‘Brain training’ technique restores feeling and movement to paraplegic patients

Eight paraplegics – some of them paralysed for more than a decade by severe spinal cord injury – have been able to move their legs and feel sensation, after help from an artificial exoskeleton, sessions using virtual reality (VR) technology and a non-invasive system that links the brain with a computer.

In effect, after just 10 months of what their Brazilian medical team call “brain training” they have been able to make a conscious decision to move and then get a response from muscles that have not been used for a decade.

Of the octet, one has been able to leave her house and drive a car. Another has conceived and delivered a child, feeling the contractions as she did so.

The extent of the improvements was unexpected. The scientists had intended to exploit advanced computing and robotic technology to help paraplegics recover a sense of control in their lives. But their patients recovered some feeling and direct command as well.

The implication is that even apparently complete spinal cord injury might leave some connected nerve tissue that could be reawakened after years of inaction.

The patients responded unevenly, but all have reported partial restoration of muscle movement or skin sensation. Some have even recovered visceral function and are now able to tell when they need the lavatory. And although none of them can walk unaided, one woman has been able to make walking movements with her legs, while suspended in a harness, and generate enough force to make a robot exoskeleton move.

“Some of our patients, for the first time, were able to get out of their houses and go back to work,” said Miguel Nicolelis, co-director of the Duke University Centre for Neuroengineering, and based at the Alberto Santos Dumont Association neurorehabilitation laboratory in São Paulo. The work is part of the Walk Again Project that unites 100 scientists from 25 countries.

The study parallels other approaches to spinal cord injury: there are hopes of stem cell therapy that could make possible natural repairs to the nervous system, and of electronic implants that might bypass a spinal cord injury to transmit the brain’s message to the muscles.

The Brazilian trial was originally intended as a test of the third approach: robotic aids driven by brainpower. The scientists gave an example of what they thought possible in 2014 when Juan Pinto, a 25-year-old paraplegic, used a brain-controlled robotic exoskeleton to kick a football during the opening ceremony of the World Cup in Sao Paulo.

The exoskeleton technology existed. Scientists had already demonstrated in a number of ways the capacity of a computer to “read” the electrical signals from a conscious command in the brain, and perform a correct action.

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