For the first time ever, a paralysed man has moved his fingers and hand with his own thoughts after an electronic neural bypass for spinal cord injuries that reconnects the brain directly to muscles, allowing voluntary and functional control of a paralysed limb. This innovation comes from a partnership between The Ohio State University Wexner Medical Center and Battelle.
Ian Burkhart, a 23-year-old quadriplegic from Dublin, USA, is the first patient to use Neurobridge, an electronic neural bypass. Burkhart is the first of a potential five participants in a clinical study.
“It is much like a heart bypass, but instead of bypassing blood, we are bypassing electrical signals,” said Chad Bouton, research leader at Battelle. “We are taking those signals from the brain, going around the injury and going directly to the muscles.”
The Neurobridge technology combines algorithms that learn and decode the user’s brain activity and a high-definition muscle stimulation sleeve that translates neural impulses from the brain and transmits new signals to the paralysed limb. In this case, Burkhart’s brain signals bypass his injured spinal cord and move his hand.
The project investigating the Neurobridge was a six-month, Food and Drug Administration (FDA)-approved clinical trial at Ohio State’s Wexner Medical Center.
Working on the internally-funded project for nearly a decade to develop the algorithms, software and stimulation sleeve, Battelle scientists first recorded neural impulses from an electrode array implanted in a paralysed person’s brain. They used the data to illustrate the device’s effect on the patient and prove the concept.
Two years ago, Bouton and his team began collaborating with Ohio State neuroscience researchers and clinicians Ali Rezai and Jerry Mysiw to design the clinical trials and validate the feasibility of using the Neurobridge technology in patients.
During a three-hour surgery on 22 April, Rezai implanted a chip onto the motor cortex of Burkhart’s brain. The tiny chip interprets brain signals and sends them to a computer, which recodes and sends them to the high-definition electrode stimulation sleeve that stimulates the proper muscles to execute his desired movements. Within a tenth of a second, Burkhart’s thoughts are translated into action.
“The surgery required the precise implantation of the micro-chip sensor in the area of Burkhart’s brain that controls his arm and hand movements,” Rezai says.
He said this technology may one day help patients affected by various brain and spinal cord injuries such as strokes and traumatic brain injury.
Battelle also developed a non-invasive neurostimulation technology in the form of a wearable sleeve that allows for precise activation of small muscle segments in the arm to enable individual finger movement, along with software that forms a ‘virtual spinal cord’ to allow for coordination of dynamic hand and wrist movements.
The Ohio State and Battelle teams worked together to investigate the correct sequence of electrodes to stimulate and allow Burkhart to move his fingers and hand functionally. For example, Burkhart uses different brain signals and muscles to rotate his hand, make a fist or pinch his fingers together to grasp an object, Mysiw explains. As part of the study, Burkhart worked for months using the electrode sleeve to stimulate his forearm to rebuild his atrophied muscles so they would be more responsive to the electric stimulation.
“I have been doing rehabilitation for many years, and this is a tremendous stride forward in what we can offer these people,” said Mysiw, chair of the Department of Physical Medicine and Rehabilitation at Ohio State. “Now we are examining human-machine interfaces and interactions, and how that type of technology can help.”