Will a new technology help paralyzed people walk again?

Gert-Jan Oskam, paralyzed from the waist down, holds on to a walker as he stands in a hallway.

Gert-Jan Oskam during a press conference in Lausanne, Switzerland, on May 23. (Fabrice Coffrini/AFP via Getty Images)

More than a decade after an injury rendered him mostly immobile, a paralyzed man is using his mind to walk again, thanks to an innovative technology that connects his brain and his spinal cord.

Gert-Jan Oskam, a native of the Netherlands, was involved in a motorcycle crash 12 years ago when he was living in China, damaging his spinal cord in his neck. He was paralyzed from the hips down and partially paralyzed in his arms, according to an Al Jazeera report.

While Oskam is excited to walk again, he is just as thrilled to be able to stand and share a beer at a bar with friends: “This simple pleasure represents a significant change in my life,” he said.

Oskam was treated at a hospital in Switzerland, but researchers in the U.S. are working on similar technology to help people with paralysis.

“Several research institutions, universities and private companies in the U.S. are conducting cutting-edge studies and clinical trials in this field of brain-spinal interface to develop solutions that can improve the quality of life for individuals with paralysis and other neurological conditions,” Shashank Agarwal, senior decision scientist at CVS Health, told Yahoo News.

Oskam walks down a hallway while holding on to a wheeled walker.

Oskam walks using his implants during the press conference. (Fabrice Coffrini/AFP via Getty Images)

These institutions include Johns Hopkins University; DARPA, a research agency under the Department of Defense; and BrainGate, a company that develops neurotechnologies, Agarwal said.

The researchers who helped Oskam published a study in May in the medical journal Nature, in which they described the implants that provided a “digital bridge” between Oskam’s brain and his spinal cord, bypassing the injured sections.

“We’ve captured the thoughts of Gert-Jan, and translated these thoughts into a stimulation of the spinal cord to re-establish voluntary movement,” Grégoire Courtine, a spinal cord specialist at the Swiss Federal Institute of Technology (EPFL) in Lausanne who was one of the lead researchers, said at a press briefing reported by the New York Times.

Jocelyne Bloch, a neuroscientist who placed the implant in Oskam, added at the press briefing, “It was quite science fiction in the beginning for me, but it became true today.”

What researchers in the U.S. are doing

“By establishing this digital bridge between the brain and the spinal cord, the brain-spinal interface allows individuals with paralysis to bypass the damaged or nonfunctioning neural pathways and regain control over their limbs,” Agarwal told Yahoo News.

One of the American companies Agarwal mentioned, BrainGate, is developing and testing medical devices aimed at restoring communication, mobility and independence to people affected by neurologic disease, paralysis or limb loss.

The company says on its website that early clinical research has shown that the technology provides intuitive control over advanced prosthetic limbs and provides people with paralysis with “easy control over powerful assistive movement and communication devices.”

It further says BrainGate ultimately aims to “enable naturally-controlled movements of paralyzed limbs.”

A deeper dive into the technology

According to Agarwal, the brain-spinal interface (BSI) is the technology being deployed to help Oskam walk again through the “digital bridge.”

The BSI contains a brain-computer interface that establishes direct communication between the brain and an external device, in this case the spinal cord.

“In some cases, brain-spinal interfaces involve the implantation of microelectrode arrays or neural implants directly into the brain,” Agarwal said. “These implants are designed to detect and record neural activity from specific areas of the brain responsible for movement intention. They can pick up electrical signals from the brain’s motor cortex, where motor commands are generated.”

The neural signals are recorded, then decoded and translated into commands that can be understood by the spinal cord or motor neurons.

“Once the decoded neural signals are obtained, they are used to stimulate the spinal cord below the level of the injury,” Agarwal said. “Electrical impulses are delivered to specific regions of the spinal cord, activating motor neurons and neural circuits responsible for coordinating movement.”

According to the Times, the EPFL research enabled Oskam to stand, walk and ascend a steep ramp with only the assistance of a walker. Video captured the stunning feat. A year later, he has maintained these abilities and has shown breakthrough signs of neurological recovery, maneuvering with crutches even when the implant was turned off.

“I treat many patients with spinal cord injuries. The motor problems are only the [tip] of the iceberg,” Dr. Georgios Matis, a neurosurgeon at the University Hospital Cologne in Germany who specializes in functional neurosurgery, told Yahoo News via direct message.

“Such patients also have chronic pain, sensory problems and problems of the autonomic nervous system (blood pressure problems, bladder & bowel problems),” Matis said. “I would expect in the future that this digital bridge can help physicians treat many more problems of patients with [spinal cord injuries].”

Has this worked with anyone else?

“[Oskam] is a pioneer in the field. As far as I know, his team was the first and only with published results in such an esteemed journal,” Matis said.

Research regarding the connecting of the brain to the spinal cord can be attributed back to 2016, when a group of scientists led by Courtine restored a paralyzed monkey’s ability to walk. Another test helped a man with a paralyzed hand regain control over it.

Then, in 2018, Courtine led a different group of scientists to help find a way to stimulate the brain through electrical-pulse generators, enabling partially paralyzed people to ride bicycles and walk.

Oskam poses with four brain-computer-interface researchers in a hallway.

Oskam with brain-computer-interface researchers at the press conference. (Fabrice Coffrini/AFP via Getty Images)

Now, with the latest advancements, people are regaining the ability to walk, swim and cycle within a single day of treatment because of the brain stimulation and the device connecting the brain to the body.

What does the future hold for this technology?

Researchers in the U.S. and abroad are looking to strengthen the technology and enhance it to the point where patients are able to fully walk and maneuver through their thoughts.

On this point, Matis added: “This is the goal and I strongly believe we will achieve this goal in the next 10 to 20 years. It is about optimizing the algorithms we are using to: one, more accurately detect and translate the brain signals, and two, apply the right combination of root stimulation patterns so that the movement becomes more ‘natural.’ The role of intensive rehabilitation (which should last years) must be highlighted!”

Cover thumbnail photo: FABRICE COFFRINI/AFP via Getty Images

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