Image by Getty/Futurism Neuroscience/Brain Science
Scientists have published fascinating research about a small, splinter-like implant in the brain that doctors can insert deep into the brain to restore muscle control and feel for paralysis patients' limbs.
Researchers led by Chad Bouton, a bioelectronic medical engineer at the Feinstein Institutes for Medical Research, and Northwell Health, discovered that the implant can record brain activity and route it through a computer, instead of the spinal cord. This allows the implant to stimulate muscles directly, effectively bypassing the patient's damaged nervous system.
However, this is not all. The system could also collect data about finger pressure and position to stimulate the sensory area of the brain. This provided subjects with a sense touch and proprioception of their own limbs.
The implant allows people to move and feel their limbs, bypassing any injury or condition that may have prevented their brains communicating with their bodies. Bouton reports that his team has FDA clearance to conduct an ambitious clinical study to test both these capabilities and give paralyzed people new levels of independence.
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Futurism sat down with Bouton to discuss his vision and goals for the neural implant. This is our conversation edited for clarity and length.
The implant is designed to restore muscle control and sensation. Is that where this idea came from?
Chad Bouton : There has been a lot of work done in stem cells. These techniques have helped to encourage neural regrowth. While that work is progressing, there are still many challenges. My career was blessed with the opportunity to participate in the BrainGate program early in my career. Patients could actually move cursors the first time electrode arrays were placed in their brains, specifically in the motor cortex. This was a huge breakthrough and a lot of attention. However, none of the patients could move. This was not the main focus of the study. A few years later, I came up with the idea that, if we could decipher the motor area signals and understand that someone is thinking about opening their hands and moving their fingers, why couldn't we now reroute these signals to the injured or damaged part of our nervous system and allow real-time stimulation for the muscles?
That is what we set out to accomplish. The first clinical study involved a paralyzed young man, who was paralyzed from the diving accident. He used a brain implant to regain movement in his hand. This was a medical breakthrough and I called it electronic neural bypass. We were referring to what we were doing as bidirectional neural bypass. These tiny sensors can even read information pressure at the fingertips and possibly reroute the signals to the brain. That's the main part of what we did.
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One concerns recording and decoding. This electrode is very thin and minimally invasive and can be inserted into the brain to record the code. We can also create and stimulate sensations at the fingertips. You know how important the fingertips are. Consider all the tasks we do daily, such as dressing ourselves and using fine motor skills. It started with one thing, but then we realized that there was a bigger problem.
What input does the implant receive and how does it translate that into improved perception and muscle control? Is it important where the injury occurred?
Bouton says: Let's take an example. If someone is in an accident that results in a spinal injury, it will be between the brains and the muscles. The information highway is part of the spinal cord, as we know. Although it is not like the brain, it does contain a network. It is quite complicated. It is quite complicated. The surgeons make very small holes in the skull to slide the electrode in. Our goal was to go a little deeper than our previous work. We wanted to get a little deeper into the brain's folds, the sulci. Since a long time, it has been known that the parts of the brain that correspond to the fingertips actually go deeper into the folds.
We emphasized the sensation of touch and how it can create or restore feeling. This is the ultimate goal. For the first time, we demonstrated that it is possible to stimulate deeper into the brain's folds and produce highly focal sensations or percepts in the fingertips. People reported feeling a bit of tingling, buzzing, or pressure at the index or tip of their thumbs. This was consistent. This was huge. The signals were also recorded as individuals moved their fingers. It was possible to tell which finger people are thinking of or moving, such as thumb or middle fingers. We also found interesting signals coming from the white matter in the brain. It was possible to decode with accuracy up to 91%. Sometimes even higher.
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Why is this important? Think about paralysis. Someone wants to move their hands again. The thin electrodes are used to record the hand's movements. These cool electrode arrays of gold can be applied directly to the skin. Based on the thought patterns of the person, we stimulate their muscles. That's how you can reroute the other direction.
FDA approval has been granted to conduct a new study that collects sensory information. This includes the sensation when someone picks up grapes or other fruits. We have developed these thin film sensors. They were placed on the fingers. They can be stretched or flattened like skin. When you touch an object, they produce an electrical signal. That signal is sent back to the computer, and the computer then sends stimulation patterns back into the brain's folds. That's what we plan to do next. FDA approval has been granted to conduct that study and close the loop, if necessary.
Does there seem to be any signal delay between the neural signal and implant and the computer to stimulate muscle? How about the opposite direction?
Bouton, The team worked hard to reduce this delay. Even if someone has not suffered a spinal injury, there is always a delay. It takes signals a while to travel. Our AI algorithms respond very quickly and have a short response time. Within seconds, we can determine what the person is looking for. This is very useful. EEG on the scalp is not perfect. There are still delays. We can reduce those delays by placing the implant in the brain, and recording directly from the brain using our new methods. This is crucial, right? Think about it. You have to minimize delays if you want it to be usable and functional.
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You are in the early stages of your research, planning for your next study. This research is only based on three patients. Is there a commercial or broader goal?
Bouton: We still need to look into this approach. This approach is minimally invasive, which is a huge advantage. We still need to create what we call a "chronic" or long-term version of the procedure that can be kept in place for longer periods. We must also continue to map out where we want to record, stimulate and monitor. We still have much to do.
Although we might be able to commercialize some of this technology in the future, I wouldn't rule out the possibility. However, it is likely that it will still be many years away.
Because Synchron, a company that does human experimentation, was approved by the FDA to ask me about its future direction, this is why I am asking. They also focus on minimally-invasive tech and created an implant that stays in the brains vasculature. This focus on minimally-invasive techniques is a growing trend in this field.
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Bouton: Yes. Yes. They are very well-known to me. They are both aware of one another, which is a great thing. They share a common goal of making BCI less invasive and more accessible to more people. This is something I admire. We want that to be the case. It also comes down to where you can place the electrodes in your brain. We want to reach as many areas as possible while remaining safe. We want to reach the hands, the fingers, the fingertips and the feet. We did this by mapping the brain, going deeper and exploring different areas. This is important as you can now help a wider range of people. It is possible to get into the speech processing and speech generation regions of the brain, as well as hearing and vision. We need to be able to see these areas and help as many people as possible. There are many conditions that can be treated with this technology in the future.
This treatment could be beneficial to patients with a wide range of conditions, including diabetes and brain injury patients. What would the universality of this type of treatment and implant be for different types of injuries? Is it possible to expand it using completely different technology or just further mapping of the brain?
Bouton: It all depends on which part of your brain you are trying to reach. As we map more, the question will be: Do we have enough electrodes? Are they close enough in range? Are they precise enough? This approach is more secure and can reach deeper places. We think it has great appeal. We can also use the same idea of stimulating and recording because we know you can do it in different parts. This is already known.
Although there is still much to be discovered, there have been some studies that stimulate the deep brainstem. This depth electrode is used to stimulate the brain in Parkinson's disease. There have been studies that stimulate deeper structures in order to treat depression and obsessive compulsive disorder. However, most of the recordings have been made in motor area. There have not been as many recordings of stimulation in humans as there have been. There is a lot more room for research. We will learn a lot, I believe. It will open up more doors for me, quite honestly.
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Do you have any other ideas?
Bouton says: We always think about the path to the patient. How can we use scientific and technological breakthroughs made in the laboratory to guide them all the way to patients? This is part of our mission and part of being part of a healthcare system. We were very focused on the patient. Even though we were all focused on the patient, even my lab with all our collaborators, I believe that we all share the same mission: to get this information out to the clinic and get the patient it.
We can now think about the path to the patient and all the roadblocks. What are the roadblocks and how can we avoid them? How can we navigate this and keep it safe? Quality of life is everything. This is the second general observation I would like to make. We are trying to do all we can to improve our quality of life and increase our independence. Many people have said to me that they just want to be independent and do more without needing help.
This has been something that I have admired over the years. That's what we wanted to do. Help people do more things without asking for help. This puts things in a new perspective.
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