First modification:
He is not the first paralyzed person to walk again thanks to electrical stimulation of his spinal cord, but he is the first to do so without external control. This patient, a quadriplegic for ten years, now has two brain implants that read his neural impulses and translate them into movement in his legs.
First, there were the rats. In 2014, a group of scientists led by Grégoire Courtine succeeded in making these animals, with their spinal cord severed, walk for 25 minutes using electrical stimulation. Without communication between the brain and the nerves that run inside the spine due to injury, that should be impossible. However, using that stimulation and a computer program designed to mimic the neural signals that indicate movement, the team got the rats to move.
Two years later, it was the monkeys. The same team managed to recreate the feat with these apes: as if they were puppet masters, they sent electrical currents to the marrows of the animals that allowed them to walk again. A decade of research later, Gert-Ian Oskan, a 40-year-old quadriplegic from the Netherlands, reaped the rewards and was able to walk, move and climb stairs without external control; just thinking about itas people without injuries do.
Oskan started his journey with the Courtine team years ago. He was one of three patients who regained some of his mobility thanks to the scientists’ first human trial. At that time, electrodes were implanted in the area of his spinal cord that controls his legs and, through a computer program that was activated thanks to sensors in his feet, electrical stimuli were sent that facilitated the patient’s residual voluntary movements.
Leaping with today’s technology is a stunt. Unlike previous trials, both with Oskan and other patients who also managed to move voluntarily in 2022 with algorithm programming that allowed them to walk, cycle or canoe, this time the control is exercised with the brain itself.
Before, electrical stimulation controlled me. Now I’m the one who controls the stimulation
A “digital bridge” between the brain and spinal cord
Oskan received two more implants in each hemisphere of the brain, particularly in the motor area. These implants collect and read the nerve signals that are awakened by the will to move.
The information is then sent to a decoding center that is carried in a suitcase on the back and that interprets the signals and transforms them into commands of electrical stimuli. These stimuli are emitted by implants that the patient has in his spinal cord (the same ones recycled from the 2018 trial), and the legs and feet receive the information to walk.
The difference with previous projects is abysmal: the movement is deliberate. Oskan himself described it this way: “Before, the electrical stimulation controlled me. Now I am the one who controls the stimulation.”
To achieve this mechanism, which does not use cables, the patient had to undergo two surgeries to receive the brain implants, in addition to the one he already had in 2018 to place those of the spinal cord. “Yes, he is a bit of a cyborg, in a way,” Courtine admits. “Our goal is to improve their daily life, their quality of life, and we must measure these achievements. He can’t walk like you and me, but for the first time in human history we have managed to reconnect two regions of the nervous system that were separated for an injury.”
The work requires overwhelming precision to function, based on a pinpoint knowledge of the human nervous system. In addition, the system relies on artificial intelligence, especially machine learning, to read Oskan’s brain signals and transmit them to the legs. Thanks to this, the algorithm can improve and become more and more precise and adapted to the person.
Improvements in the short, medium or long term?
While precise, the mechanism is also complex and elaborate, and carries some risks. Surgeries to install implants involve the possibility of bleeding or infection. In fact, Oskan himself suffered a mild infection in one of the brain implants, which, fortunately, was not serious. The material and design is personalized and expensive: in addition to the implants, there is a backpack that the patient must carry on his back and a kind of headband that is placed on his head when he wants to use this technology so that the brain begins to transmit .
For these reasons, thinking about applying this “digital bridge” on a large scale is practically impossible, at least in the short, or even medium term. However, Courtine, together with Jocelyn Bloch, a neurosurgeon who has accompanied the project for years, have created a company to seek commercial outlets for their findings.
Just because it’s complex doesn’t mean the progress isn’t hopeful. For example, Oskan’s nervous system was enhanced by the technology even when it was not activated, as if his neurons had remembered connections forgotten in the paralysis. That reinforces the theory that electrical stimulation can become a useful treatment, beyond walking again or not.
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