Brain and Spine Implants Allow Paralyzed Man to Walk Naturally Again

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Gert-Jan Oskom was living in China in 2011 when he was in a motorcycle accident that left him paralyzed from the waist down. Now, with a combination of devices, scientists have given him back control of his lower body.

“For 12 years I’ve been trying to get my feet back,” Mr Oscum said at a press briefing on Tuesday. “Now I have learned how to walk normally, naturally.”

one in the study Published on Wednesday in the journal Nature, the Swiss researchers described implants that provide a “digital bridge” between Mr Oskom’s brain and his spinal cord, bypassing the injured parts. The invention allowed Mr. Oscum, 40, to stand, walk and climb a steep ramp with only the aid of a walker. More than a year after the implant, he has retained these abilities and has actually shown signs of neurological recovery, walking with crutches even when the implant is off.

“We took Gert-Jahn’s ideas, and translated these ideas into spinal cord stimulation to restore voluntary movement,” said Grégoire Courtin, a spinal cord specialist at the Swiss Federal Institute of Technology, Lausanne. ,” lead the research, said in the press briefing.

Jocelyn Bloch, a neuroscientist at the University of Lausanne who implanted Mr. Oscum, added, “It was science fiction for me at the beginning, but today it became reality.”

In recent decades there have been many advances in technical spinal cord injury treatment. In 2016, Dr. A group of scientists led by Courtin was able to restore the ability to walk in paralyzed monkeys, and another helped a man regain control of his crippled hand. In 2018, a different group of scientists led by Dr. Courtin developed a method Stimulate the brain With electrical-pulse generators, allows partially paralyzed people to walk and ride bicycles. last year, More advanced Brain stimulation procedures allowed paralyzed individuals to swim, walk and cycle within a day of treatment.

Mr. Oscum had undergone stimulation procedures over the years, and had even regained some ability to walk, but his improvement eventually plateaued. At the press briefing, Mr. Oscom said that these stimulation techniques made him feel that there was something exotic about locomotion, an alien distance between his mind and body.

The new interface changed that, he said: “Before the stimulus was controlling me, and now I’m controlling the stimulus.”

In the new study, the brain-spinal interface, as the researchers called it, took advantage of an artificial intelligence thought decoder to read Mr Oscum’s intentions – detectable as electrical signals in his brain – and send them to the muscles. corresponds to the movements of The etiology of natural movement, from thought to intention, was preserved. A single joint, such as Dr. Courtin described it, as a digital bridge spanning the injured parts of the spinal cord.

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

Dr. Jackson added that scientists in the field had been theorizing about connecting the brain to spinal cord stimulators for decades, but this is the first time they have been shown to have such success in a human patient. “It’s easy to say, it’s very difficult to do,” he said.

To achieve this result, the researchers first implanted electrodes into Mr Oscum’s skull and spinal cord. The team then used a machine-learning program to see which parts of the brain light up when he tries to move different parts of his body. The idea was that the decoder was able to match the activity of certain electrodes with specific intentions: one structure would light up whenever Mr Oscum tried to move his ankles, another when he tried to move his hips.

The researchers then used another algorithm to connect the brain implant to the spinal implant, which was set to send electrical signals to different parts of his body, triggering 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 were sent between the brain and spinal cord every 300 milliseconds, Mr. Oscom could quickly adjust his strategy based on what was working and what wasn’t. Within the first treatment session he could flex his hip muscles.

Over the next few months, researchers fine-tuned the brain-spinal cord interface to better fit basic actions like walking and standing. Mr. Oscum regained a somewhat healthy-looking gait and was able to navigate steps and ramps with relative ease, even after months without treatment. Additionally, after a year in treatment, he began to see marked improvement in his movement without the aid of a brain-spinal cord interface. The researchers documented these improvements in weight-bearing, balance and walking tests.

Now, Mr. Oscum can take a limited walk around his home, get in and out of a car and stop at a bar for a drink. For the first time, she said, she feels like she’s in control.

The researchers acknowledged shortcomings in their work. It is difficult to distinguish subtle intentions in the brain, and although the current brain-spinal interface is suitable for walking, it cannot possibly be said to restore upper body movement. Treatment is also invasive, requiring multiple surgeries and hours of physical therapy. Current systems do not cure all spinal cord paralysis.

But the team hoped that further advances would make the treatment more accessible and more systematically effective. “That’s our real objective,” said Dr. Courtin, “to make this technology available to all patients who need it.”

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