Patient with quadriplegia regained muscle movement using bridging technologies

A man who was paralyzed below his shoulders is believed to be the first person with quadriplegia to have arm and hand movement restored by the use of temporarily implanted technologies, according Case Western Reserve University researchers.

According to a press release, Bill Kochevar, who was injured in a bicycling accident and had not moved his right arm or hand for 8 years, can now hold a makeshift handle pierced through a dried sponge, which he has used to scratch his nose. He can also feed himself with a fork.

“By taking the brain signals generated when Bill attempts to move, and using them to control the stimulation of his arm and hand, he was able to perform personal functions that were important to him,” Bolu Ajiboye, PhD, assistant professor of biomedical engineering at Case Western University and lead study author, said in the release.

With researchers from the Cleveland Functional Electrical Stimulation Center at the Louis Stokes Cleveland VA Medical Center and University Hospitals Cleveland Medical Center, the team used a brain-computer interface with recording electrodes under the Kochevar’s skull and a functional electrical stimulation system to reconnect his brain to his muscles.

According to the release, a pair of 96-channel electrode arrays implanted in Kochevar’s motor cortex record brain signals that are created when he imagines movement of his arm and hand. The brain-computer interface extracts information from the brain signals about what movements he intends to make and then passes the information to command the electrical stimulation system.

To prepare to use his arm again, Kochevar used his brain signals to move a virtual arm on a computer screen and completed the task “within a few minutes.” After Kochevar completed months of training, researchers implanted the 36 electrodes of the functional electrical stimulation system that animate muscles in the upper and lower arm.

The brain-computer interface transferred the recorded brain signals into the intended movement command, which the functional electrical stimulation system converted into patterns of electrical pulses. The pulses triggered the muscles that control Kochevar’s hand, wrist, arm, elbow and shoulder. In addition, Kochevar uses a mobile arm support, which is also under his brain’s control, to compensate for gravity.

According to the release, Kochevar’s strength, range of motion and endurance improved with 45 weeks of exercise. He is now able to activate is muscles and move each joint in his right arm individually by thinking about performing a physical task.

References:

Ajiboye AB, et al. Lancet. 2017;doi:10.1016/S0140-6736(17)30601-3.

www.case.edu

Disclosure: The researchers report funding from the NIH and the Department of Veterans Affairs.

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