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A combination of physical therapy and neurological implants has restored a man’s control over his lower body after 12 years of paralysis.
Gert-Jan Oskam was living in China in 2011 when he was in a motorcycle accident that left him paralyzed from below his hips. Now, a combination of brain and spinal implants have acted as a “digital bridge,” bypassing damaged parts of his spinal cord to help him to stand and walk, even over steep inclines.
At first, he was walking with the aid of a walker. However, the treatment also seems to have induced neurological recovery — more recently, Oskam has regained the ability to walk with crutches, even when the implant was turned off.
“For 12 years I’ve been trying to get back my feet,” Oskam said in a press briefing on Tuesday. “Now I have learned how to walk normal, natural.”
The researchers who made the recovery possible outlined the technology behind the “digital bridge” and its limitations in a study published in Nature. The brain-spine interface (BSI), which wirelessly connects two implants in the sensorimotor cortex to the spinal implants, used machine learning to translate the electrical signals in Oskam’s brain to the desired movements and sent those signals over the damaged portions of the spine and down to the muscles in his legs.
“We’ve captured the thoughts of Gert-Jan, and translated these thoughts into a stimulation of the spinal cord to re-establish voluntary movement,” Dr. Grégoire Courtine, a spinal cord specialist at the Swiss Federal Institute of Technology, Lausanne, and leader of the research team told the press on Tuesday.
The study noted that the BSI could be calibrated within minutes, used independently at home, and had proven reliable over the year.
“However,” the study noted, “this recovery required wearable motion sensors to detect motor intentions from residual movements or compensatory strategies to initiate the preprogrammed stimulation sequences. Consequently, the control of walking was not perceived as completely natural. Moreover, the participants showed limited ability to adapt leg movements to changing terrain and volitional demands.”
There have been numerous advances in this field in the last few years — in 2016 another team led by Dr. Courtine was able to overcome paralysis to allow monkeys with damaged spinal cords to walk — the same year, another brain implant treatment was able to give a quadriplegic man limited control over one of his hands under laboratory conditions. Another scientific team led by Courtine in 2018 was able to simulate brain signals using electrical-pulse generators to allow partially paralyzed people to walk and ride bicycles, and other procedures in 2022 allowed patients to walk, swim and cycle within a day of treatment.
The subtleties of some brain signals are still difficult to read, limiting the ability for finer movements, and the researchers do not believe that the technology as it stands now is well suited for treating upper body paralysis. The treatment also requires several invasive surgeries and extensive physical therapy.
That being said, Oskam can now move around his home, enter and exit cars, and stand, resulting in an increased quality of life. Oskam reportedly said that for the first time, he feels like he’s in control.
The research team is optimistic that further advances will make their treatments more widespread.
“This is our true objective,” Dr. Courtine said, “to make this technology available across the world for all the patients who need it.”