The communication system that the family was already using was being automated. The team connected an eye- tracking device to a computer software that would read out colors and row numbers and allow the man to spell out words using his eye movements.
The man became less able to communicate using the device as he lost control over his eye movements. The electrical activity of brain cells can be recorded with tiny electrodes. The procedure that involves drilling a hole in the skull and cutting away the brain's protective layers has a small risk of infections and damage to the brain. It was a last resort if BCIs and eye-trackers don't work anymore.
The man consented to the procedure using his eyes. His wife and sister gave their consent as well. The procedure was approved by an ethics committee and Germany's Federal Institute for Drugs and Medical Devices at the end of the year. In March, surgeons implanted two tiny grids, each measuring 1.5 millimeters across, into the man's motor cortex, a region of the brain responsible for controlling movement.
The team tried to help the man communicate after the implant. The man was asked to imagine making physical movements, and this has helped other recipients control their limbs, and is the approach Neuralink plans to take. The idea is to get a reliable signal from the brain and translate it into a command.
The team couldn't get it to work. After 12 weeks of trying, they decided to try a different approach called neurofeedback. A person can learn how to control their brain activity with the help of neuroscience. A computer would play an audio tone when the man's brain activity increased. A fall in brain activity would make the tone go down.
He was able to increase and decrease the sound tone within two days.
The paper-based computer system the man used to communicate with his family was mimicked by the team. The man would hear the word yellow or blue to choose a block of letters. He would play individual letters and use a rising or descending tone to either select or dismiss them.
The man was able to communicate entire sentences in this way. One of the first sentences the man was spelled was translated as "boys."
It takes around a minute to select each letter. Researchers think the device has improved the man's quality of life. He has asked for specific meals and soups, directed his caregivers on how to move and massage his legs, and asked to watch films with his young son. One sentence was translated as "I love my cool son."
The last word was always beer.
One of the first sentences the man spelled was translated as “boys, it works so effortlessly."
He envisions a catalog of frequently used words that could eventually allow software to autocomplete the man's words as he spells them.
Other studies have found that similar electrodes are still functioning five years after being implanted in other people, but no one knows how long the electrodes will last in the man's brain. A single day can make a difference for a locked-in person.
Within the next 10 to 15 years, Nazarpour thinks the technology could be offered to similarly locked-in individuals.
The director of research development at the Motor Neurone Disease Association in the UK agrees that the timelines are realistic. He wonders how many people with motor neuron disease stand to benefit from BCIs.
The man who received the BCI has a disease called progressive muscular atrophy. Motor nerves that travel from the spine to muscles are targets of this form of the disease. The motor cortex in the brain is one of the most important parts of the disease.
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