BRAIN-SPINE INTERFACES TO REVERSE UPPER- AND LOWER-LIMB PARALYSIS

ended

A spinal cord injury (SCI) alters the communication between the brain and spinal cord. The consequences are dramatic impairments of upper-limb and lower-limb motor functions, which have a profound impact on the affected person, their family, and society. Currently, there are no approved therapies for SCI. The resulting costs of care amount to more than 2.5 M? over the lifetime of a person with SCI. Two ERCs combined with two ERC-PoCs enabled us to prototype two brain-spine interfaces (BSIs) that link the intended movements decoded from motor cortex activity to precise electrical stimulations of the spinal cord to promote these movements. These BSIs restored walking and arm/hand movements in nonhuman primate models of SCI, and as we report here, enabled one patient with chronic paralysis to walk again outdoors. These prototypes were partly based on repurposed devices that were not optimized for the intended applications, and thus presented shortcomings. Here, we propose to integrate two breakthrough technologies to develop two fully-implantable BSIs that will remedy these limitations. The first technology consists of the only existing fully-implantable neurosensor for wireless monitoring of cortical activity in humans based on high-density grids positioned over the dura mater. The second technology is the only implantable neurostimulation system dedicated to the recovery of movement after paralysis. This system combines an implantable pulse generator that enables highly reliable, real-time control of spinal cord stimulation, and a portfolio of electrode arrays that have been designed to leverage the mechanisms through which this stimulation restores movement. Two small scale clinical trials will demonstrate that these BSIs restore lower-limb and upper-limb movements in humans with chronic paralysis. These studies will provide specifications for industrial versions of the BSIs, opening the path to a commercially-viable revolution for people living with paralysis.