[WEB SITE] Paralyzed man uses intention of movement to control robotic arm – Medical News Today

A 34-year-old man left paralyzed after suffering a bullet wound has become the first person to have a neuroprosthetic device implanted in the brain region responsible for movement intention, allowing him to control a robotic arm with his mind.

Thanks to the neuroprosthetic device, Sorta is able to control a robotic arm with just his thoughts.
Image credit: Spencer Kellis, Caltech

Erik Sorto, a father of two from California, endured a gunshot wound at the age of 21, severing his spinal cord and leaving him unable to move his arms and legs. Thanks to the new device, Sorto is now able to shake hands, pick up a beverage and even play “rock, paper, scissors.”

“I was surprised at how easy it was [to control the robotic arm],” says Sorto. “I remember just having this out-of-body experience, and I wanted to just run around and high-five everybody.”

The success of the neuroprosthetic device is the result of a joint project involving researchers from the California Institute of Technology (Caltech), Keck Medicine of the University of Southern California (USC) and the Rancho Los Amigos National Rehabilitation Center in Downey, CA.

In the journal Science, principal investigator Richard Anderson, James G. Boswell professor of neuroscience at Caltech, and colleagues explain how they implanted the device and how it works.

Previously, research into neuroprosthetics has focused on implanting devices in the motor cortex – the area of the brain that controls movement. Though this has allowed patients to possess some control over robotic limbs, results have been inconsistent, with motion often being severely delayed or shaky.

For this project, the team focused on the posterior parietal cortex (PPC) – the brain region that controls the intention of movement rather than movement itself.

PPC activity recorded by tiny electrode arrays and decoded to control robotic arm

Surgeons from Keck Medicine of USC implanted two small electrode arrays – 4 mm x 4 mm in size – into Sorta’s PPC. One electrode array controls reach, while the other controls grasp. Each array consists of 96 active electrodes that note the activity of each nerve cell in the PPC.

A cable connects the electrode arrays to a computer system that reads nerve cell activity in the PPC, decoding it to determine the brain’s intention of movement and control devices it is connected to – in this case, a robotic arm and a computer cursor.

The surgery – conducted on April 17th, 2013 – was a complex procedure and took 5 hours to complete, according to the team.

“These arrays are very small so their placement has to be exceptionally precise, and it took a tremendous amount of planning – working with the Caltech team to make sure we got it right,” says neurosurgeon Charles Liu, professor of neurological surgery and neurology and biomedical engineering at USC.

“Because it was the first time anyone had implanted this part of the human brain, everything about the surgery was different: the location, the positioning and how you manage the hardware,” he adds. “Keep in mind that what we’re able to do – the ability to record the brain’s signals and decode them to eventually move the robotic arm – is critically dependent on the functionality of these arrays, which is determined largely at the time of surgery.”

Sorta and the research team talk more about the procedure in the video below:

Study offers hope for patients with paralysis

Sorto started rehabilitation at the Rancho Los Amigos National Rehabilitation Center 16 days after the procedure.

Though he was able to use his thoughts to move the robotic arm immediately, it took weeks of mind training to refine arm movements. Now, Sorta is able to carry out a number of tasks using the arm, such as picking up a beverage.

“He’s been able to do various things,” Andersen told The Washington Post. “He can play video games and do rock paper scissors, he can grasp objects. And of course he had a personal goal, which is to control the speed at which he drinks a beer, so we implemented that first.”

According to the Christopher & Dana Reeve Foundation, around 6 million people in the US are living with some form of paralysis – the equivalent to almost 1 in 50 Americans.

The success of the neuroprosthetic device so far has excited neurological researchers, representing another step toward helping patients with full or partial paralysis.

Study investigator Christine Heck, associate professor of neurology and co-director of the Neurorestoration Center at USC, says:

“We are at a point in human research where we are making huge strides in overcoming a lot of neurologic disease.

These very important early clinical trials could provide hope for patients with all sorts of neurologic problems that involve paralysis such as stroke, brain injury,ALS and even multiple sclerosis.”

The project is ongoing, with Sorto committing to another year of study.”This study has been very meaningful to me,” he says. “As much as the project needed me, I needed the project. It gives me great pleasure to be part of the solution for improving paralyzed patients’ lives.”

The National Institutes of Health, the Boswell Foundation, the Department of Defense and the USC Neurorestoration Center funded the study.

In December 2014, Medical News Today reported on a study published in the Journal of Neural Engineering, in which researchers revealed how a 52-year-old quadriplegic woman was able to control a robotic arm with her mind.

That study detailed similar techniques to those used in this latest research, though the electrode arrays were implanted into the patients left motor cortex rather than the PPC.

Written by Honor Whiteman

Source: Paralyzed man uses intention of movement to control robotic arm – Medical News Today

[Abstract] Recovery of functional connectivity of the sensorimotor network after surgery for diffuse low-grade gliomas involving the supplementary motor area.

Abstract

OBJECTIVE

The supplementary motor area (SMA) syndrome is a well-studied lesional model of brain plasticity involving the sensorimotor network. Patients with diffuse low-grade gliomas in the SMA may exhibit this syndrome after resective surgery. They experience a temporary loss of motor function, which completely resolves within 3 months. The authors used functional MRI (fMRI) resting state analysis of the sensorimotor network to investigate large-scale brain plasticity between the immediate postoperative period and 3 months’ follow-up.

METHODS

Resting state fMRI was performed preoperatively, during the immediate postoperative period, and 3 months postoperatively in 6 patients with diffuse low-grade gliomas who underwent partial surgical excision of the SMA. Correlation analysis within the sensorimotor network was carried out on those 3 time points to study modifications of its functional connectivity.

RESULTS

The results showed a large-scale reorganization of the sensorimotor network. Interhemispheric connectivity was decreased in the postoperative period, and increased again during the recovery process. Connectivity between the lesion side motor area and the contralateral SMA rose to higher values than in the preoperative period. Intrahemispheric connectivity was decreased during the immediate postoperative period and had returned to preoperative values at 3 months after surgery.

CONCLUSIONS

These results confirm the findings reported in the existing literature on the plasticity of the SMA, showing large-scale modifications of the sensorimotor network, at both inter- and intrahemispheric levels. They suggest that interhemispheric connectivity might be a correlate of SMA syndrome recovery.

Source : Recovery of functional connectivity of the sensorimotor network after surgery for diffuse low-grade gliomas involving the supplementary motor area

[WEB SITE] Bionic implant could help paralyzed people ‘walk with the power of thought’ – Medical News Today

A team of researchers is developing a revolutionary bionic brain implant to help paralyzed people control a robotic exoskeleton just by thinking about it.

The team plans to test the stentrode in humans in 2017; they will insert it via a vein and implant it next to the motor cortex, where it will pick up brain signals so the patient can control an exoskeleton just by thinking about it. Image credit: University of Melbourne

The team is hoping to test the matchstick-sized stent electrode, or “stentrode,” in a group of paralyzed patients with spinal cord injuries in 2017.

The device is inserted via a blood vessel and is deposited in a blood vessel next to the motor cortex – the part of the brain that generates signals that control movement – bypassing the need for complex brain surgery.

The brain-machine interface is not dissimilar to the idea of a heart pacemaker, in that it interacts electrically with tissue using sensors inserted into a vein, except the vein is inside the brain.

The medical innovation is the work of 39 scientists, researchers and engineers from 16 departments at the University of Melbourne in Australia, who report their work so far in a paper published in the journal Nature Biotechnology.

First author and neurologist Dr. Thomas Oxley, who among other things heads the multi-disciplinary vascular bionics lab at Melbourne, says:

“We have been able to create the world’s only minimally invasive device that is implanted into a blood vessel in the brain via a simple day procedure, avoiding the need for high-risk open brain surgery.”

Their goal is to help completely paralyzed patients regain mobility by recording their brain activity and converting those signals into electrical commands that control exoskeletons and prosthetic limbs.

“In essence this is a bionic spinal cord,” explains Dr. Oxley.

The signals could also be used to control wheelchairs and computers, say the researchers.

Pre-clinical trials suggest stentrode is effective, safe for long-term use

The pre-clinical trials described in the paper show that the type of brain activity the stentrode picks up are the sort that can control the movement of bionic limbs.

The researchers carried out experiments on sheep that show the device can record high-quality signals emitted from the motor cortex, and it can be safely inserted via angiography without incurring the risks associated with open brain surgery.

The results suggest the implanted stentrode is safe for long-term use. The researchers were able to successfully record brain activity over many months, and the quality of the recording improved as the device was incorporated into tissue.

Stroke and spinal cord injuries are leading causes of disability, affecting around 1 in 50 people. In the US, nearly 6 million people are living with paralysis.

In Australia – where the stentrode is being developed – around 150,000 people are living with severe disability following a stroke, and around 20,000 people have spinal cord injuries – the typical patient being a 19-year-old male.

The team plans to start the first in-human trial in 2017; the intention is to achieve direct brain control of an exoskeleton in three paralyzed patients.

At the moment, to switch to a different mode like stand, start, stop or turn, the user has to operate a joystick. When the trial patients begin to use the stentrode, it will be the first human-operated device that enables direct control of the switching between these modes.

In the following video, the researchers describe where the idea of the stentrode came from, how they developed it and the technique for implanting it:

The researchers see potential for the stentrode to help patients with Parkinson’s disease, epilepsy and other brain diseases.

The news follows that of another medical innovation Medical News Today learned about recently, where researchers have developed and successfully tested an external electrical forehead patch as a treatment for chronic post-traumatic stress disorder(PTSD). The patch, which is worn during sleep, is powered by a 9-volt battery and sends a weak current to stimulate nerves in the forehead.

Written by Catharine Paddock PhD

Source: Bionic implant could help paralyzed people ‘walk with the power of thought’ – Medical News Today

[WEB SITE] Turning breath into words – new device unveiled to give paralysis victims a voice – Medical News Today

 

A new device which transforms paralysis victims’ breath into words – believed to be the first invention of its kind – has been developed by academics from Loughborough University.

Billed as a tool to help bring back the art of conversation for sufferers of severe paralysis and loss of speech, the prototype analyses changes in breathing patterns and converts ‘breath signals’ into words using pattern recognition software and an analogue-to-digital converter. A speech synthesizer then reads the words aloud.

The Augmentative and Alternate Communication (AAC) device is designed for patients with complete or partial loss of voluntary muscle control who don’t have the ability to make purposeful movements such as sniffing or blinking – gestures which previous AAC devices have come to rely upon.Dr David Kerr, Senior Lecturer in the School of Mechanical and Manufacturing Engineering, and Dr Kaddour Bouazza-Marouf, Reader in Mechatronics in Medicine, said the device learns from its user, building up its knowledge as it goes. It allows the user to control how he or she wishes to communicate – effectively enabling them to create their own language by varying the speed of their breathing. The academics have been joined in the project by Dr Atul Gaur, Consultant Anaesthetist at Glenfield Hospital.

“What we are proposing is a system that learns with the user to form an effective vocabulary that suits the person rather than the machine,” said Dr Kerr.

Continue —> Turning breath into words – new device unveiled to give paralysis victims a voice – Medical News Today

[WEB SITE] New noninvasive treatment enables paralyzed men to move again

Five men who were completely paralyzed from the waist down have been able to move their legs thanks to a new noninvasive procedure.

Paralyzed patients were able to voluntary move their legs after electrical stimulation to their spinal cords.

The new technique, details of which are reported in the Journal of Neurotrauma, is believed to represent the first time patients have regained voluntary leg movement without the need for invasive treatments such as surgery.

Instead, scientists utilized electrical stimulation therapy and physical rehabilitation exercises to treat patients.

Senior author Prof. V. Reggie Edgerton hopes these findings will enable scientists to look at spinal cord injuries “in a new way,” offering hope to millions of people with paralysis.

Roderick Pettigrew, director of the National Institute of Biomedical Imaging and Bioengineering at the National Institutes of Health (NIH), echoed this view and believes spinal cord injuries may no longer be “a life sentence of paralysis.” He says:

“The potential to offer a life-changing therapy to patients without requiring surgery would be a major advance; it could greatly expand the number of individuals who might benefit from spinal stimulation.”

“It’s a wonderful example of the power that comes from combining advances in basic biological research with technological innovation,” he adds.

This is not the first time Prof. Edgerton has investigated how paralysis can be alleviated. Last year, he and his research team investigated paralysis in four men.

Each was paralyzed from the waist down for years but were able to move from their hips to their toes following epidural electrical stimulation of their spinal cords.

Stimulation was elicited by a device called an epidural stimulator, which needed to be surgically implanted into the patient’s spinal cord.

Encouraged by these results, Prof. Edgerton and colleagues pressed on and earlier this year, researchers demonstrated involuntarily stepping movements could be induced in uninjured patients without the need for surgery.

It was this reaction that served as the catalyst for the researchers to see if the same noninvasive method could be applied to patients suffering from paralysis.

The results were ‘remarkable’

In the most recent study, five men – each completely paralyzed from the waist down for more than 2 years – underwent a 45-minute training session per week for 18 weeks.

Electrodes were placed on a patient’s skin on their lower back, which administered a unique pattern of electrical currents. This caused no discomfort to the patients and no surgery was required.

At the beginning of the study, the patient’s legs only moved when the stimulation induced was strong enough to generate involuntary step-like movements. As the study went on, the men attempted to move their legs further while receiving stimulation and the range of movement significantly increased.

For the final 4 weeks, patients were given a twice-daily dose of buspirone – a drug that has ben shown to mimic the actions of serotonin. Buspirone has also been reported to induce locomotion in mice with spinal cord issues.

By the end of the study, the men were able to move their legs with no stimulation at all, but still with the addition of buspirone. The range of movements displayed were also, on average, the same as when the patients were receiving stimulation.

The video below shows one of the men moving their legs following the procedure:

Prof. Edgerton describes the result as “remarkable” after he, and other experts, believed completely paralyzed patients no longer had any neural connections in the spinal area. He says:

“The fact that they regained voluntary control so quickly must mean that they had neural connections that were dormant, which we reawakened.”

Prof. Edgerton hopes this development may pave the way for new treatments for patients suffering from paralysis, especially those who have repeatedly had surgery and do not wish to do so again. Also, the treatment is estimated to be one-tenth the cost of an implanted stimulator.

Almost 6 million Americans have some form of paralysis, including nearly 1.3 million with spinal cord injuries.

A further follow-up study by Prof. Edgerton and his team has already begun. Using the same patients, he hopes to see if the men can be trained again with the noninvasive spinal stimulation therapy to bear their weight fully. This is a feat that has already been achieved by four men with surgery implanted stimulators.

Although it is likely to be years before the treatment is widely available, Prof. Edgerton hopes this can be a landmark discovery in the innovation of treatments toward paralysis.

“Many people thought just a few years ago we might be able to achieve these results in perhaps one out of 100 subjects, but now we have nine of nine,” he says. “I think it’s a big deal, and when the subjects see their legs moving for the first time after paralysis, they say it’s a big deal.”

Written by Peter Lam

via New noninvasive treatment enables paralyzed men to move again – Medical News Today.

[VIDEO] Stroke Recovery: Medications for Spasticity and Paralysis

http://www.healthguru.com/embed/bXC

Stroke Recovery: Medications for Spasticity and Paralysis

Expert: Stephen Silberstein, M.D. Thomas Jefferson University,Professor of Neurology

Spasticity is a common side effect of stroke. Thankfully, there are medications that can help. Watch this to learn more.

Transcript: A group of drugs called benzodiazepines act on the GABA receptor in the central nervous system to relax muscles and ease the effects of spasticity. Valium, or diazepam, and Klonopin, or clonazepam, are often recommended. Tizanidine, which is marketed under the name Zanaflex, works in the central nervous system to relax muscles. Tizanidine’s effect is short-acting and should be saved for times when immediate relief is needed. Medications such as Dantrolene sodium and baclofen, are other options for easing the contractions, tightness and paralysis of muscles.

via Stroke Recovery: Medications for Spasticity and Paralysis | Healthguru.

[BOOK] Medical books online: Physiotherapy book online

Medical books online is a website for doctors,nurses,medical students to give review about medical book its contains, about its author and its usefulness. Physiotherapy book online Practical guide to hemiplegia treatment book review Hemiplegia, a lot of unremarkably referred to as a stroke, isn’t simply a medical specialty or a contractor condition, however one with a psychosocial impact on the patient’s life. A sensible Guide to paralysis Treatment addresses the therapy management of paralysis specializing in the broader wants of the patient. This book is split into varied topics starting from basic anatomy and physiology of the human brain and development of the systema nervosum, to clinical diagnosing, symptomology, and therefore the management of paralysis complications. The necessities of rehabilitation medication and approach to treatment area unit lined intimately. For fast reference, varied exercises and treatment techniques area unit divided into lying, sitting and standing positions. Chapters on orofacial rehabilitation, perception, orthotics and management of complications offer a home care programme for paralysis patients. fifty five pictures and illustrations enhance the data provided during this comprehensive guide to paralysis treatment. Key Points

• Clear format for fast reference and sensible use
• Chapters embody basic anatomy of human brain and systema nervosum through to symptoms and rehabilitation
• 55 pictures, illustrations and tables.

via medical books online: Physiotherapy book online.

[ARTICLE] Brain-controlled muscle stimulation for the restoration of motor function

Highlights

• Functional electrical stimulation (FES) restores motor function following paralysis.

• FES control signals are currently limited to patients’ residual movements.

• Brain–machine interfaces (BMIs) may offer more natural, dexterous control of FES.

via Brain-controlled muscle stimulation for the restoration of motor function.