Paraplegics Take a Step to Regain Movement
Source: Duke Today
Paraplegics Take a Step to Regain Movement
Nicolelis lab-created brain-machine interface help patients regain some feeling
August 10, 2016
A screen grab from a video summarizing the experiment shows a patient learning to use an avatar to walk in virtual reality. Image courtesy of AASDAP/ Lente Viva Filmes
Eight people who have spent years paralyzed from spinal cord injuries have regained partial sensation and muscle control in their lower limbs after training with brain-controlled robotics, according to a study published Aug. 11 in Scientific Reports.
The patients used brain-machine interfaces, including a virtual reality system that used their own brain activity to simulate full control of their legs. Videos accompanying the study illustrate their progress.
The research -- led by Duke University neuroscientist Miguel Nicolelis, M.D., Ph.D., as part of the Walk Again Project in São Paulo, Brazil -- offers promise for people with spinal cord injury, stroke and other conditions to regain strength, mobility and independence.
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Several patients saw changes after seven months of training. After a year, four patients’ sensation and muscle control changed significantly enough that doctors upgraded their diagnoses from complete to partial paralysis. ... Most patients saw improvements in their bladder control and bowel function, reducing their reliance on laxatives and catheters, he said. These changes reduce patients’ risk of infections, which are common in patients with chronic paralysis and are a leading cause of death, Nicolelis said.
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This study was funded by grants from the Brazilian Financing Agency for Studies and Projects (FINEP 01·12·0514·00), Brazilian Ministry of Science, Technology and Innovation, and the Itaú Bank. The authors list additional acknowledgements in the manuscript. They declared no competing financial interests related to this work.
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Read more: http://today.duke.edu/2016/08/paraplegics
Ana R. C. Donati, Solaiman Shokur, Edgard Morya, Debora S. F. Campos, Renan C. Moioli, Claudia M. Gitti, Patricia B. Augusto, Sandra Tripodi, Cristhiane G. Pires, Gislaine A. Pereira, Fabricio L. Brasil, Simone Gallo, Anthony A. Lin, Angelo K. Takigami, Maria A. Aratanha, Sanjay Joshi, Hannes Bleuler, Gordon Cheng, Alan Rudolph & Miguel A. L. Nicolelis
Received: 21 April 2016
Accepted: 04 July 2016
Published online:11 August 2016
Abstract
Brain-machine interfaces (BMIs) provide a new assistive strategy aimed at restoring mobility in severely paralyzed patients. Yet, no study in animals or in human subjects has indicated that long-term BMI training could induce any type of clinical recovery. Eight chronic (3–13 years) spinal cord injury (SCI) paraplegics were subjected to long-term training (12 months) with a multi-stage BMI-based gait neurorehabilitation paradigm aimed at restoring locomotion. This paradigm combined intense immersive virtual reality training, enriched visual-tactile feedback, and walking with two EEG-controlled robotic actuators, including a custom-designed lower limb exoskeleton capable of delivering tactile feedback to subjects. Following 12 months of training with this paradigm, all eight patients experienced neurological improvements in somatic sensation (pain localization, fine/crude touch, and proprioceptive sensing) in multiple dermatomes. Patients also regained voluntary motor control in key muscles below the SCI level, as measured by EMGs, resulting in marked improvement in their walking index. As a result, 50% of these patients were upgraded to an incomplete paraplegia classification. Neurological recovery was paralleled by the reemergence of lower limb motor imagery at cortical level. We hypothesize that this unprecedented neurological recovery results from both cortical and spinal cord plasticity triggered by long-term BMI usage.
= new reply since forum marked as read
I'm not sure what to call it.
