loop while walking, providing real-time sensory feedback. For example, when patients step on their heel, they experience a corresponding induced sensation from the sock at that exact location, enhancing their balance and confidence.

The preliminary results found that after just one day of using the neuroprosthesis, the majority of people involved in the study reported significant improvements in sensation and movement coordination, in addition to reduced pain.

Measurements taken by the researchers showed that the electrical stimulation not only restored feeling in the feet, but also improved the patients' sensory abilities and gait stability.

Using magnetic resonance imaging, the study also found that the brain processes these restored sensations in a similar way to natural sensory stimuli, allowing intuitive use of the neuroprosthesis.

A statement from the Medical University of Vienna said: “Reduced mobility as a result of diabetic neuropathy means that patients move less, which in turn accelerates the progression of diabetes and increases the risk of complications. More research is needed before NeuroStep can be used in clinical practice. Future studies, which the team is already conducting, will focus on the long-term use of the neuroprosthesis and its effect on the progression of diabetic neuropathy.”

Read the full report in Nature Communications

Read the DRWF diabetes information leaflet Foot health and diabetes here