An international team of scientists has used a wireless "brain-spinal interface" to bypass spinal cord injuries in a pair of rhesus macaques, restoring intentional walking movement to a temporarily paralyzed leg. The researchers, who describe their work in the journal Nature, say this is the first time a neural prosthetic has been used to restore walking movement directly to the legs of nonhuman primates.

The study was performed by scientists and neuroengineers in a collaboration led by Ecole Polytechnique Federale Lausanne (EPFL) in Switzerland, together with Brown University, Medtronic and Fraunhofer ICT-IMM in Germany. The work builds upon neural technologies developed at Brown and partner institutions, and was tested in collaboration with the University of Bordeaux, Motac Neuroscience and the Lausanne University Hospital.

"The system we have developed uses signals recorded from the motor cortex of the brain to trigger coordinated electrical stimulation of nerves in the spine that are responsible for locomotion," said David Borton, assistant professor of engineering at Brown and one of the study's co-lead authors. "With the system turned on, the animals in our study had nearly normal locomotion."

The work could help in developing a similar system designed for humans who have had spinal cord injuries.

"There is evidence to suggest that a brain-controlled spinal stimulation system may enhance rehabilitation after a spinal cord injury," Borton said. "This is a step toward further testing that possibility."

Grégoire Courtine, a professor at EPFL who led the collaboration, has started clinical trials in Switzerland to test the spine-part of the interface. He cautions: "There are many challenges ahead and it may take several years before all the components of this intervention can be tested in people."

Re-establishing communication

Walking is made possible by a complex interplay among neurons in the brain and spinal cord. Electrical signals originating in the brain's motor cortex travel down to the lumbar region in the lower spinal cord, where they activate motor neurons that coordinate the movement of muscles responsible for extending and flexing the leg.

Injury to the upper spine can cut off communication between the brain and lower spinal cord. Both the motor cortex and the spinal neurons may be fully functional, but they are unable to coordinate their activity. The goal of the study was to re-establish some of that communication.

The brain-spinal interface used a pill-sized electrode array implanted in the brain to record signals from the motor cortex. The sensor technology was developed in part for investigational use in humans by the BrainGate collaboration, a research team that includes Brown, Case Western Reserve University, Massachusetts General Hospital, the Providence VA Medical Center, and Stanford University. The technology is being used in ongoing pilot clinical trials, and was used previously in a study led by Brown neuroengineer Leigh Hochberg in which people with tetraplegia were able to operate a robotic arm simply by thinking about the movement of their own hand.Image removed.David Borton (right) helped to develop the wireless neurosensor technology in the lab of Brown engineering professor Arto Nurmikko (left).: Mike Cohea /Brown University