Implanted system allows quadriplegic man to use arm, hand

Implanted brain-recording and muscle-stimulating systems reanimated the limb, which the man hadn't been able to move in eight years.
By Amy Wallace  |  March 29, 2017 at 10:28 AM
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March 29 (UPI) -- Break-through technology gave a man with quadriplegia the ability to move his right arm and hand again after not being able to for nearly a decade.

Bill Kochevar was paralyzed below his shoulders in a bicycling accident eight years ago and had lost the ability to use his hands, arms and legs but thanks to break-through technology, he recently grabbed a mug of water, drew it to his lips and drank through a straw using his right arm and hand.

Kochevar is the first person to have a brain-computer interface with recording electrodes implanted under his skull and a functional electrical stimulation, or FES, system, which activates his arm and hand essentially reconnecting his brain to his paralyzed muscles.

"For somebody who's been injured eight years and couldn't move, being able to move just that little bit is awesome to me," Kochevar said in a press release. "It's better than I thought it would be."

The technology that enabled Kochevar to move was developed by a team of researchers at Case Western Reserve University, the Cleveland Functional Electrical Stimulation, or FES, Center at the Louis Stokes Cleveland VA Medical Center and University Hospitals Cleveland Medical Center.

"He's really breaking ground for the spinal cord injury community," said Bob Kirsch, chair of Case Western Reserve's Department of Biomedical Engineering and executive director of the FES Center. "This is a major step toward restoring some independence."

The technology works by using the person's own brain signals to control the stimulation of limbs.

"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," said Bolu Ajiboye, an assistant professor of biomedical engineering.

The research is part of the ongoing BrainGate2 pilot clinical trial conducted by a consortium of academic and U.S. Department of Veterans Affairs institutions studying the safety and feasibility of the implanted brain-computer interface, or BCI system in people with paralysis.

A team of surgeons implanted two 96-channel electrode arrays -- each the size of a baby aspirin -- into Kochevar's motor cortex. The arrays record brain signals created when he thinks of moving his arm or hand. The brain-computer interface takes information from the brain on the movements he wants to make and passes the information to command the electrical stimulation system.

The BCI decodes the recorded brain signals into the intended movement command, which is then converted by the FES system into patterns of electrical pulses. These pulses are sent through the FES electrodes to stimulate the muscles controlling Kochevar's hand, arm, wrist, elbow and shoulder. A mobile arm support allows Kochevar to raise his arm and reach out.

Kochevar practiced how to use brain signals to move a virtual-reality arm on a computer before trying it in real life and did rehabilitation for 45 weeks to overcome muscle atrophy from lack of movement for eight years.

He can now make each joint in his right arm move individually and the muscles are activated to coordinate with him thinking of feeding himself or drinking.

"I'm making it move without having to really concentrate hard at it," Kochevar said. "I just think out... and it goes."

The research was published in The Lancet.

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