New Device Allows Brain to Bypass Spinal Cord and Move Paralyzed Limbs

Read the full article New Device Allows Brain to Bypass Spinal Cord and Move Paralyzed Limbs at NeuroscienceNews.com.

For the first time ever, a paralyzed man can move his fingers and hand with his own thoughts thanks to an innovative partnership between The Ohio State University Wexner Medical Center and Battelle.

Image: Researchers hope the technology may one day help patients affected by various brain and spinal cord injuries such as strokes and traumatic brain injury. Credit Ohio State University.

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Ekso™ is a bionic suit, or exoskeleton, which enables individuals with lower extremity paralysis to stand up and walk over ground with a weight bearing, four point reciprocal gait. Walking is achieved by the user’s forward lateral weight shift to initiate a step. Battery-powered motors drive the legs and replace neuromuscular function.

New Device Allows Brain to Bypass Spinal Cord and Move Paralyzed Limbs

For the first time ever, a paralyzed man can move his fingers and hand with his own thoughts thanks to an innovative partnership between The Ohio State University Wexner Medical Center and Battelle.

Ian Burkhart, a 23-year-old quadriplegic from Dublin, Ohio, is the first patient to use Neurobridge, an electronic neural bypass for spinal cord injuries that reconnects the brain directly to muscles, allowing voluntary and functional control of a paralyzed limb. Burkhart is the first of a potential five participants in a clinical study.

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What are the odds that you can accomplish your dreams? What if you were given one in a million odds of making it happen? Would you give up? Aaron Baker was given a one in a million odds by his doctor of ever feeding himself again after a catastrophic spinal chord injury. Undeterred Aaron would start a journey to be that one in a million to beat the odds and reach his goal of reaching the Para Cycling National Championships. Watch his story in the award winning documentary All That I Am

Aaron has since finished the Para Cycling National Championships, cycled across the United States Twice, and walked across Death Valley. Aaron has founded the Center of Restorative Exercise so that others could receive the same kind of training he received to make his recovery. His center has since changed the lives of countless people who were counted out after strokes, spinal chord injuries, MS, Cerebral Palsy and other debilitating diseases and disorders. 

The original definition of the disorder sleep paralysis was codified as a nightmare by Samuel Johnson in his book “A Dictionary of the English Language”. Sleep paralysis was widely considered to be the work of demons, and more specifically an incubus, which was thought to sit on the chests of sleepers. In Old English the name for this being was mare or mære (from a proto-Germanic *marōn, cf. Old Norse mara), hence comes the mare part in nightmare.

Mind-controlled exoskeleton to help disabled people walk again

Every year thousands of people in Europe are paralysed by a spinal cord injury. Many are young adults, facing the rest of their lives confined to a wheelchair. Although no medical cure currently exists, in the future they could be able to walk again thanks to a mind-controlled robotic exoskeleton being developed by EU-funded researchers.

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The system, based on innovative ‘Brain-neural-computer interface’ (BNCI) technology - combined with a light-weight exoskeleton attached to users’ legs and a virtual reality environment for training - could also find applications in the rehabilitation of stroke victims and in assisting astronauts rebuild muscle mass after prolonged periods in space.

In the United Kingdom, every eight hours someone suffers a spinal cord injury, often leading to partial or full lower-body paralysis. In the United States, more than 250.000 people are living with paralysis as a result of damage to their spinal cord, usually because of a traffic accident, fall or sporting injury. Many are under the age of 50, and with no known medical cure or way of repairing damaged spinal nerves they face the rest of their lives in a wheelchair.

But by bypassing the spinal cord entirely and routing brain signals to a robotic exoskeleton, they should be able to get back on their feet. That is the ultimate goal of researchers working in the ‘Mind-controlled orthosis and VR-training environment for walk empowering' (Mindwalker) project, a three-year initiative supported by EUR 2.75 million in funding from the European Commission.

'Mindwalker was proposed as a very ambitious project intended to investigate promising approaches to exploit brain signals for the purpose of controlling advanced orthosis, and to design and implement a prototype system demonstrating the potential of related technologies,' explains Michel Ilzkovitz, the project coordinator at Space Applications Services in Belgium.

The team’s approach relies on an advanced BNCI system that converts electroencephalography (EEG) signals from the brain, or electromyography (EMG) signals from shoulder muscles, into electronic commands to control the exoskeleton.

The Laboratory of Neurophysiology and Movement Biomechanics at the Université Libre de Bruxelles (ULB) focused on the exploitation of EEG and EMG signals treated by an artificial neural network, while the Foundation Santa Lucia in Italy developed techniques based on EMG signals modelled by the coupling of neural and biomechanical oscillators.

One approach for controlling the exoskeleton uses so-called ‘steady-state visually evoked potential’, a method that reads flickering visual stimuli produced at different frequencies to induce correlated EEG signals. Detection of these EEG signals is used to trigger commands such as ‘stand’, ‘walk’, ‘faster’ or ‘slower’.

A second approach is based on processing EMG signals generated by the user’s shoulders and exploits the natural arm-leg coordination in human walking: arm-swing patterns can be perceived in this way and converted into control signals commanding the exoskeleton’s legs.

A third approach, ‘ideation’, is also based on EEG-signal processing. It uses the identification and exploitation of EEG Theta cortical signals produced by the natural mental process associated with walking. The approach was investigated by the Mindwalker team but had to be dropped due to the difficulty, and time needed, in turning the results of early experiments into a fully exploitable system.

Regardless of which method is used, the BNCI signals have to be filtered and processed before they can be used to control the exoskeleton. To achieve this, the Mindwalker researchers fed the signals into a ‘Dynamic recurrent neural network’ (DRNN), a processing technique capable of learning and exploiting the dynamic character of the BNCI signals.

'This is appealing for kinematic control and allows a much more natural and fluid way of controlling an exoskeleton,' Mr Ilzkovitz says.

The team adopted a similarly practical approach for collecting EEG signals from the user’s scalp. Most BNCI systems are either invasive, requiring electrodes to be placed directly into brain tissue, or require users to wear a ‘wet’ capon their head, necessitating lengthy fitting procedures and the use of special gels to reduce the electrical resistance at the interface between the skin and the electrodes. While such systems deliver signals of very good quality and signal-to-noise ratio, they are impractical for everyday use.

The Mindwalker team therefore turned to a ‘dry’ technology developed by Berlin-based eemagine Medical Imaging Solutions: a cap covered in electrodes that the user can fit themselves, and which uses innovative electronic components to amplify and optimise signals before sending them to the neural network.

'The dry EEG cap can be placed by the subject on their head by themselves in less than a minute, just like a swimming cap,' Mr Ilzkovitz says.

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Problem: I now have so many unread books that trying to choose which one to read next has become physically paralysing.

Solution: Book lottery! The name of every unread book has been written down on the back of a raffle ticket and placed in this handy glass bowl on my desk. That way, the next time I want something new to read, I can pick a book at random without going catatonic in front of the shelves.

Nose cell transplant enables paralysed dogs to walk

Scientists have reversed paralysis in dogs after injecting them with cells grown from the lining of their nose.

The pets had all suffered spinal injuries which prevented them from using their back legs. The Cambridge University team is cautiously optimistic the technique could eventually have a role in the treatment of human patients. The study is the first to test the transplant in “real-life” injuries rather than laboratory animals.

In the study, funded by the Medical Research Council and published in the neurology journal Brain, the dogs had olfactory ensheathing cells from the lining of their nose removed. These were grown and expanded for several weeks in the laboratory.

Will we ever really be able to keep ahead of the next virus?

'About 20' cases of polio-like illness found in California

"About 20" cases of a polio-like syndrome have been identified in California children over the past 18 months, a Stanford University researcher says.

Dr. Keith Van Haren, a pediatric neurologist at Lucile Packard Children’s Hospital Stanford, has written a report about five of the early cases.

In that report, which will be presented in April at the American Academy of Neurology’s annual meeting, neurologists said they had identified five patients who developed paralysis in one or more of their limbs between August 2012 and July 2013. All five children had been vaccinated against the poliovirus. Treatment did not seem to help the children regain their motor function.

Samples from two of those children tested positive for enterovirus 68, a rare virus that has been linked to severe respiratory illness in the past.

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Bypass Commands From the Brain to Legs Through a Computer

Read the full article Bypass Commands From the Brain to Legs Through a Computer at NeuroscienceNews.com.

Gait disturbance in individuals with spinal cord injury is attributed to the interruption of neural pathways from brain to the spinal locomotor center, whereas neural circuits locate below and above the lesion maintain most of their functions. An artificial connection that bridges the lost pathway and connects brain to spinal circuits has potential to ameliorate the functional loss. A Japanese research group, led by Shusaku Sasada and Yukio Nishimura, has successfully made an artificial connection from the brain to the locomotion center in the spinal cord by bypassing with a computer interface. This allowed subjects to stimulate the spinal locomotion center using volitionally-controlled muscle activity and to control walking in legs.

The research is in Journal of Neuroscience. (full access paywall)

Research: “Volitional Walking via Upper Limb Muscle-Controlled Stimulation of the Lumbar Locomotor Center in Man” by Syusaku Sasada, Kenji Kato, Suguru Kadowaki, Stefan J. Groiss, Yoshikazu Ugawa, Tomoyoshi Komiyama, and Yukio Nishimura in Journal of Neuroscience. doi:10.1523/JNEUROSCI.4674-13.2014

Image: When turning off the computer-aided spinal cord bypass, the lower extremities which were in a relaxed state did not move even if the subject was swinging his/her arms. With the bypass turned on, when the subject swung his/her arms by his/her own will and a walking motion of the lower extremities began in rhythm to the motion of the arms. Credit Yukio Nishimura.

This image shows an artificial connection that connects brain to spinal circuits. Credit Yukio Nishimura.

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Polio and the Iron Lung,

From the early 1900’s up to the 1960’s polio ravaged Europe and North America, crippling hundreds of thousands of people.  A dangerous virus that causes severe fever,  in about 1% of cases the disease will cause damage to the motor neurons of the central nervous system (brain, spinal chord).  This causes muscular disorders and paralysis for victims who face such a symptoms.  Thousands of children and adults lost the ability to walk in the early 20th century, even future US President Franklin D. Roosevelt.

For others the consequences were even more dire. Many lost the ability to breathe as the disease paralyzed the diaphragm, which is the motor of respiration. When a person breathes , the diaphragm contracts,  causing the lungs to expand as well as the chest and ribs.  This expansion causes the pressure within the lungs to be lower than the outside air.  As a result air rushes into the lungs leading to inhalation.  When the diaphragm relaxes, pressure within the lungs increases resulting in air rushing out of the lungs, or exhalation.  A person suffering from paralysis above the diaphragm may have severe problems with respiration, or may not be able to breathe at all as the diaphragm is unable to contract.  Often such people may need mechanical assistance with breathing.

In the late 1920’s and 1930’s the first negative pressure ventilators were introduced to aid people who had breathing problems due to paralysis, most notably victims of polio.  Colloquially known as the “iron lung”, the negative pressure ventilator worked by creating pressure changes which aided a dysfunctional diaphragm.  The iron lung consisted of a large tank in which the patient laid in, with his or her head sticking out. The pressures within the tank would rise and fall, simulation the changing pressures within the lungs. Unfortunately the patient was completely confined to and dependent of the iron lung throughout treatment.  Fortunately most patients would be rehabilitated by the machine as it stimulated the nervous system and strengthened the diaphragm.  Most patients would only spend a few weeks within the lung.  Many however, would be forced to spend months, years, or even a lifetime in the machines.  

The use of the iron lung skyrocketed in the 1940’s and 1950’s as the polio epidemic peaked.  The number of people paralyzed by polio made demand so high, that they were put to use mere hours after production.  Many city hospitals had entire wards and floors which had nothing but rows and rows of iron lung machines.  The prevalence of iron lung machines decrease in the 1960’s after massive government sponsored vaccination programs nearly eradicated the disease in developed nations.  In addition, the invention of better, more portable ventilation systems were invented for people with respiratory issues.  By 2008, the number of people dependent on iron lung machines in the US numbered only 30.  An Australian woman named June Middleton is credited for living the longest in an iron lung, spending 50 of her 83 years within the machine.  Today, Polio is all but eradicated within developed nations as most of the population is immune to virus.  In poorer nations polio continues to be a scourge that maims thousands.

Monkey uses its mind to control another primate, in tests scientists hope could help paralysed people
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Scientists have developed a way for monkeys to control “avatars” that could be used to help paralysed people move their bodies. In the tests scientists found that brain signals from the master monkey’s mind could be used to stimulate an avatar’s spinal cord to control its movements. The findings published in the Natural Communications journal have been called a “key step forward” and could help people who have damaged their spinal cord to the extent that its stops information flowing from the brain to the body. People with such damage are often left unable to walk or feed themselves, and researchers say that even the smallest amount of movement could dramatically improve a person’s life, the BBC reported. The scientists from Harvard Medical School in the US envisage their findings could go towards creating machinery to help patients. As researchers said they could not justify paralysing a monkey for the study, they used a conscious monkey with an implanted brain chip, and an unconscious avatar to be controlled. During the experiment, the conscious monkey’s movements were mapped according to patterns of electrical activity in its neurons. The scientists then hooked the avatar’s spinal cord up to 36 electrodes to measure how it moved according to different combinations of stimulation. In a different test, as the sedated monkey held a joystick, the master thought about moving a cursor up and down. In 98 per cent of tests, the master could correctly control the avatar’s arm. (via Monkey uses its mind to control another primate, in tests scientists hope could help paralysed people - Science - News - The Independent)

Spinal Stimulation Helps Four Patients with Paraplegia Regain Voluntary Movement

Four people with paraplegia are able to voluntarily move previously paralyzed muscles as a result of a novel therapy that involves electrical stimulation of the spinal cord, according to a study funded in part by the National Institutes of Health and the Christopher & Dana Reeve Foundation. The participants, each of whom had been paralyzed for more than two years, were able to voluntarily flex their toes, ankles, and knees while the stimulator was active, and the movements were enhanced over time when combined with physical rehabilitation. Researchers involved in the study say the therapy has the potential to change the prognosis of people with paralysis even years after injury.

“When we first learned that a patient had regained voluntary control as a result of spinal stimulation, we were cautiously optimistic,” said Roderic Pettigrew, Ph.D., M.D., director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB) at NIH, which provided support for the study. “Now that spinal stimulation has been successful in 4 out of 4 patients, there is evidence to suggest that a large cohort of individuals, previously with little realistic hope of any meaningful recovery from spinal cord injury, may benefit from this intervention.”

One of the most impressive and unexpected findings of the study is that two of the patients who benefited from the spinal stimulation had complete motor and sensory paralysis. In these patients, the pathway that sends information about sensation from the legs to the brain is disrupted, in addition to the pathway that sends information from the brain to the legs in order to control movement. The researchers were surprised by the outcome; they had assumed that at least some of the sensory pathway needed to be intact for the therapy to be effective.

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