Apr 17th 2018

Paralysis Treatment Set to Be Revolutionized With Neuroprosthetics

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Imagine a paralysis treatment that uses a wireless router device on your brain to move your limbs. That’s only a few steps beyond how Cleveland resident Bill Kochevar regained the use of his right hand following a bicycle accident that left him paralyzed from the shoulders down.

New Brain Prosthetics

Earlier this year, researchers at Case Western Reserve University and Brown University published a study in The Lancet that described the new technology, an example of a neuroprosthetic. Kochevar, 53, had two tiny recording devices — smaller than postage stamps — implanted in the motor cortex region of his brain. These microelectrode arrays, known as a brain–computer interface (BCI), are equipped with dozens of tiny metal probes that can listen to neural activity. This is decoded and transmitted to a network of 36 implanted electrodes in the patient’s upper and lower right arm that function like a pacemaker, stimulating the muscles in his hand, shoulder and elbow to restore movement. With the help of a flexible, supportive armrest, Kochevar is now able to grasp and move objects, such as feeding himself and bringing a mug to his lips to drink.

The researchers wrote that the study “represents a major advance, with a clear translational path for clinically viable neuroprostheses for restoration of reaching and grasping after paralysis.”

Cochlear Implants Show the Way

Scientists have been working on paralysis treatment technologies for decades, trying everything from motorized leg braces to cellular transplants; BCIs have been helping patients since 1998. The significant feature of the Kochevar experiment is that it bypasses the damaged spinal cord to directly connect the brain with target muscles.

According to The Mayo Clinic, the technology isn’t unlike cochlear implants, which use an external microphone and transmitter to send radio signals to an implanted unit that can receive them and stimulate electrodes inserted into the cochlea, skipping parts of the middle ear where damage has caused deafness. There are hopes of using similar know-how to treat blindness and even restore memories eroded by Alzheimer’s disease.

Kochevar’s newfound movement is the result of two surgeries, physiological training and a lot of engineering. The patient had to train by first watching a virtual representation of his arm doing certain movements. When he tried moving his arm the same way, the resulting brain activity was recorded. The recording served as the basis for a decoding system that would translate his intentions into commands for his arm electrodes.

Wi-Fi for the Body

While Kochevar has a wired connection from his brain implants, study coauthor John Donoghue, Ph.D., head of the Wyss Center for Bio and Neuroengineering at Campus Biotech in Geneva, Switzerland, is working on a wireless link between the brain and muscle groups to help people with paralysis, according to MIT Technology Review. Made of titanium and roughly the size of a matchbox, the device could gather information from the brain at internet speeds. “A radio inside your head” and “the most sophisticated brain communicator in the world” was how Donoghue described it to the news source. That device is also in the early stages of development.

While paralysis treatment experts hailed the Kochevar experiment as a breakthrough and the first of its kind in the world, they noted the resulting movements were rudimentary and cautioned that the technology was far from being ready to go from lab bench to widespread clinical use.

“We actually have a handle on everything that we need. There are no significant novel discoveries we need to make for the system,” Abidemi Bolu Ajiboye, Ph.D., lead author of the study, told CNN. “There were no significant adverse events, the system is safe, so as far as the clinical trial endpoint goes, he has met those.”

Reversing paralysis is a long-term, complex challenge that requires a combination of medicine, technology and the body’s innate power to heal and adapt. If the success of cochlear implants is any guide, BCIs could help restore movement and improve quality of life for countless people. The continued development of these technologies will help people in similar situations and open doors for cures and assistance we once never thought possible.

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