Monday, June 15, 2009

Turning thoughts into action

Mass General initiates trial of brain-computer interface device for patients with paralysis

Leigh Hochberg, MD, PhD

Leigh Hochberg, MD, PhD

Research aimed at developing restorative neurotechnologies that could help people with paralysis is beginning a new trial at Massachusetts General Hospital. The BrainGate2 pilot clinical trial is testing an investigational device designed to allow users to control computer cursors, robotic arms and wheelchairs using the power of brain signals.

BrainGate2 will be conducted jointly by physician researchers at Mass General and neuroscientists and engineers at Brown University. Leigh Hochberg, MD, PhD, a vascular and critical care neurologist at Mass General and Brigham and Women’s Hospital, is recruiting up to 15 individuals with quadriplegia for this trial, which expands on previous research evaluating how people with spinal cord injury, brainstem stroke, muscular dystrophy, or amyotrophic lateral sclerosis (ALS) may be able to use brain signals to control assistive devices.

"We are working to develop and test technologies that we hope will help patients with devastating illnesses that limit their ability to move or to speak. The goal of our research is to harness the brain signals that ordinarily accompany movement and to translate those signals into actions on a computer, like moving a cursor on the screen, or the movement of a robotic or prosthetic limb," says Hochberg, who is also an associate professor of Engineering at Brown University and an investigator in the Rehabilitation R&D Service, Department of Veterans Affairs.

The BrainGate Neural Interface System is an investigational device not yet available for clinical use. It works by decoding brain signals from the motor cortex - a part of the brain that controls movement. In the previous clinical trial, four study participants had the motor cortex sensor implanted. A computer was then connected to the sensor through a port on the head, allowing them to control a computer cursor by simply thinking about the movement of their own paralyzed hand.

"We learned an incredible amount with the assistance of the first participants in the BrainGate trial, not only about how the motor cortex continues to work after paralyzing illness or injury, but also about how to harness these powerful intracortical signals for controlling computers and other assistive devices," Hochberg says.

The BrainGate2 trial will expand on the previous findings, honing the hardware and software that decode the brain signals that are causing the cursor to move on a screen. The ultimate goal of the work is to "turn thought into action." Hochberg and his team hope the device will eventually allow users to point and click on a computer screen, control a prosthetic limb and a robotic arm and control functional electrical stimulation (FES) of nerves disconnected from the brain due to paralysis.

"The research is focused not only on the ability to operate a computer, but also to assist people with ALS, spinal cord injury and stroke to regain control over their environment," says Hochberg.

The potential to restore function after paralysis is only one potential benefit. The research team is also exploring the use of these information-rich neural signals to better understand and treat other neurological disorders and diseases.

John Donoghue, PhD, director of the Brown Institute for Brain Science, said the new trial is taking place at a time of great promise for neurotechnology research.

"We are entering a new age of neurotechnology," says Donoghue, whose lab developed the technology and who continues to lead the research with Hochberg. "Our fundamental understanding of the nervous system, combined with advances in engineering may help people with brain and spinal cord injuries and diseases."

Research supported by grants from:

  • National Institutes of Health
  • National Institute for Biomedical Imaging and Bioengineering
  • National Institute for Child Health and Developmental Disorders
  • National Center for Medical Rehabilitation Research
  • National Institute on Deafness and Other Communication Disorders
  • National Institute for Neurological Disorders and Stroke Rehabilitation R&D Service
  • Department of Veterans Affairs
  • Doris Duke Charitable Foundation
  • MGH-Deane Institute for Integrated Research on Atrial Fibrillation and Stroke
  • Katie Samson Foundation

This research is supported in part by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development.

Learn more about Mass General's Stroke Service in the Department of Neurology as well as the BrainGate2 trial.

Watch the story on CBS' "60 Minutes"

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