Researchers are bringing brain-computer interface capabilities from the lab to the home.
They demonstrated that a small portable system facilitates the hand grip of a paralyzed patient by a spinal cord injury, allowing the patient to pick up a toothbrush and other objects.
In addition, the system can be set up by a caregiver in a matter of minutes.
“The fact that we’ve brought this into the house shows great promise,” said Kevin C. Davis, medical and doctoral student in the Department of Biomedical Engineering at the Miller School of Medicine at the University of Miami, Miami, in Florida. Medscape Medical News.
If investigators can continue to show that the technology improves independence and lowers the costs of supportive care for patients with paralysis, “watch out for these devices,” Davis said.
The results were presented at the 2021 annual meeting of the American Association of Neurological Surgeons (AANS).
Evidence suggests that approximately 54 million people in the United States are living with paralysis. Most cases are caused by stroke (33.7%), followed by spinal cord injuries (27.3%) and multiple sclerosis (18.16%), Davis reported.
Lifetime costs of spinal cord injury can range from $ 1 million to $ 5 million, he noted. “Given the need for supportive care, any potential marginal improvement in independence could reduce supportive care costs and improve quality of life,” he added.
There is currently no treatment for spinal cord injuries. Interventions aim to mitigate primary injury and minimize secondary injury and maximize any residual function. This is where a brain-to-computer interface system “can really come into play,” Davis said.
“Brain-computer interface” refers to “any system that takes neural data and translates it into something useful for the individual,” he said.
Both invasive and non-invasive neural signal recording methods have allowed patients to control computer cursors and communicate via spellings, texting, and text-to-speech.
“But there is still a translation problem to bring this technology from the lab to the clinic and to the patient’s home,” said Davis.
Quadriplegic patients report that restoring arm and hand function is the area they most want to target. To deliver this in the home, the systems need to be simple to install, intuitive to configure, and easy to maintain, Davis said.
To address this challenge, his team partnered with Medtronic to launch a clinical trial to deploy an electrocorticography-based brain-computer interface system that uses deep brain stimulation technology (DBS).
“We basically took something that was designed for DBS in Parkinson’s disease and other movement disorders and reused it for a different patient population and for a different purpose, ”Davis said.
The first patient to receive the system was a 21-year-old man who was paralyzed at the age of 17 from a C5 spinal cord injury. He could flex his biceps and had other limited movements in his arm, but he had no manual dexterity.
To enable use of the system, wires were placed on the surface of the motor hand region of the human brain, and wires connected to the DBS sensing device were inserted under the skin just below its clavicle. This device collects neural data.
A mini-computer that converts the signal into motion was then placed behind his wheelchair. A special glove that is connected to the computer with a Bluetooth signal allows him to open and close his hand.
Using the system, this patient is able to pick up a toothbrush, brush their teeth, and handle a fork and spoon, among other tasks.
The next step, said Davis, is to implant the system in other patients and possibly decode the movements of both hands. In the future, the system could allow more complex movements using other joints, such as the elbow and wrist, he added.
Proof of concept
Comment for Medscape Medical News, Angela M. Richardson, MD, PhD, assistant professor of neurological surgery, Indiana University School of Medicine, Indianapolis, Indiana, noted that this is the first fully implanted device for home use and that this research represents “an important proof of concept. “
“It has the potential to increase complexity with future generations of the device, both in terms of the type of information that could be detected and decoded, as well as the types of movements the glove could be designed to produce. “said Richardson, who was not involved in the research.
She stressed the importance of providing patients with the ability to grip with their hand.
“This is important to allow more independence for a patient; for example, grabbing and holding a spoon allows a person to feed themselves,” said Richardson.
The study was funded by the Miami Project to Cure Paralysis. Davis did not report any relevant financial relationship.
American Association of Neurological Surgeons (AANS) Annual Meeting 2021: Plenary Session II. Presented August 24, 2021.