Technology Helps A Paralyzed Man Transform Thought Into Movement

Apr 13, 2016
Originally published on May 4, 2016 4:11 pm

Ian Burkhart, now 24, was paralyzed in 2010 after diving into a wave in shallow water. The accident left him with some arm movement but no use of his hands.

Then, about two years ago, scientists in Ohio equipped Burkhart with a system that allowed him to control his right wrist and hand with his thoughts.

"The first time moving my hand — that was really just like that flicker of hope," Burkhart told reporters during a media briefing Tuesday. The briefing was held to publicize a study in this week's issue of Nature, which describes Burkhart's progress since he started using the system.

After many months of practice, Burkhart can now perform tasks like pouring water from a bottle, grasping small objects, and swiping a credit card through a card reader. He can also control the movement of individual fingers.

It's all possible because of technology that intercepts and decodes electrical signals from the brain before they reach Burkhart's damaged spine.

"We're actually routing them around the spinal cord injury and then reinserting those signals into the muscles," says Chad Bouton, the study's first author and vice president of advanced engineering at the Feinstein Institute for Medical Research in Manhasset, N.Y.

The system relies on electrodes implanted in Burkhart's brain, a computer interface attached to his skull, and electrical stimulators wrapped around his forearm.

At first, Burkhart could grasp objects, but he would drop them when he moved his arm. His skill has improved steadily, though, Bouton says.

"Ian is learning how to think about very detailed movements and the machine is actually learning how to decipher those signals more effectively as well," Bouton says. "So they're actually learning together."

Burkhart's achievements have received a great deal of media attention. But he is just one of many paralyzed people using technology that allows them to perform daily tasks using their thoughts.

And much of the technology Burkhart relies on is also in use at other research centers, says Robert Kirsch, chairman of the department of biomedical engineering at Case Western Reserve University and executive director of the Cleveland Functional Electrical Stimulation Center.

"The brain computer interfacing that they did is kind of garden variety," Kirsch says. "And the electrical stimulation that they've done is really old-fashioned."

Other groups have obtained better results using electrical stimulators that are implanted in muscles, instead of placed on the skin, Kirsch says. That approach requires extra surgery but allows more precise control of muscles, he says.

At a scientific meeting last year, a member of Kirsch's team reported on a person using their technology who is able to use thoughts to trigger muscles in both the arm and hand. That's important, Kirsch says, because, unlike Burkhart, many other paralyzed people have no use of their arms or shoulders.

More than a decade of experiments has shown that paralyzed people can learn to use their thoughts to control computers, robotic arms and even their own limbs, says Leigh Hochberg, a professor of engineering at Brown University. Unfortunately, the systems that make this possible still aren't suitable for use at home, he says.

What people who are paralyzed really want, Hochberg says, is "a fully implanted technology, one that doesn't have wires or plugs that are sticking up above the scalp, doesn't have wires that are wrapped around the outside of the arm."

And that, he says, will require technological advances — including the ability to transmit signals from the brain without using wires.

"The process of getting from where we are today, which is some exciting early clinical research, all the way through to a clinically useful, vetted device that will help someone with paralysis is still a long one," Hochberg says.

Even so, Hochberg and other paralysis researchers say the wait will probably be measured in years, not decades.

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ARI SHAPIRO, HOST:

A spinal injury can paralyze a person by blocking the electrical signals that usually travel from the brain to muscles in the body. Now scientists are finding ways to bypass a damaged spine. NPR's Jon Hamilton reports on a study of a paralyzed man who has regained the ability to do simple things, like pour water from a bottle.

JON HAMILTON, BYLINE: The man is Ian Burkhart. He was paralyzed in 2010 after diving into a wave in shallow water. The accident left him with some arm movement but no use of his hands. Then about two years ago, scientists equipped Burkhart with a system that allows him to control his right hand with his thoughts.

IAN BURKHART: The first time of moving my hand, that was really just, like, that flicker of hope, knowing that this is something that's working. I will be able to use my hand again.

HAMILTON: Burkhart was speaking at a media briefing to publicize the study, which appears in the journal Nature. After many months of practice, he can grasp objects and even move individual fingers. Chad Bouton of the Feinstein Institute for Medical Research, says that's possible because of technology that is intercepting and decoding electrical signals before they reach Burkhart's damaged spine.

CHAD BOUTON: And these signals are coming from the brain, the motor area of the brain. And we're actually routing them around the spinal cord injury and then reinserting those signals into the muscles of the paralyzed patient, and that patient is actually regaining movement.

HAMILTON: Here's how the system works - there are electrodes implanted in Burkhart's brain that pick up the signals and send them to a computer via a plug in his skull. Then the computer sends its own signals to stimulators wrapped around Burkhart's forearm, causing muscles that control the hand to contract. Bouton says Burkhart's ability to use his hand is improving steadily.

BOUTON: Ian is learning how to think about very detailed movements, and the machine is actually learning how to decipher those signals more effectively as well. So they're actually learning together.

HAMILTON: The system was developed by a team at Ohio State University and Battelle Memorial Institute. It all sounds very impressive, but to people in the field it's actually pretty routine. Robert Kirsch is at Case Western Reserve University.

ROBERT KIRSCH: The brain computer interfacing that they did is kind of garden-variety. There's a number of groups around the country doing very similar things. And the electrical stimulation that they've done is really old-fashioned and has a very limited upside.

HAMILTON: Kirsch says other groups have obtained better results using electrical stimulators surgically implanted in the muscles instead of placed on the skin. Leigh Hochberg at Brown University says it's clear now that paralyzed people can use thoughts to control computers, robotic arms and even their own limbs. But all of this happens in hospitals and labs with researchers running the equipment. Hochberg says what paralyzed people really need is a technology they can use on their own at home.

LEIGH HOCHBERG: A fully implanted technology, one that doesn't have wires or plugs that are sticking up above the scalp, doesn't have wires that are wrapped around the outside of the arm. The ideal technology in many ways is one that's invisible.

HAMILTON: And Hochberg says that will require technological advances, like smaller computers and a way to transmit signals from the brain without using plugs and wires.

HOCHBERG: The process of getting from where we are today, which is some exciting early clinical research, all the way through to a clinically useful, vetted device that will help people with paralysis is still a long one.

HAMILTON: Even so, researchers say the wait is probably year, not decades. Jon Hamilton, NPR News. Transcript provided by NPR, Copyright NPR.