According to the researchers, a surgically implanted computer chip enables messages to travel from Burkhart’s brain to his limbs, bypassing the damaged spinal cord.
In Wednesday’s issue of the journal Nature, researchers report that Burkhart is the first person with quadriplegia to successfully control how his muscles are activated using signals recorded from within the brain’s motor cortex. “The electronic neural bypass technology in this study demonstrates what is possible in the future, and can offer hope for movement restoration to millions of people worldwide living with paralysis,” said researcher Gaurav Sharma, of the Battelle Memorial Institute in Columbus, Ohio. Burkhart may show the way for revolutionary advances in their treatment, the researchers said. He is able to move his shoulder and flex his bicep but movements below the elbow are only possible using the technology in the lab in Columbus, Ohio. For the experimental treatment, surgeons in 2014 implanted a computer chip in an area of Burkhart’s brain that includes 96 electrodes that penetrate just below the surface. It monitors a relatively small population of brain cells in the region that controls movement of his right hand, sampling the activity 3 million times a second. “By recording signals from the motor cortex, interpreting and transmitting signals by computer directly to the paralyzed hand muscles, we bypass the damaged spinal cord,” Sharma said. After three sessions a week for 15 months, Burkhart was able to grasp a glass bottle, pour contents into a jar, grasp a stir stick and transfer it without dropping it. It’s a demonstration of six basic hand and wrist movements. He can grab a credit card and swipe it through a reader. He can move individual fingers and hold a toothbrush. “For me being in a wheelchair and not being able to walk is not the biggest thing, but the lack of independence because you have to rely on so many people for things,” Burkhart told reporters. “The first time I was able to open and close my hand it really gave me that sense of hope that I already had in the back of mind, but this made it more real.” Burkhart is hopeful he will be able to use the system outside of the clinical study to improve his quality of life. The technology is still in its early stage, but with improvements, researchers hope the system will eventually aid the everyday lives of people like Burkhart with spinal cord injuries, and perhaps others with stroke or traumatic brain injury. “It is conceivable that this technology could be used to link brain activity to stimulate leg muscles to help people with lower limb paralysis,” Sharma said. However, the current system can only be used in a controlled laboratory environment. “Our next goal is to build upon our experience from this study to develop a system that is not only portable, but also something that a patient can take home to assist with their activities of daily living or rehabilitation,” he said. Many technological advances and regulatory approvals will be required to make this system usable in a home setting, including robust computer software and hardware, and smaller devices, Sharma said. The current trial authorizes up to four additional patients, he said. “We are currently recruiting a second participant for our clinical study and hope to begin that work this summer,” he said. Dr. Gayatri Devi, a neurologist and memory loss specialist at Lenox Hill Hospital in New York City, called this technology a breakthrough for paralyzed patients. “This is a phenomenal demonstration of the power of technology in helping patients with spinal cord injury to live more independently,” she said. “It is both an emotional and a neurologic breakthrough for a quadriplegic patient to be able to place a straw in a cup of water and to drink from it.” Even though this technology involves invasive brain surgery, it gives hope in an area of rehabilitation where there was little hope earlier, Devi said. “While each patient will need to be individually evaluated for such intervention, the future is now brighter for the rehabilitation of patients with cord injuries,” she said.
