A paralysed man can walk again with brain and spine implants

The implants of Gert-Jan Oskam provide a "digital link" between his damaged spinal cord and brain. Photo / Jimmy Ravier via The New York Times

In 2011, Gert-Jan Oskam, a Dutchman living in China, was involved in a motorcycle crash that paralysed him from the hips downward. Scientists have now given him control of his body with a combination devices.

His lower body once again.

Oskam told a Tuesday press conference (Wednesday New Zealand time) that he had been trying to regain his feet for 12 years. "Now I know how to walk normally, naturally."

A study published in the Journal on Wednesday revealed that the average person spends about 2% of their time watching television.

Nature

Researchers in Switzerland have described implants which provide a "digital bridge" between Oskam’s brain and spinal cord, bypassing damaged sections. Oskam was able to walk, stand and climb a steep slope with the help of a walker. He has maintained these abilities for more than a full year since the implant. He has even shown signs of neurological improvement, walking on crutches when the implant is turned off.

Gregoire Courtine said, "We have captured Gert-Jan's thoughts and translated them into a spinal stimulation to restore voluntary movement." Gregoire Courtine is a spinal specialist at the Swiss Federal Institute of Technology in Lausanne who led the research.

Jocelyne Bloch is a neuroscientist from the University of Lausanne, who implanted the implant into Oskam. She said, "It was science fiction at first for me, but today it became real".

In recent decades, there have been many technological advances in the treatment of spinal cord injuries. In 2016, a team of scientists led Courtine were able to restore paralyzed monkeys' ability to walk, while another group helped a crippled man regain the control of his hand. Courtine led a group of scientists in 2018 who devised an electrical-pulse generator to stimulate the brain, allowing people with partial paralysis to walk again and ride a bicycle. In 2018, more advanced brain stimulation techniques allowed paralysed patients to walk, swim and cycle in just one day.

Oskam is now able stand and walk using a walker. He has been paralysed for over a decade. Photo / Jimmy Ravier via The New York Times

Oskam underwent stimulation procedures in the past and even recovered some walking ability, but his progress eventually plateaued. Oskam told the press that he felt that the stimulation technologies left him with a feeling of alienation between his mind, and body.

He said that the new interface had changed his perspective: "Before, I was controlled by stimulation, but now, I am in control of stimulation."

The researchers used a brain-spine interfacing system to decode Oskam's thoughts, which were detected as electrical signals within his brain, and to match these to muscle movements. The natural movement etiology, from intention to thought, to action was preserved. Courtine said that the only addition was the digital bridge which spans the damaged parts of the spinal cord.

Andrew Jackson, who is a neuroscientist from Newcastle University and was not involved with the study, commented: 'It raises fascinating questions about autonomy, as well as the origin of commands. You continue to blur the philosophical line between the brain and technology.

Jackson said that scientists had been theorizing about the connection between the brain and spinal cord stimulators in the field for decades, but this was the first time that they had achieved a similar success with a patient. He said that it was easy to say but much harder to do.

The researchers implanted electrodes into Oskam's spine and skull to achieve this result. The team used a machine learning program to see which areas of his brain lit up when he moved different parts of his body. This thought decoder could match the activity in certain electrodes to specific intentions: One configuration lit up when Oskam moved his ankles and another when he moved his hips.

Researchers then used another algorithm in order to connect the spinal implant with the brain implant. The spinal implant was programmed to send electrical signals from different parts of the body to spark movement. The algorithm could account for small variations in muscle contractions and relaxations. Oskam was able to quickly adapt his strategy because the brain-spine signals were sent at 300 millisecond intervals. In the first session of treatment, Oskam was able to twist his hips.

In the following months, researchers refined the brain-spine interaction to better suit basic actions such as walking and standing. Oskam was able, after several months of treatment-free time, to walk with a healthy gait. He could also navigate steps and ramps relatively easily. After a year of treatment, Oskam began to notice improvements in his movements without the help of the brainspine device. Researchers documented improvements in walking, balance and weight bearing tests.

Oskam is now able to walk around his home in a limited manner, enter and exit a vehicle and stand in a bar while having a drink. He said that for the first time he felt in control.

Researchers acknowledged that their work had limitations. The subtle intentions of the brain can be difficult to discern. Although the current brain-spine system is good for walking, it may not be suitable for restoring upper body movement. Treatment is invasive and requires multiple surgeries as well as hours of physical therapy. The current system doesn't fix all spinal paralysis.

The team, however, hoped that future advances would make this treatment more effective and accessible. Courtine stated that the team's true goal was to make the technology available worldwide for patients who needed it.

This article was originally published in

The New York Times

.

Written by: Oliver Whang

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