This first of-a-kind double neural bypass by the team at Northwell Health’s Feinstein Institutes for Medical Research is said to form an electronic bridge that allows information to flow between the man’s paralysed body and brain to restore movement and sensations in his hand.
The research team unveiled the trial participant’s progress four months after a 15-hour open-brain surgery that took place on March 9, 2023 at North Shore University Hospital (NSUH) in Manhasset, New York.
“This is the first time the brain, body and spinal cord have been linked together electronically in a paralysed human to restore lasting movement and sensation,” said Chad Bouton, professor in the Institute of Bioelectronic Medicine at the Feinstein Institutes, vice president of advanced engineering at Northwell Health, developer of the technology and principal investigator of the clinical trial. “When the study participant thinks about moving his arm or hand, we ‘supercharge’ his spinal cord and stimulate his brain and muscles to help rebuild connections, provide sensory feedback, and promote recovery.
Bouton continued: “This type of thought-driven therapy is a game-changer. Our goal is to use this technology one day to give people living with paralysis the ability to live fuller, more independent lives.”
Paralysed from the chest down following a diving accident in 2020, Keith Thomas, 45, of Massapequa, NY, is the first person to use the technology.
Prior to the surgery, Feinstein Institutes’ researchers and clinicians spent months mapping Thomas’ brain using functional MRIs to determine the areas responsible for arm movement and for the sensation of touch in his hand.
Thomas was conscious during parts of the procedure and able to give surgeons real-time feedback; as they probed portions of the surface of his brain, Thomas told them what sensations he was feeling in his hands.
“Because we had Keith’s images, and he was talking to us during parts of his surgery, we knew exactly where to place the brain implants,” said Ashesh Mehta, MD, PhD, professor at the Feinstein Institutes’ Institute of Bioelectronic Medicine, director Northwell’s Laboratory for Human Brain Mapping and the surgeon who performed the brain implant. “We inserted two chips in the area responsible for movement and three more in the part of the brain responsible for touch and feeling in the fingers.”
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In the laboratory, with two ports protruding from his head, Thomas was then connected to a computer that uses AI to read, interpret and translate his thoughts into action, known as thought-driven therapy and the foundation of the double neural bypass approach.
The bypass starts with Thomas’ intentions (such as thinking about squeezing his hand), which sends electrical signals from his brain implant to a computer. The computer then sends signals to electrode patches placed over his spine and hand muscles located in his forearm to stimulate and promote function and recovery.
Sensors at his fingertips and palm send touch and pressure information back to the sensory area of his brain to restore sensation. This two-arm electronic bridge forms the novel double neural bypass.
In the lab, Thomas can move his arms at will and feel his sister's touch as she holds his hand, which is the first time he has felt anything in the three years since his accident.
The researchers said Thomas is starting to see some natural recovery from his injuries thanks to this new approach, which could reverse some of the damage for good, adding that arm strength has more than doubled since enrolling in the study and he is beginning to experience new sensations in his forearm and wrist, even when the system is turned off.
The team’s hope is that the brain, body and spinal cord will relearn how to communicate, and new pathways will be forged at the injury site thanks to the double neural bypass.
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