Restoring movement lost to stroke

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From violinists to metal welders, finely tuned hand and arm movements are the foundation of craft, while all of us rely on proficient use of hands for the activities of daily life. Yet, more than 25 million people worldwide lost functional movements to subcortical stroke. Subcortical stroke often interrupts the communication between the cortex and the cervical spinal cord circuits, which leads to permanent hand and arm paralysis. The result is a vastly reduced quality of life and enormous socioeconomic burden for the affected, their families, and the society. A treatment that can effectively restore functional movements after subcortical stroke does not yet exist. Still, the motor cortex, which orchestrates movements, and the spinal cord motor circuits that directly control muscles remain largely intact. We aim to reverse the hand and arm paralysis of people with subcortical stroke by developing a digital bridge that reconnects the motor cortex with the cervical spinal motor circuits. This brain-spine interface consists of fully-implantable recording and stimulation systems that link cortical signals to spatiotemporal sequences of epidural electrical stimulation targeting spinal cord regions involved in the production of hand and arm movements. Our preliminary results in people with spinal cord injury strongly indicate that the brain-spine interface can restore natural control of movement and promote neurological recovery. Therefore, we are confident that a cervical brain-spine interface can reverse hand and arm paralysis incurred by stroke and, therefore, become the first viable treatment option for subcortical stroke survivors. Beyond the development and validation of the cervical brain-spine interface for stroke survivors, this project will build the intellectual property necessary to secure funding that will bring this treatment into widespread clinical use.