Brain and spine implants allow paralyzed man to walk naturally again

Gert-Jan Oskam was living in China in 2011 when he was in a motorcycle accident that left him paralyzed from the waist down. Now scientists have combined various devices to give him control of his lower body again.

“I’ve been trying for 12 years to get back on my feet,” Oscam said at a news conference on Tuesday. Now I learned how to walk normally and naturally.

In a study published Wednesday in the journal Nature, Swiss researchers described an implant that provides a digital bridge between Oscams’ brain and spinal cord to bypass the damaged area. The discovery enabled Oskam, 40, to stand up and walk up steep slopes with the help of a walker alone. It’s been over a year since the implant was inserted and he has retained these abilities and is indeed showing signs of neurological recovery and the implant has been switched off. I am still walking with crutches.

We have captured Gerd Jan’s ideas and translated these ideas into spinal cord stimulation to reestablish voluntary movement, says study leader Gourgoire, a spinal specialist at the Swiss Federal Institute of Technology Lausanne. Courtine says: said at his press conference.

“At first it was pure science fiction for me, but today it’s true,” added Jocelyn Block, a neuroscientist at the University of Lausanne who placed Oscam’s implant.

In recent decades, many advances have been made in the treatment of spinal cord injuries. In 2016, a group of scientists led by Dr. Cotain successfully restored the ability to walk in a paralyzed monkey, while another group helped a man regain control of a crippled hand. In 2018, another group of scientists, also led by Dr. Cortin, devised a way to stimulate the brain with an electrical pulse generator to enable partially paralyzed people to walk or ride a bike again. Last year, a more advanced brain stimulation procedure enabled paralyzed subjects to swim, walk and ride a bike within a day of treatment.

Oscam had previously undergone stimulation procedures and had regained some ability to walk, but eventually the improvement plateaued. At a press conference, Oscam said these stimulation techniques made him feel something different about locomotion, a different distance between mind and body.

The new interface has changed this, he said: Stimuli used to control me, now I control them.

In the new study, the cerebrospinal interface, as the researchers call it, used an artificial intelligence thought decoder to read Oscam’s intentions, which could be detected as electrical signals in his brain, and matched them to muscle movements. The etiology of natural movement, from thought to intention to action, was preserved. The only addition, as Dr. Cortin explained, was a digital bridge that spanned the damaged part of the spine.

“The study raises interesting questions about the source of autonomy and command,” said Andrew Jackson, a neuroscientist at Newcastle University who was not involved in the study. You continue to blur the philosophical boundaries between what the brain is and what technology is.

Scientists in the field have theorized for decades to connect the brain to a spinal cord stimulator, but this is the first time such success has been achieved in a human patient, Dr. Jackson said. added. Easy to say, but much harder to do, he said.

To achieve this result, the researchers first implanted electrodes into Oscam’s skull and spine. The team then used a machine learning program to see which parts of his brain lit up when he tried to move different parts of his body. This thought decoder was able to match the activity of specific electrodes to specific intentions. One configuration lit up when Mr. Oscam tried to move his ankle, another lit up when he tried to move his hip.

The researchers then used a different algorithm to connect brain implants to spinal implants and set them up to send electrical signals to different parts of the body to induce movement. The algorithm was able to account for slight variations in the direction and speed of contraction and relaxation of each muscle. And because signals between his brain and spine are sent every 300 milliseconds, Mr. Oscam can quickly adjust his strategy based on what’s working and what’s not. I was. During his first therapy session, he was able to twist a muscle in his hip joint.

Over the next few months, researchers fine-tuned the brain-spine interface to better accommodate basic movements like walking and standing. Despite months of no treatment, Oskamu gained a somewhat healthy-looking gait and was able to traverse stairs and ramps with relative ease. Additionally, after a year of treatment, I began to notice definite improvement in my movement without the help of the brain-spine interface. The researchers documented these improvements on weight-bearing, balance, and gait tests.

Currently, Mr. Oskamu can walk around the house to a limited extent, get in and out of the car, and stand at the bar for a drink. For the first time, he said, he felt in control.

The researchers acknowledged the limitations of their study. The brain’s subtle intentions are hard to distinguish, and while the current brain-spine interface is good for walking, the same probably isn’t true for recovering upper-body movement. The treatment is also invasive, requiring multiple surgeries and hours of physical therapy. Current systems do not solve all spinal cord palsy.

But the researchers hoped that further advances would make treatments more accessible and more systematically effective. Dr. Courthin said it is our true purpose to make this technology available worldwide to all patients who need it.

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