Neural stimulation of brain through robotic exoskeleton suit can reverse spinal cord paralysis and help paralysis patients regain sensation in their limbs, according to a new study conducted by researchers at Neurorehabilitation Laboratory, Brazil, and Center for Neuroengineering, Duke University, Durham, NC, USA, respectively.
Eight paraplegic subjects were part of a ground breaking experiment being carried out by neuroscientist Dr Miguel Nicolelis, MD, PhD, Duke University, where they were being trained to learn to control a robotic exoskeleton for walking. The original neural training of the paralysis patients was a part of the “Walk Again” Project in São Paulo, Brazil, and involved using a virtual reality system which used brain-machine interfaces i.e., brain activity to control the legs of the robotic suit.
“We couldn’t have predicted this surprising clinical outcome when we began the project,” said Nicolelis, also the co-director of the Duke Center for Neuro-engineering.
The Walk Again project, consisting of 100 scientists from 25 countries, first gained international recognition back at the 2014 FIFA World Cup in São Paulo. At the opening ceremony Julian Pinto, a young paraplegic, was seen wearing the brain-controlled robotic suit, which enabled him to kick a soccer ball. All of the trainees used the same exoskeleton avatar design during their training, along with caps fitted with 11 electrodes which recorded brain activity.
According to a research conducted by Christopher & Dana Reeve Foundation, a staggering number of Americans suffer from paralysis. It was estimated more than 1 in 50 American live with paralysis which is equal to 5.6 million people. A majority of these paralyzed individuals die early due to complications arising from loss of activity.
All of the eight trainees had complete lower body paralysis due to spinal cord injuries or stroke for at least 3 years to as long as 13 years. The initial phase was virtual reality training which then progressed to using the robotic suits. All of the trainees regained some sort of sensation and muscle control in the paralyzed parts of their body after training for seven months. Four of the patients showed such improvement in sensations and muscle control that their paralysis diagnosis was changed from complete to partial.
“Until now, nobody has seen recovery of these functions in a patient so many years after being diagnosed with complete paralysis,” said Nicolelis.
Paralysis can be defined as loss of sensations or muscle movements. Paralysis occurs when a person receives some sort of external or internal injuries which break the signaling mechanism between the brain, spinal cord and all subsequent muscles in the body. Paralysis can be categorized as complete or partial and can occur in any part or area of the body.
The original aim of the program was to rehabilitate strength, mobility and independence in the paraplegics. The amazingly unexpected detailed results of the program haveen published in the journal Scientific Reports.
The participants also experienced bowel and bladder improvement as a result of all the movement and lower reliance on laxatives and catheters. The researchers noted all the training movement also reduced the patient’s risk of catching infections, which commonly cause death in cases of chronic paralysis.
Although the scientists are not sure about exact reason for the rehabilitation of the neural senses, they believe re-engaging the spinal cord nerves during the weekly training sessions may have rekindled the dormant nerves. Even after trauma some nerves survive damage but they may remain dormant since the connection from the brain is cut off. Stimulation of such nerves may re-awaken them enough to send or receive signals from the brain.
“Nobody expected we would see what we have found, which is partial neurological recovery of sensorimotor and visceral functions,” said Nicolelis.
The most astonishing case of rehabilitation from the study was of ‘Patient 1’, a 32-year-old woman who had been paralyzed for the last 13 years. Early on in the training the patient was unable to stand even using braces but after training with brain-machine interference for 13 months she was able to dramatically move her legs by herself and even walk using a walker.
All of the participants have continued to receive training going on nearly two years. The researchers plan to publish more data on the participant’s recovery very soon. A new trial with patients who have recently suffered spinal cord injuries will also be launched soon, to see if they respond to the stimulus faster or better.
The research has undoubtedly proven to be a new hope for people with paralysis. To understand the gravity of the new findings we have to take a look at the quality of life of paraplegics. Individuals with paralysis are not only deprived from movement but they also face numerous health complications stemming from reduced muscle mass, skin breakdowns, infections, along with lowered efficiency of cardiovascular and respiratory functions, which often lead to depression, uncontrolled gastrointestinal movement, loss of sexual functions, frequent illnesses, and often these conditions can prove to be life-threatening.