Menu Close

Grégoire Courtine, a French-born neuroscientist at École Polytechnique Fédérale de Lausanne in Switzerland, is the International Paraplegic Foundation chair in spinal cord repair at the Center for Neuroprosthetics and the Brain Mind Institute at the Swiss Federal Institute of Technology in Lausanne.

Courtine and Jocelyne Bloch of HBP partners EPFL and CHUV have created a device that allows patients with total spinal cord injuries to stand, walk, and even participate in recreational activities such as swimming, cycling, and canoeing. The device is called a “digital bridge.”

The “digital bridge” device is a breakthrough study that could represent a quantum leap in the treatment of certain brain and central nervous system injuries. The device uses artificial intelligence to decode brain signals that enable the patient to move around independently.

“When there’s a spinal cord injury, the brain is disconnected from the spinal cord, so the communication is interrupted,” said Courtine during a press call Tuesday. “And what we’ve been able to do here is to reestablish the communication between the brain and the region spinal cord that controls leg movement with a digital bridge.”

That so-called “digital bridge” can effectively turn thought into actions – or, as Courtine put it, it can “capture thoughts” and translate them into a stimulation of the spinal cord.

According to the study published in the Journal Nature, the experimental treatment has been tried just once. Gert-Jan Oskan is a 40-year-old Dutch man who suffered a spinal cord injury in a bicycle accident. For nearly 12 years, he was unable to walk, step or stand. Courtine’s team implanted two devices, one into Oskan’s brain, and another into his spinal cord. The two devices communicate wirelessly, hence the digital bridge, or as the paper calls it, the “brain-spine interface,” or BSI.

Now, Oskan, whom Courtine calls the first “test pilot” of the newly invented system, has regained function in his knees, hips and ankle joints. He can walk – slowly, with the help of crutches – for about 300 to 600 feet. He can stand, with support from his hands, for two to three minutes at a time. He can even climb a few stairs.

Perhaps most remarkably, the treatment appears to work even after the system is shut off.

The implant has been life-changing, says Oskam. “Last week, there was something that needed to be painted and there was nobody to help me. So I took the walker and the paint, and I did it myself while I was standing,” he says.

When Oskam thinks about walking, the skull implants detect electrical activity in the cortex, the outer layer of the brain. This signal is wirelessly transmitted and decoded by a computer that Oskam wears in a backpack, which then transmits the information to the spinal pulse generator.

After around 40 rehabilitation sessions using the brain-spine interface, Oskam had regained the ability to voluntarily move his legs and feet. That type of voluntary movement was not possible after spinal stimulation alone, and suggests that the training sessions with the new device prompted further recovery in nerve cells that were not completely severed during his injury. Oskam can also walk short distances without the device if he uses crutches.

Bruce Harland, a neuroscientist at the University of Auckland in New Zealand, says that this continued improvement in spinal function is great news for anyone with a spinal-cord injury, “because even if it’s a longer-term chronic injury, there’s still a few different ways that healing could happen”.

“It’s certainly a huge jump” towards improved function for people with spinal-cord injuries, says neuroscientist Anna Leonard at the University of Adelaide in Australia. And, she says, there is still room for other interventions – such as stem cells – to improve outcomes further. She adds that although the brain-spine interface restores walking, other functions such as bladder and bowel control are not targeted by the device. “So, there’s certainly still room for other areas of research that could help progress improvements in outcomes for these other sort of realms,” she says.

Antonio Lauto, a biomedical engineer at Western Sydney University, Australia, says that less-invasive devices would be ideal. One of Oskam’s skull implants was removed after about five months because of an infection. Nevertheless, Jocelyne Bloch, the neurosurgeon at the Swiss Federal Institute of Technology who implanted the device, says that the risks involved are small compared with the benefits. “There is always a bit of risk of infections or risk of haemorrhage, but they are so small that it’s worth the risk,” she says.

Courtine’s team is currently recruiting three people to see whether a similar device can restore arm movements.