back to article Experimental brain-spine computer interface helped a paralyzed man walk

A paper in Nature reveals how a brain implant and computer-controlled prosthetic helped a paraplegic man in his recovery from a partially severed spinal cord. Some two years after the research project began, the newly published study describes how some experimental technology from the Ecole Polytechnique Fédérale de Lausanne ( …

  1. lglethal Silver badge
    Pint

    Awesome!

    Great work all round by those Scientists.

    I wonder if there is a specific reason for taking the signals direct from the Cortex rather than just intercepting the signal from the spinal cord. The Cortex would seem a more difficult solution (lots of signals to filter out), but then again, maybe you get a much cleaner signal when you know what your looking for.

    Still, it's awesome that the body seems to be beginning to repair itself and get signals through the damage even without the artificial help.

    Beer for those Boffins and for the guy willing to be a Guinea Pig!!!! ---->

    1. Roger Greenwood
      Pint

      Re: Awesome!

      I heard him being interviewed yesterday on the radio, and he specifically mentioned having a beer with his friends (stood up) was a great joy. I would also like to share a beer with all those involved, incredible achievement.

    2. Wellyboot Silver badge
      Boffin

      Re: Awesome!

      Absolutely!

      The spinal cord regenerating links now that nervous system on both sides of the break are synchronized by this device is a real eye opener, in the long term, this result alone will open many related disorders to investigation, essentially a bodge fix to 'get you walking'* is pointing to a cure for paralysis.

      Fingers crossed that Gert continues to improve and is able to disconnect permanently in a few years.

      * in itself, utterly life changing for the individual

  2. Fr. Ted Crilly Silver badge

    The trousers

    Gromit! They've gone wrong!!!!

  3. jmch Silver badge
    Pint

    Fantastic work!!

    Pints all round for those involved!!

    "with regular use over a sustained period, new connections are reforming in his spinal cord and reestablishing connections with his brain."

    The human body is absolutely awesome

  4. StrangerHereMyself Silver badge

    Regenerative medicine

    I don't believe in non-biological replacements for human organs, like artificial hips and shoulders. I believe we should focus on regenerative medicine, where new body parts are regrown or repaired. New cartilage could eliminate the suffering of millions of people and probably reduce health care costs since operations for imperfect replacements wouldn't be needed.

    Same with this setup. Sure, it's great this person can "walk" again, but they should focus on repairing his spinal injury by regrowing part of it, not "bridging" it with some Frankenstein creation.

    The only positive would be the reduction of muscle atrophy which plagues the handicapped.

    1. jmch Silver badge
      Facepalm

      Re: Regenerative medicine

      Agree that the ideal goal would be to artificially grow natural tissues that can be grafted into the body, or even better get the body to grow missing bits 'on demand'. But that ranges between extreme bleeding edge current research that won't be mainstream for decades to absolute science fiction that won't be possible for centuries, or possibly, ever.

      This sort of 'Frankenstein creation' is not only something that can help further our understanding of regenerative medicine (did you not see the bit about some of the patients' nervous system regrowing under the external stimulation??), but it's actually improving someone's quality of live RIGHT NOW. That alone makes it worth it.

      1. StrangerHereMyself Silver badge

        Re: Regenerative medicine

        I agree that repairing the nervous system is far beyond our capability and understanding at the moment, but cartilage, for example, should be doable. Instead of spending money and effort improving artificial hip replacements we should focus on replacing cartilage.

        Same with cancer. We're spending enormous amounts on medicines that only prolong life marginally whilst our real focus should be on repairing the DNA of cancerous cells which will CURE cancer.

        1. Anonymous Coward
          Anonymous Coward

          Re: Regenerative medicine

          My wife, the great SF reader, surgeon and oncologist, would like to teach you a few facts about distinguishing science from fiction, about bothering to read the relevant journals to see what is and isn't being researched. And boring practical things like the relative costs of quality-adjusted years of life.

          Oh, and she has one of those nice loose jackets and boring coloured belts from one of those "pick 'em up and fling 'em down" sports and a mean look in her eye.

          1. Michael Wojcik Silver badge

            Re: Regenerative medicine

            Indeed. Anyone who declares "X will cure cancer!" doesn't know much about cancer, and probably doesn't know much about X.

            1. StrangerHereMyself Silver badge

              Re: Regenerative medicine

              I DO know that someone won the Nobel prize in 1976 for discovering that cancer is a genetic disease where DNA has gone haywire. It's therefore a logical conclusion that repairing DNA will cure cancer.

          2. StrangerHereMyself Silver badge

            Re: Regenerative medicine

            What's Science Fiction today is reality tomorrow.

        2. Wellyboot Silver badge

          Re: Regenerative medicine

          Investigating the process that is regenerating nerve connections will likely shave years (decades?) off the time needed to understand the nervous system to the point where we can start growing and inserting the correct tissue.

          Repairing cancer cell DNA (individually, & by the million) will be a non starter for many decades*, targeted removal and growing healthy replacement cells to replace them is within reach.

          Incrementally improving what we have while at the same time researching possible replacements is not just pragmatic, it provides the best solution for the greatest number of people 'now'.

          I'd rather have a permanent implant like this than wait most of my life in a wheelchair while the ideal solution (two hour operation and it's fixed) is perfected, especially as the former doesn't preclude the latter.

          * In-situ DNA resequencing > Sci-Fi.

        3. mpi Silver badge

          Re: Regenerative medicine

          > whilst our real focus should be on repairing the DNA of cancerous cells

          Cancer cells are not a damaged part that needs to be repaired, they are abberantly multiplying cells that need to be destroyed. There is no repair process. In fact our own body tries to kill cells that leave normal cell-cycle regulations by means of CD8 Cytotoxic Killer T-cells.

          1. Jon 37

            Re: Regenerative medicine

            Presumably if the cancer is caused by a genetic mutation in some cells, then fixing that would at least stop the cancer from growing and spreading?

            (To be clear, I don't agree with all the nonsense posted above. Just curious about your total rejection of a genetic treatment for at least some cancers. I was under the impression that was actually starting to be done. But maybe I have misunderstood and this is a chance for me to learn something new?)

            1. mpi Silver badge

              Re: Regenerative medicine

              > then fixing that would at least stop the cancer from growing and spreading?

              Yes it would, the problem is, doing that reliably, against a high number of variated, accumulated defects, and doing it in a very precise targeted way.

              Cancer cells mutate, at a high rate. They have to, otherwise they couldn't escape the bodies self defense mechanism (the aforementioned CD8 cells and other senescense and termination signals). And cancer doesn't form from one second to the next, a cell has to accumulate numerous mutations to become malignant. Eg. it has to figure out how to escape cell cycle control (which is itself a huge system involving many biochemical pathways), and how to ignore termination signals from the outside, and how to escape phagocytes from the immune system, and how to induce angiogenesis around it, and so on and so forth. This results in a huge number of mutations, and variations within a population of cancer cells.

              Imagine trying to fix a broken car that leaks fuel. Now imagine trying to fix the same car, after it was run over by a bulldozer. That's the kind of change we are talking about here.

              So even if I find a way to fix all the accumulated the defects in situ of one population of these cells, one possible outcome is that it clears the competition for cancerous cells with other mutation characteristics the treatment didn't target.

              And targeting such a treatment isn't exactly easy. What happens if the insitu repair changes the DNA in healthy cells around the cancer? It might well cause new abberant cells to form.

              And even if I could do all that, the cancer still needs to be removed, and the problem is that this is not always possible surgically.

              That's why treatments try to kill cancer cells, and/or delay their growth, and/or support the body in killing them, instead of trying to "fix" them

              1. StrangerHereMyself Silver badge

                Re: Regenerative medicine

                It's obvious that cancer cells don't mutate the genes that makes them cancerous in the first place. Target those genes and you've solved the riddle. Repairing the DNA of non-cancerous cells means a NOP on those genes.

                I suspect that we only need to repair several dozen genes to fix cancer. The cancer will stop growing and will be cleaned up by the body itself after a while.

                1. mpi Silver badge

                  Re: Regenerative medicine

                  >It's obvious that cancer cells don't mutate the genes that makes them cancerous in the first place.

                  Pray tell, how do you define "genes that make them cancerous" exactly?

                  Most of the relevant sequences a cancerous cell changes, are things that already exist in the genetic code, and exist _for a reason_. E.g. Angiogenesis is required, otherwise wounded tissue couldn't heal and kids couldn't grow. Some cells need to change the usual cell cycle controls, otherwise there would be no stem cell populations eg. in the bone marrow, and Memory-B-Lymphocytes couldn't hyper-proliferate in case of an infection.

                  These are not some "bad genes" that we can just target. These are integral part of how our cells function. They are used by cancer cells in abberant ways. More on that later.

                  Additionally many of the changes in cancerous cells are not about turning some genes on, but turning genes OFF. DNA Repair mechanisms, or transmembrane receptors reacting to termination signals are prime examples. Sometimes, these mechanisms may also expressed at lower rates due to a mutation that affects the patiens genome in general.

                  Lastly, coming back to how these changes work: Expression of genes is far more complex than just mutating it's sequence. Expression levels are controlled by the genes own sequence, signals to the transcription machinery, signals to the mRNA processing machinery, and the epigenetic code, aka. histone modifications, DNA methylation and chromosome packing. Please show me a peer reviewed paper about approaches to manipulate epigenetic coding in a targeted way on a fine grained level.

                  1. jmch Silver badge

                    Re: Regenerative medicine

                    "Expression of genes is far more complex than just mutating it's sequence. Expression levels are controlled by the genes own sequence, signals to the transcription machinery, signals to the mRNA processing machinery, and the epigenetic code, aka. histone modifications, DNA methylation and chromosome packing."

                    Absolutely, and in many cases we still have only the foggiest idea of how non-coding DNA (which used to be called junk DNA at one point) affects the way that coding DNA is affected (triggered / inhibited). Not to mention that all of the things you mention are 'internal' epigenetic mechanisms. There are a whole lot of 'external' epigenetic mechanisms such as food, climate, stress etc.

        4. Filippo Silver badge

          Re: Regenerative medicine

          You seem to have an either/or view of scientific research, where it works like one of those videogames where you have to choose which tech you'll develop next, and you have to choose between clicking on "cellular regeneration" or "neural implants" or "chemotherapics" or "DNA editing" on some tech tree GUI.

          Hint: that is not how real scientific research works. Not even close. Saying "we would get more progress on X if we'd only stop researching Y" does not work. It pretty much only makes sense temporarily in an emergency (eg. how we stopped everything to get a COVID vaccine ASAP). Otherwies, "focusing" on something to the detriment of other research is unbelievably inefficient, because then you'll lose the cross-field effects.

          Case in point, the prosthesis in the article appears to have yielded some unexpected neural regeneration effects. This insight could turn out to be nothing, but it could also turn out to be critical. If we had followed your policy and ditched prosthetics to only click on regeneration, we'd have missed out on that, standing a pretty good chance of delaying progress on regeneration.

          1. Doctor Syntax Silver badge

            Re: Regenerative medicine

            And, of course, the people with skill, knowledge and aptitude for Y do not necessarily have the same in regard to X.

            Research and development is done by people and people are not readily interchangeable.

          2. StrangerHereMyself Silver badge

            Re: Regenerative medicine

            I'm not saying we should abandon artificial hips and knees straight away, but we should freeze development and funnel all funds into cartilage research. Every dollar, pound or euro can only be spent once, you know.

            The money is being spread too thin, and the most promising avenues are underfunded, slowing their progress. At this pace it could take decades or centuries to get artificial cartilage out of the lab.

            1. M.V. Lipvig Silver badge

              Re: Regenerative medicine

              Wrong-o. Money is not single use, it churns and burns and eventually returns. The bleeding edge research you want is funded by those mundane hip implants you don't want. Every time you buy an aspirin, a medication that's been around a thousand years, part of the money goes to the drug company's research team working on Dr McCoy's "grow a new kidney" pill. Research here can lead to improvements there. About the only place that stopping investing helps science would be telescope development, because we really would be better off developing space travel over optical imaging as we can only guess when looking vs going there and knowing. So far as medicine though, we need all avenues open. Quite often, research on one disease actually yields an effective treatment for other diseases. Trying to tunnel vision research will drastically reduce its effectiveness.

              1. I could be a dog really Bronze badge

                Re: Regenerative medicine

                Quite often, research on one disease actually yields an effective treatment for other diseases.

                Indeed. A few years ago a company was developing/trialling a drug to control blood pressure, and some of the trial subjects reported an "interesting" side effect. As a result of that side effect, lots of men now have an oral treatment for impotence via a "little blue pill". Just one mundane example of many.

                And of course, the other issue is "who decides" ? Some government agency ? We don't have to look hard to see how governments dictating tech policy tends to be ... chooses words carefully ... "suboptimal".

            2. mpi Silver badge

              Re: Regenerative medicine

              > Every dollar, pound or euro can only be spent once, you know.

              Wrong. They can be spent an arbitrary number of times. That's pretty much the point of currency in a circulatory economic system. I get paid, I buy groceries, company selling groceries licenses ERP solution, supplier subcontracts my company, I get paid, I buy groceries, ...

              > but we should freeze development and funnel all funds into cartilage research. Every dollar, pound or euro can only be spent once, you know.

              Forgetting for a moment that not every researcher and lab and piece of equipment can be applied to all research equally, let's just say we did an "all eggs in one basket" resource allocation. And what if that research turns out ot be a dead end? That happens, all the time in fact.

    2. GrumpenKraut
      Meh

      Re: Regenerative medicine

      From the article: "The brain-spine interface (BSI) implant used in this case seems to be helping him to grow new nerve connections."

      Also read up on "Nirvana fallacy".

    3. mpi Silver badge

      Re: Regenerative medicine

      > I don't believe in non-biological replacements for human organs

      You can believe or disbelieve whatever you want, fact is, my Mum has an artificial hip, and several other skeleton-related implants required due to damage caused by an autoimmune disorder.

      Before she got the implants, there were months where she could barely walk unassisted. And she was in pain nearly all the time.

      Now she's enjoying her retirement by traveling the world with my Dad. Among other things they go dancing, swimming, hiking and snorkeling, none of which would be possible for her, without those amazing titanium replacement parts in her body.

      > but they should focus on repairing his spinal injury by regrowing part of it, not "bridging" it with some Frankenstein creation.

      Capital idea. If you have a plan how to do that, feel free to link us the peer-reviewed paper that explains the process.

      1. Michael Wojcik Silver badge

        Re: Regenerative medicine

        If you have a plan how to do that...

        Well, step 1 is boldly declaring that everyone else is wrong and should listen to SHM, the world's sole authority on regenerative medicine and oncology.

        Completing the plan is, apparently, an exercise for the reader.

    4. Filippo Silver badge

      Re: Regenerative medicine

      Okay, but that's a bit like saying that you don't believe in solar panels because we should focus on nuclear fusion.

      While we'd all like to regrow severed nerves and eroded cartilages, and there is quite a bit of research going on in these fields, the fact is that we currently cannot do it (except in limited cases, which did not include the patient from the article).

      Also, in case you did not read the entire article, the prosthesis seems to actually also be causing some nerve pathway regeneration in the patient, which is exactly what you were asking for. An effect that can now be studied, yielding new insights on regeneration, and that would not have been discovered, if everyone had just dismissed neural prosthetics as "Frankenstein".

    5. well meaning but ultimately self defeating

      Re: Regenerative medicine

      You’re welcome to develop medicine that can do this. Until then, maybe your beliefs are irrelevant compared to others actual work and achievements.

  5. Doctor Syntax Silver badge

    Congratulations to the team. And best wishes not only to Gert-Jan but also to Liam; that sounds like it must have been a nasty accident, Liam.

  6. Anonymous Coward
    Anonymous Coward

    In the late 70s/early 80s

    I read in the science bit of "OMNI" of a blind guy who had a grid (may have been 8x8 or 16x16) of slice of silicon inserted into his visual cortex and connected to a camera. It worked well enough that in the right conditions they could recognise a letter.

    1. I could be a dog really Bronze badge

      Re: In the late 70s/early 80s

      Indeed, and there's been ongoing development of such systems since. Although ...

      Wasn't there a case reported here not that long ago where users of one such system woke up one morning to find it "not working" and they were blind again ? Something to do with the company going bust and it's servers being turned off.

  7. that one in the corner Silver badge

    Wonderful story to end the week with

    Bravery and an uplifting use of tech. A real pick-me-up after - well, no need to dwell on that.

    Thank you for reporting this. I hope there will be many more opportunities for similar.

    1. Version 1.0 Silver badge
      Happy

      Re: Wonderful story to end the week with

      I've been very happy to be working with the researchers in the USA doing this work for about 15 years now, we build an EMG system that allows the researchers to detect the patients muscle contractions while stimulating the muscles based on their spinal data collection work. It's always made me so happy to talk with the researchers as they explain how their patients arrive in the lab in a wheelchair and then get up and walk around!

      We only designed the data collection system, the researchers are doing the great work, we've just given them a product that works in their muscle stimulation environment.

  8. xyz Silver badge

    Opportunity knocks...

    >>The brain-spine interface (BSI) implant used in this case seems to be helping him to grow new nerve connections.

    Insert Musk jokes here.

  9. mpi Silver badge

    Holy ...

    >However, he is now able to walk for very short distances without the aid of the prosthesis. That suggests that with regular use over a sustained period, new connections are reforming in his spinal cord and reestablishing connections with his brain.

    This...is amazing. Not just the sterling work by the scientists and medical professionals that went into this...but that the body can do something like that!

    1. Phones Sheridan Silver badge

      Re: Holy ...

      Life, finds a way, and I can't believe I just quoted a film that also has the line "It's a UNIX system. I know this" as a pre-rendered 3d animation navigates a file structure flow chart!

    2. Anonymous Coward
      Anonymous Coward

      Re: Holy ...

      Doc! DOC!!! This is great and all but, I need you to build a second interface between me brain and me willie! PLEASE!!!

  10. Snert32

    What's next?

    Monitoring brain activity to control local muscles that were otherwise out of communication is a wonderful achievement, obviously still in early stages but fantastic progress! I don't want to minimize the achievement, but can this brain activity also be used to control muscles in a DIFFERENT body? Run like a horse, swim like a fish, or perhaps even another human being? I don't see it in the near future, but I don't see it as impossible, either...

    1. Wellyboot Silver badge

      Re: What's next?

      Yes, the system could theoretically control another creature but the horse/fish (whatever) would be barely functional* and that's before the ethical issues involved would have a pitchfork wielding mob at your door.

      On the other hand it's one step nearer to Gundam suits and there will be a budget for that!

      *Gert is walking, not doing Parkour (yet)

    2. M.V. Lipvig Silver badge
      Joke

      Re: What's next?

      "and the other receives data from the electrodes over UHF. "

      I was kinda thinking the other direction - could an Atari joystick and a UHF transmitter let me turn this guy into a live action Pitfall Harry?

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