Device that controls paralysed hands through thought: can it transform the lives of the spinally injured?
As a spinal injury solicitor, I always get very excited about the various technological advances that can help improve the lives of my spinally injured clients.
As it happens, a fascinating breakthrough was announced yesterday where a neuroprosthetic device was used to control the movement of paralysed limbs. Although it is still early days, it is a big step forward in the field of neuroprosthetics.
What is a neuroprosthetic and what does it actually do?
Put simply, it is a device that is placed inside the brain to let the brain communicate directly with, in this case, paralysed hands. It is like re-wiring the section of the nervous system that stopped working as a result of an accident. The neuroprosthetic uses thought control to move the paralysed hands, which are placed in mobile supports to help with gravity.
Bill Kochevar is tetraplegic and unable to move his arms. He took part in this pioneering research. Thanks to the small device being planted inside his brain, he was able to tell his hands what to do by simply thinking about it.
Why are neuroprosthetics important for our spinally injured clients?
The research behind this device has taken many months and years to develop to this stage. Watching Bill being able to feed himself for the first time since his spinal injury proves it was well worth the wait!
This research is unprecedented in that it enables someone with no hand control to use reaching and grasping functions in both of his hands.
Bill, who was injured after a cycling accident 8 years ago, said:
“this research has enhanced my ability to do things. (…) I am still wowed every time I do things.”
I know from speaking with many of my spinally injured clients, often the most devastating effect of their spinal injury is not being able to do the most basic of tasks for themselves.
Although to some, being able to hold up a drink to your mouth or feed yourself might seem like a small achievement, I have no doubt that for my spinally injured clients, particularly those who have unfortunately lost use of their hands and arms, having a device like this would be a huge step towards regaining their independence in everyday life.
I very much hope that this new technology can be developed further and made more widely available so that my clients may be able to benefit from it. At the moment, Bill has trialled the only successful demonstration of the device and it has taken years of refining to reach this point. There is still a great deal of work to be done before this product could be suitable for the mass market and can begin to improve the lives of the majority who live with a spinal cord injury.
I cannot wait to see what further tasks can be performed with the help of this device.
Statement from the Spinal Injuries Association on the neuroprosthetic device
The Spinal Injuries Association has released the following statement in respect of this research:-
“The Spinal Injuries Association supports new avenues of research into spinal cord injury. We were encouraged to hear of the developments for this new technology, published in The Lancet, and what it could potentially mean for spinal cord injured people in the future.
It is very promising to see research which takes steps into restoring functional arm movements to a man with complete paralysis, through a system that decodes brain signals and transmits them to sensors in the arm, allowing this paralysed man to regain some movement from the shoulders down in his hand and arm. The Spinal Injuries Association considers this type of research important to building the body of knowledge that could potentially transform the lives of spinal cord injured people in the future.
Although this research is a positive move forwards, we recommend current injured people receive the news cautiously. The research is still at an early stage and has currently only been tested on one paraplegic man in the US and is therefore a long way from being a proven treatment for spinal cord injured people.”
Raquel Siganporia, one of the Trustees for Spinal Injuries Association endorses the above statement. She also says:-
“Whilst it is still just one piece of the puzzle, this research represents an important step forward in understanding how our body works and helps promote medical knowledge towards full spinal cord repair. It more important than ever that more funding is given towards medical research into spinal cord repair. This breakthrough shows that the right technology is already out there but funds are needed to develop it further and make it more widely available so that people can benefit from it.
In the meantime, the services provided by the Spinal Injuries Association are invaluable to those who are newly injured and their families. The Spinal Injuries Association support and guide them through the real maze of issues that they are likely to face after sustaining their spinal cord injury.”
I hope that with the correct level of funding, this technology can be expanded so that every day people affected by spinal cord injury will benefit.
The ground breaking study behind the neuroprosthetic device
In this study, 53 year-old Bill Kochevar, who was paralysed from below the shoulders eight years ago, underwent surgery to have the neuro-prosthesis fitted.
This involved brain surgery to place sensors in the motor cortex area of his brain responsible for hand movement – creating a brain-computer interface that learnt which movements his brain signals were sending instructions for. This initial stage took four months and included training using a virtual reality arm.
He then underwent another procedure placing 36 muscle stimulating electrodes into his upper and lower arm, including four that helped restore finger and thumb, wrist, elbow and shoulder movements. These were switched on to stimulate the muscles for eight hours a week over 18 weeks to improve strength, movement and reduce muscle fatigue.
The researchers then wired the brain-computer interface to the electrical stimulators in his arm, using a decoder to translate his brain signals into commands for the electrodes in his arm. The electrodes stimulated the muscles to produce contractions, helping Bill intuitively complete the movements he was thinking of. The system also involved an arm support to stop gravity simply pulling his arm down.
During his training, Bill described how he controlled the neuro-prosthesis: “It’s probably a good thing that I’m making it move without having to really concentrate hard at it. I just think ‘out’ and it just goes.”
12 months after having the neuro-prosthesis fitted, Bill was asked to complete day-to-day tasks, including drinking a cup of coffee and feeding himself. First of all, he observed while his arm completed the action under computer control. During this, he thought about making the same movement so that the system could recognise the corresponding brain signals. The two systems were then linked and he was able to use it to drink a coffee and feed himself.
He successfully drank in 11 out of 12 attempts, and it took him roughly 20-40 seconds to complete the task. When feeding himself, he did so multiple times – scooping forkfuls of food and navigating his hand to his mouth to take several bites.
“Although similar systems have been used before, none of them have been as easy to adopt for day-to-day use and they have not been able to restore both reaching and grasping actions,” said Dr Ajiboye. “Our system builds on muscle stimulating electrode technology that is already available and will continue to improve with the development of new fully implanted and wireless brain-computer interface systems. This could lead to enhanced performance of the neuro-prosthesis with better speed, precision and control.”
At the time of the study, Bill had had the neuro-prosthesis implanted for almost two years (717 days) and in this time experienced four minor, non-serious adverse events which were treated and resolved.
Despite its achievements, the neuro-prosthesis still has some limitations, including that movements made using it were slower and less accurate than those made using the virtual reality arm Bill used for training. When using the technology, Bill also needed to watch his arm as he lost his sense of proprioception – the ability to intuitively sense the position and movement of limbs – as a result of the paralysis.
Alex Dabek is a Senior solicitor in the Spinal Injury team at Bolt Burdon Kemp. If you or a loved one have suffered an injury as a result of an accident or someone else’s negligence or you are concerned about the treatment you have received, contact us free of charge and in confidence on 020 7288 4812 or at AlexDabek@boltburdonkemp.co.uk for specialist legal advice. Alternatively, you can complete this form and one of the solicitors in the Spinal Injury team will contact you. You can find out more about the Spinal Injury Team.