We are Ian Burkhart, Dr. Marcie Bockbrader M.D., Ph.D.from Ohio State and Dr. Dave Friedenberg Ph.D from Battelle. In 2010, Ian dove into a wave in the Atlantic Ocean and hit a sandbar. He suffered a spinal cord injury that left him paralyzed from the chest down. Four years later, he volunteered to participate in a project that required the implantation of a tiny chip in his brain that allows a computer and algorithms to “listen” to some of the neurons in his motor cortex associated with hand movement. Now, with the help of a computer, algorithms and a special sleeve that stimulates his forearm muscles, Ian can think of a movement he’d like his hand to do and the Battelle NeuroLife system helps him move his paralyzed hand.

Ian has had the implant for much longer than was anticipated, and we’re still getting clear signal. He comes in for sessions twice a week where we work on different functional grips and grasps that Ian would like to regain as well as playing Battleship, a guitar video game and driving a car simulator. For now, Ian can only use the system in the lab but we are working hard to make the system portable so Ian and others can take it home and use it in their everyday lives. Dr. Bockbrader is a neurorehabilitation physiatrist and is the principal investigator for the NeuroLife implanted brain-computer interface clinical trial. Dave Friedenberg is a PhD statistician who leads development of the machine learning algorithms used to decode Ian’s brain data and is in charge of the ever-growing body of big data being produced by the NeuroLife project.

We’ve been featured on CBS, CNN, HBO’s Vice, the front page of the Washington Post and in many other journalistic outlets. One great recent example appeared on Bloomberg last year. We’ve also published lots of papers on the subject, for instance, we published this paper in Nature Medicine in the November 2018 edition about using deep learning algorithms to better address concerns of potential users like Ian. Last week, NVIDIA published a blog about our project.

Proof: Ian Burkhuart, Marcie Bockbrader, David Friedenberg verified Twitter

Good night for now. We'll check back to see what questions we didn't have time to get to. Thanks everyone

Comments: 271 • Responses: 76  • Date: 

JenKurinna236 karma

Hi, I'm a C4 quadriplegic with no use of my hands and arms at all. I'm wondering whether you plan to involve more participants at this research? If so, how can I apply for a trial and who is a contact person? Thanks in advance for your answer.

BattelleNeuroLife137 karma

IB: Unfortunately this phase of the study is not currently enrolling, but hopefully will be accepting subjects in the fall pending future funding. To learn more about eligibility criteria look on ClinicalTrials.gov Or contact Erin Woodburn [email protected]

hahayouguessedit36 karma

How can I and others contribute to your studies so that people like u/JenKurinna can be involved in the study? Thank you for this. I love smart people!! Keep up the good work!

BattelleNeuroLife46 karma

MAB: If you'd like to support our work with donations, contact Rachel E. Heine and say you would like to support Marcie Bockbrader, Ian Burkhart, and Battelle with the NeuroLife Clinical trial. Her contact info is:
Director of Development
The Ohio State University Wexner Medical Center
and Health Sciences Colleges Advancement
452 W. 10th Avenue, Suite H1245B
Columbus, OH 43210
614-366-2383 Office / 614-425-9445 Mobile
[[email protected]](mailto:[email protected])

If you'd like to support our work in other ways, tell your friends and colleagues what you've learned here. Or become an advocate and write your state and congressional representatives about it. Raising awareness about the potential for neurotechnology to overcome disability is the first step. In addition to financial support for the studies themselves, we need to improve the ability of those with disabilities to get to and stay at sites doing research. Endowments set up for participants' costs associated with research participation would facilitate access for many.

BattelleNeuroLife11 karma

Thanks so much! You can contact Erin Woodburn [email protected]

thedevillivesinside10 karma

Do you type with a voice to text program? Your grammar and punctuation are quite good

BattelleNeuroLife16 karma

MAB: We cheated and used a scribe to help us with this one, but Ian can type pretty quickly and accurately on his iPad keyboard.

Titsona-Bullmoose93 karma

Asking the obvious one, have you tried jerking off yet?

BattelleNeuroLife160 karma

IB: The current version of the system is only used in the lab with mixed company. However I’m sure we will be discussing your question during our next meeting.

Dannington66 karma

Are you more machine now than man, and if so, are you twisted and evil?

BattelleNeuroLife116 karma

IB: The system allows me to move my arm almost the same as I could prior to my spinal cord injury. The machine is simply making up for the lost connection between my brain and my hand. If I/we wanted to become more machine than man it would involve a robotic approach that could give me superhuman strength and reflexes so I could take over the world.

suckbothmydicks28 karma

So now you can masturbate again?

BattelleNeuroLife35 karma

IB: See my answer to Titsona-Bullmoose.

pridepuppy2161 karma

If the chip is implanted what’s needed that he can’t bring home to make it function? How many brain surgeries did the implant require? How did you locate the place in the brain necessary- brain mapping or was it already known?

BattelleNeuroLife59 karma

IB: The implant required one surgery to place the micro electrode array (MEA) into the motor cortex. This location was selected after using fMRI. In order to bring home the system we will need portable equipment to translate neural signals to the stimulation sleeve.

Another surgery will be required to remove the MEA when the study is completed.

Photos

Twitchy4life45 karma

So I'm guessing this device bypasses the spinal injury to directly send signals to his arm? If so what kind of materials did you need to use/ invent yourself to help prevent the body from rejecting the brain implant. And if you have to constantly take imunosuppresant drugs to reduce the chance of a rejection.

Edit: Additional question, does the implant to computer interface work both ways, in that when you touch something can you feel it? Can you feel if it's hot or cold?

BattelleNeuroLife54 karma

MAB: The brain “chip” we use is a Blackrock Microsystems Utah microelectrode array. For the implantable hardware, see: https://blackrockmicro.com/neuroscience-research-projects/human-research-systems/ Or follow: @BlackrockMicro

There is always neuroinflammation after chip implantation, but eventually a scar forms around the electrodes. The scar CAN be a problem for recording the brain, but we’ve been able to work around it and get good recordings for about 5 years. No immunosuppressant drugs are needed to prevent rejection. The most important ways to minimize inflammation are to: (1) prevent/treat infections immediately, whether they are from the urinary tract, skin or other body areas; (2) take probiotics (several lines of evidence suggest that gut health affects the central nervous system; (3) manage stress (again, there’s a link between stress and whole body inflammation; (4) optimize nutrition (there is evidence that low sugar, high omega 3 diets are anti-inflammatory); and maybe even (5) take melatonin every night at bedtime.

As the physician-researcher on the team (MAB), one of my jobs is to keep Ian healthy and catch infections early.

The bypass all happens outside Ian’s body, going through a computer workstation, decoder software, and a wearable muscle stimulator that is calibrated to activate forearm muscles that generate the movement that Ian thinks about doing. Because none of these parts are implanted, we can reanimate Ian’s paralyzed arm without worrying about rejection of implants in his arm or hand.

Twitchy4life14 karma

Thank you! This is very interesting research that can benefit many people!

BattelleNeuroLife25 karma

DF: To answer your second question, our interface only works in the one direction but there are other groups, for instance at University of Pittsburgh, that are using bi-directional systems.

Ian can't feel if he is touching something although we think we may have found something of a workaround for this problem that we hope to be publishing soon. Stay tuned!

PyroDesu13 karma

Out of curiosity, are you familiar with the work of Kevin Warwick? He did something similar with a chip embedded on his median nerve back in 2002, using it to control a robotic arm and receive sensations. I'm sure working with a peripheral nerve and artificial limb is vastly easier than working directly with the motor cortex and an intact but nonfunctional limb, but his research does seem to have interesting implications for work like yours.

BattelleNeuroLife8 karma

See reply above about Warwick.

BattelleNeuroLife14 karma

MAB: The community of neurotech researchers is really small. Dr Warwick is one of the pioneers in the field. One thing that distinguishes our work is the goal of developing it for use as an assistive device in people's homes. We've gotten to the point that multiple groups know how to implant brain chips and use neural interfaces for different functions in the lab. What's next is optimizing the system to end-user specs, so that a person like Ian could use it at home without needing his whole physician-engineering-data scientist team sitting next to him!

ChillTheFuxkOut22 karma

Really exciting and heartwarming to read such effort! Fascinating stuff. Layman here with an interest in science. I appreciate any responses!

In what form does the technology recieve brain signals? For example, is it like a direct current coming from different directions, at different intensities? In simpler forms: 1's and 0's at their respective intensities? Or is it a continuous/layered stream in some form?

Does the chip become "part" of the brain? For instance, does the chip carry on signals from one neuron to the other that it's inbetween, if at all? Or is it always an end/start point and never an intemediary?

What measures are taken to assure this technology cannot be accessed/hacked locally or over wifi/bluetooth or whatever it is you use to communicate back to your computer?

And one ridiculous question just out of curiosity..

If all went well, could your technology potentially be evolved to control things other than motor responses? Maybe more complex things such as immune responses and other internal responses?

Kind Regards.

BattelleNeuroLife29 karma

MAB: Thank you! We really enjoy pushing the limits of what neurotechnology can do – all with the goal of helping Ian regain as much of his body’s function as possible.

The technology acquires brain signals through an implanted, 96-channel electrode array. Each channel detects voltage that is continuously generated from active neurons in its neighborhood. The sampling rate is 30kHz; this means that the number of voltage measurements that we collect is 30,000 per second and this streams continuously in real-time while Ian uses the system. We have to use signal processing methods to mathematically translate the “raw” voltage data into normalized response intensity that we can use as neural features for our machine learning decoder algorithms. For our initial proof-of-concept report, with signal processing details see: https://www.nature.com/articles/nature17435

The chip becomes scarred into the brain, but not part of the brain. And the eventual intent is to remove it when it is no longer functional (or something better comes along). It acts as a microphone to listen to local neural activity. It doesn’t carry signals from one neuron to another, although others are working on new technology to do that (particularly for memory enhancement).

Right now, the tech can’t be hacked because it is all wired: the brain chip is connected by cable to a computer, the computer is offline (not on an Ethernet or WiFi network), and the decoded instructions for movement are transferred by USB to a muscle stimulator that is in direct contact with Ian’s arm. We are working towards remote control of devices (car) for mobility, and that will require a secure, non-hackable network. If brain activity were hacked, what the hacker would see is a large stream of numbers, ranging from -1000 to 1000 microvolts (though numbers can be larger with environmental noise). The real concern would be if the connection to Ian’s arm were networked, and thus, hackable – we don’t want a hacker taking control of Ian’s hands! This is why we are currently using a wired system.

Lastly, yes, the system can be used to control more than just muscle stimulation. The system is modular with 3 parts: (1) the neural implant hardware and software to listen to the brain, (2) the machine learning algorithms to interpret brain activity, and (3) the output control system that acts on the body or environment. If you were to replace part (3) with something that controlled immune, organ, or other responses, yes, you could control other body functions with a thought. For example, some people are thinking about how to link the brain chip to a peripheral nerve stimulator (which could help with urination or other autonomic function) or a spinal cord stimulator (to help with walking, pain or spasticity).

Puggerfly19 karma

Hi Ian and team! Just want to say I'm really excited to see you're finally doing an AMA and I can't wait to see what you do next. -Amanda

Now for my question: What's been the most exciting and/or surprising moment for you all over the last few years? Have there been any outcomes that you never really expected?

BattelleNeuroLife28 karma

DF: Certainly the first time Ian was able to move using the system was a big thrill for all of us. We had been preparing for that moment for a long time and weren't sure it would work until it actually did.

BattelleNeuroLife21 karma

MAB: Hi Amanda! Thank you for your enthusiasm and support! For me, the most exciting and surprising moment occurred when Ian began to be able to use the system while doing other things – this means that he now treats the neural interface as “part of him”. For example: We’ve done cognitive testing (using Digit Span) and found that Ian can do challenging cognitive tasks while multitasking to use the BCI system – just like a healthy person can scratch his nose or drink from a cup while answering a question. And Ian can use the system for fun activities too. He played Battleship and beat our grad student while using the BCI to move the game pieces.

BattelleNeuroLife18 karma

IB: Hi Amanda! One of the most surprising things is how much we have been able to accomplish with so little. Personally I’m excited that the system works and the hope it provides for the future to myself and others with similar issues.

However stay tuned for more exciting findings that are currently in press detailing some positive unintended consequences of the 4+ years of using this bypass system.

AlpacaAlias19 karma

Hey, what you guys are doing is really amazing! I have a few questions for how it works though:

What is the delay between his brain and the movement of his arm? Is it significantly greater than without the chip?

Additionally, does Ian have an exoskeleton in order to move his arm with commands coming from the chip implanted in his brain?

BattelleNeuroLife28 karma

DF: In the original system, the lag was usually around one second. Recently we've been exploring using deep learning algorithms and have found that they can speed up the response time by about 200 milliseconds. The response time is a really important metric that we are constantly trying to improve. You can check out some of our recent work on the topic here and here

Ian hasn't used the chip to control an exoskeleton (at least not yet), but it is a possibility. Like most individuals with spinal cord injuries, Ian is more interested in regaining use of his own limbs as opposed to using something like an exoskeleton.

BattelleNeuroLife12 karma

Thanks so much for all the thoughtful, candid and inspired questions. We will come back another time and update Reddit on what progress we've made and answer more questions. Good evening everyone, and thanks again.

masdar16 karma

Thank you for doing this AMA, and especially for pioneering amazing innovations in biotech!

BattelleNeuroLife2 karma

MAB: Thank you for your enthusiasm! Many people put in long hours to pioneer this technology, but we also know that there is much more work to be done.

nb4ban3 karma

I know you are signed off. I just wanted to know if the technology needs to be turned off while sleeping. Or does it recognize the difference in wavelength/signals produce while Ian might be dreaming?

BattelleNeuroLife3 karma

MAB: The system that Ian uses right now has only been tested in the lab. Sometimes, we do unintentionally bore him into sleep...what we see then is that his neural activity and the decoders go quiet. This is true for early stage sleep, but we might see something different if/when he was dreaming as in later stage, or REM, sleep.

We've discussed the idea of doing a sleep study with Ian to see what neural activity occurs after practicing with the BCI. In theory, we should see patterns consistent with "memory consolidation", which helps a person form the connections necessary to establish memories or become skilled at a practiced activity. We just haven't gotten around to that yet. So much to do, so little time!

Finally, we've developed a take home system that is ready for testing. We expect that Ian will take off the system when sleeping if he uses it at home, but in theory, that's not strictly necessary. We'll let Reddit know if we find recognizable similarities and differences between wakeful motor intent and dreaming of moving.

9degree_hill12 karma

In the future, will the visual stimulus that helps guide Ian to perform a particular task or movement be less necessary?

BattelleNeuroLife13 karma

DF: Yes! We typically use visual cues when we are calibrating our algorithms. For instance, we'll ask Ian to think about moving his hand in the same way a virtual hand on a computer monitor. This gives us a dataset where we know exactly when he is thinking of different hand movements which is precisely what we need to train our machine learning algorithms. Once the algorithm is trained, Ian can use the system without the visual cues. For instance, he'll play Battleship and move when it's his turn.

We're thinking about how we can eliminate the algorithm calibration step (and the associated visual cues) all together. Typically, we calibrate the algorithms every session, but for this technology to be practical for all-day, everyday use we need to minimize or ideally eliminate the need to calibrate the algorithms every day.

Traies12 karma

Hi Ian, congratulations on the successful surgery! I wish you all the best! This is more a question for the technical team, in a human hand you can move the thumb in all sorts of directions and pivots and move the fingers in different planes as well, how far off from fully realistic hand movement is the hand currently? What are the current limitations of the hand and is this down to the hand itself, the chip, the understanding of the brain, the difficulty of pinpointing the precise points etc etc. Also secondly, is the chip capable of reading ALL of the associated signals for hand movement, or is that still too early to fully determine? Well done to you all, great work, so good to see humanity progressing like this in our own lifetimes and even better for you being part of it!

BattelleNeuroLife17 karma

DF: Thanks for the question! We electrically stimulate Ian's muscles to move his own hand. We've been able to get quite a few different grips as well as individual fingers. It's certainly not as dexterous as his hand was before the injury, which as you alluded to is a combination of the data quality, decoding, and stimulation system. But, we know if we can send Ian home with a system that restores several functional grasps it will allow him to live more independently and make a big difference in his life.

The chip is most certainly not reading all the signals for hand movement. Here's an image of Ian's brain responding to thinking about moving his hand.

https://twitter.com/iburkhart/status/1088164687286550536/photo/1

As you can see there are several areas that are active and we're only listening to a piece of one of those areas.

There are about 100 billion neurons in the brain and we're only listening to at most a few hundred.

Batou203410 karma

I've always wondered this - are the signals you record and relay unique to each person? If you relayed them in someone else would something random, or nothing happen? Or does each human brain use the same signals for each command? also are you familiar with the work of prof kevin warwick of reading university who used this kind of implant to relay signals to his wife to see if she could sense his emotions?

BattelleNeuroLife10 karma

MAB: Pretty much, everyone is different. But the system can be adapted to each individual. Ian had to learn how to use the system, so there was a degree of "tuning his brain" to the implant. That would have to happen for each person who uses the system. As for Kevin Warwick, there are some similarities between decoding emotions and movement, but there are lot more differences.

gu1d3b0t8 karma

How good is the binding interface between electrode and tissue? Have you solved the scarring problem or is the implant going to get gunked up in scar tissue and stop functioning after a while?

BattelleNeuroLife11 karma

MAB: Scar has probably formed around the interface, in spite of our best efforts to limit neuroinflammation (see answer to Twitchy4life above). This has resulted in changes in signal impedance and intensity. However, we’ve used the system successfully with Ian for almost 5 years with the same implant in the same location. We are still obtaining functionally useful recordings. Part of the reason is our choice of neural signal for the decoders. We’re not using individual spikes, but rather a population response, which appears to be much less affected by scarring. We’ve studied best type of signal processing and neural features for chronic implants, see: https://bioelecmed.biomedcentral.com/articles/10.1186/s42234-018-0011-x

Our results suggest that using LFP or mean wavelet power over a low to mid frequency band can provide enough information for our classifiers to decode motor intent with chronically implanted electrodes

Bleabot7 karma

This is really cool research and technology! Is there any application for this kind of technology in treating neurological conditions that affect motor function (ataxia, for example)?

BattelleNeuroLife10 karma

MAB: The short answer is – Yes! With a large caveat: Neurotechnology is still in its infancy and we probably won’t see solutions for ataxia in the short term. The best treatment for ataxia is still hard work through physical therapy to rewire the central nervous system, although there is some evidence that therapy along with neuromodulation (like tDCS) may be able to help.

The long answer is that the technology we –and others – are working on can be generalized to many conditions, because the hard problems are figuring out how to read and interpret neural activity in real time and how to “close the loop” to recreate smooth and coordinated body control. For it to help with ataxia, we need to speed up the feedback time between the brain and the arm control, and add sensors to the limb – all of which we are working on doing. As we perfect these techniques, we will have more tech-enhanced tools to help speed neurorecovery from stroke, bridge lesions in the spinal cord or other brain areas, and return voluntary body control to people who currently have impairments. The important factor here is that using the technology will always involve working with rehabilitation therapists, because the user has to relearn how to connect brain and body through the neurotechnology device.

Macrockian6 karma

Question for Ian - How long did it take to be able to train your mind to use the interface, or was it instantaneous?

BattelleNeuroLife12 karma

IB: It took me about 4 months (3 days a week for 3.5hrs each) to become comfortable with the response of the system. Before my spinal cord injury I never thought about “how” I was moving my arm so I needed to learn exactly what I needed to think about. This improved once I was given feedback from my hand moving with the help of muscle stimulation.

DigiMagic6 karma

Why did you actually need so much training - are the electrodes not quite in the right place in the brain, not sensitive enough, too sparse?

BattelleNeuroLife6 karma

IB: I was using the system right away but in order to get a comfortable response that I could rely on it took sometime. The electrodes are placed in an optimal position in the motor cortex however our method of analyzing neural data involves looking at groups of neurons instead of individual spikes.

Haley_Reedy6 karma

Hi NeuroLife team - I'm a college student who has a multitude of friends studying Neuroscience and Computer Science. Do you think this technology will be relevant in college classrooms in the next few years? Do you think introducing this research to students would create new perspectives for future neurotechonology developments?

BattelleNeuroLife8 karma

DF: Absolutely, students are already a big part of this project. At Battelle, we typically have multiple college/grad school level interns who have made tremendous contributions to the hardware, software as well as helping with the clinical sessions. Several Ohio State students in Dr. Bockbrader's lab have made similar contributions. If you look at the papers that we publish, almost all of them have at least one student/intern author.

MAB: Absolutely! We’ve given lectures at Ohio State University for Biomedical Engineering seminars, Grand Rounds in Physical Medicine & Rehabilitation for medical students and residents, and I have both undergraduate and graduate students working in my lab. There is at least one college psychology textbook that features Ian’s story with videos. We also give talks at academic conferences that undergraduates often attend.

There are a few other sites that are using implanted BCI technology (for robotic arm control, for communication, with primates or humans) – so we encourage you to look for opportunities to get involved in this work! We KNOW that introducing this research to students will create new perspectives, and that new perspectives are critical for developing insights to solve the hard problems with neurotechnology. It’s going to take a critical mass of smart people with all kinds of skills (statistics, machine learning, electrical engineering, computer science, materials science, neuropsychology, rehabilitation medicine, neurosurgery and others) working with patient-end users, commercial entities and regulatory teams from the FDA to take this technology from a novelty to something that can positively impact people’s lives on a daily basis.

Macrockian6 karma

Were there any unexpected positive outcomes from using the BCI for Ian? Did long-term use provide additional mobility or control when not using the device? And I know this is probably an unrealistic outcome.

BattelleNeuroLife9 karma

IB: Stay tuned for more exciting findings that are currently in press detailing some positive unintended consequences of the 4+ years of using this bypass system.

My use of the NeuroLife system has certainly improved some of my muscle mass and coordination.

buckeye17385 karma

How much longer will this study go on for? Do you guys know?

For each of you individually, what has been the best moment?

Ian, would you participate in any more studies like this once it has concluded?

BattelleNeuroLife7 karma

IB: Our study was only intended to involve me for one year to prove feasibility, however, now 5 years later we are still working to push the current iteration of the NeuroLife system as far as possible. Currently this phase of our FDA approval ends in April 2019. If future funding is secured then the next phase will start shortly after.

Personally the best moment was the first time I saw my hand actually move, proving that the system works and provides hope for the future to myself and others with similar issues. [CBS This Morning](https://www.youtube.com/watch?v=HIH-HITMrQw) This type of technology is certainly something I will be involved in but it depends on if I am eligible for future studies. I know this will have an impact on individuals in the future and I am happy to work to that goal in anyway possible.

Yrouel865 karma

Can you differentiate between just imagining to move your hand (like I can imagine waving to someone but not actually move my arm and hand) and actually wanting to move it?

BattelleNeuroLife5 karma

IB: The majority of the time I am thinking about the actual movement i.e. hand open, hand close, index extend; however I can imagine the movement without doing it just like I can with my shoulder that I do have control over naturally.

BattelleNeuroLife5 karma

MAB: Since Ian is paralyzed, it's a little bit difficult to distinguish movement intent that would result in a movement if his spinal cord was intact from movement imagery (like imagining waving). One thing we can do is compare neural activity for actions where he has partial innervation - when some muscle twitches get through with movement intent that aren't activated with motor imagery. But this approach only gives limited insight into the workings of the nervous system.

We tried comparing the motor imagery vs. intent in one of our papers (Colachis et al., 2018 - Dextrous control of seven functional hand movements using cortically-controlled transcutaneous muscle stimulation in a person with tetraplegia) - you can read more about the similarities and differences between brain states when imagining doing a task vs. the motor intent associated with doing an object transfer task. Other groups have also done functional imagining comparing the two conditions and it is clear that there is overlap in activation, but also that the two conditions can be distinguished. We have seen evidence of proprioceptive feedback in Ian's motor cortex, so it's likely that at least part of what's different in brain response between activated intent and imagery is the sensation of doing the movement.

Ahlq8025 karma

What did it feel like to start being able to control your hand again? Also that’s amazing!

BattelleNeuroLife8 karma

IB: The amount of joy I had just from Opening and closing my hand that first day was tremendous! Due to my spinal cord injury I lost all sensation in my hand so I cannot actually feel it moving but only way I know that it is opening is from my visual sense. I now have strong faith in the system that it is accurately responding without me needing to look at my hand.

BattelleNeuroLife5 karma

MAB: IB had to step out, so unfortunately he can't answer this. I can tell you what he's told me, though. First, we were ALL excited when the system actually worked. (see his comments to buckeye1738) Secondly, it was hard for Ian to imagine controlling his hand at the beginning. He had to concentrate - he compared it to taking a calculus test - to be able to get his hand to do what he wanted. Now, control feels more natural to him, he's integrated the BCI into his body concept, he's more coordinated in his use of his hands with the system, and he can do more things without trying as hard.

K_Landry4 karma

Are there any longterm concerns for scar tissue on the brain eventually degrading the MEA?

BattelleNeuroLife4 karma

MAB: Yep, but so far, we're still getting good signals after almost 5 years. See response to gu1d3b0t for more discussion. Likely this version of the neural implant can and will be improved over time. What we've found is that the current version is "good enough" to use as the basis for take-home system development.

expectedpanic4 karma

This so amazingly cool. I'm so impressed with what you have accomplished scientifically and how much effort Ian must have put in to get the system to work. Keep up the good work!

Why start with the arm? The hand is one of the most complex muscle groups. Why not a leg? Do you see the need to have multiple chips/surgeries for different body parts?

BattelleNeuroLife6 karma

MAB: We started with the arm because returning hand function to someone who has lost it is an important way to restore independence. Several studies among those with 4-limb paralysis (also called tetraparesis) report that return of hand function is a very high priority of people with cervical spinal cord injury. There are reasonable alternatives (e.g., wheelchair) to restore mobility for those who want to get around their house or in the community, even though walking will always be preferred to the wheelchair. There are a few assistive devices (e.g., U-cuff, text-to-speech interface, mouth stick) that can help a person with paralysis interact with their environment, but there is no substitute for manual dexterity when it comes to making a sandwich or pouring milk for lunch. We wanted to give Ian and others back the freedom that comes with being able to use his hands again.

Having said that, other groups are working on leg control and ambulation. For some people, an epidural spinal cord stimulator (see Harkema's work) may help restore lower limb function. So there may be other, better, solutions for lower limb paralysis. Time will tell.

You could certainly do multiple surgeries and implant multiple chips for different body parts, with a reasonable expectation that they would work well independently or as an assembly. However, from my perspective as a physician and a researcher, I always have to ask whether the risk is worth the benefit. Any implant can get infected, any surgery can have complications. For these reasons, I would definitely not recommend this type of neurosurgery and implant to an otherwise able-bodied, healthy person.

jordanleveledup4 karma

Was security a concern during the design process?

BattelleNeuroLife6 karma

MAB: Always. The way we are addressing security concerns for now is to hardwire all connections from the brain to the computer and back to the user's body. As we develop systems meant to leave the lab, we are using technology to make these cables and connections smaller and more unobtrusive. However, another goal is to enable users to control mobility aids (cars, wheelchairs) or environmental controls (smart home technology) - this will require secure wireless technology. Our team at Ohio State and Battelle is unique in that it grows to match our needs, pulling in experts from different domains to address problems we encounter.

AlgolApe573 karma

The system has been prove with other similar patients? could you extend this to other parts of the body? How much money and time have you spend in the development of this system? Will it work for people with no arms/legs ( who lose it in accidents ) ? Sorry for the broken english. Wish you all guys the best and success in your research.

BattelleNeuroLife4 karma

MAB: The neuroimplant from Blackrock Micro has been used in BCI systems for a few dozen humans. Yes, you can extend the general concept to other parts of the body and other types of prosthetics. Some of the systems were designed to control communication devices for people with conditions like ALS, others have been used to control robotic limbs (see Jen Collinger and Robert Gaunt's work from the University of Pittsburgh) for people with stroke, spinal cord injury, or motor neuron disease. There are also other peripheral nerve devices under development that help restore sensation from and control to artificial limbs for amputees. Do a google search for Greg Clark from the University of Utah and Kevin Walgamott (the prosthetic user) for more info - they are testing the "Luke" arm, a neuroprosthetic to replace Kevin's dominant, left arm, which he lost in an accident. The technology is amazing!

EDIT: Sorry - I forgot to answer the cost question: Money - it's taken at least $15 million USD to get to this point, although, to be truthful, we've lost count. All of this money has come through donations to The Ohio State University and from Battelle's internal research and development budget. We're looking for additional funding options to carry the project forward into the future. As for time, it's important to note that many people working on neuroimplant technology have come before us. Ian was just the first human to reanimate his own paralyzed limb using this version of the BCI technology. Not counting the years of other people's efforts that our work depends on, it took Battelle and Ohio State about 6 years to get where we are...and we're still working to improve the whole BCI system.

AlgolApe573 karma

The system has been prove with other similar patients? could you extend this to other parts of the body? How much money and time have you spend in the development of this system? Will it work for people with no arms/legs ( who lose it in accidents ) ? Have you thought about involving virtual reality in the development of the system? Sorry for the broken english. Wish you all guys the best and success in your research.

BattelleNeuroLife3 karma

MAB: We use virtual reality with the system as part of training and testing. It works really well to help users visualize the movement they are trying to make. We have also used VR to try to figure out whether visual or somatosensory feedback was more important for Ian feeling like he was in control of his arm. In addition, we have used a VR car simulator - Ian can drive the car and parallel park using his thoughts! You absolutely could play video games in VR using your thoughts and the BCI system. Stay tuned on these topics - there will be more to come soon!

AlgolApe572 karma

just wow. The cyborgs are coming!! very exited about your research.

BattelleNeuroLife2 karma

MAB: Technically speaking, the cyborgs are HERE. Anybody with a pacemaker for a heart arrhythmia, cochlear implant for deafness, or deep brain stimulator for Parkinson's disease tremor is benefitting from cyborg technology.

Also: Take a look at the "Luke" as in Luke Skywalker arm -

https://www.coe.utah.edu/2017/12/05/greg-clark-robotic-arm/

fd3653 karma

Are brain transplants a thing? And if yes, would the newly received brain give the patient the old persons memories?

BattelleNeuroLife2 karma

MAB: At least one group in Russia has tried to transplant the head of one dog onto the body of another. In that sense, yes, brain transplants have been attempted with some degree of success. The dogs didn't survive all that long. And it's hard to get an answer from the dogs as to what the quality of their experiences were like post-implant. The hard problem that remains to be solved is how to reconnect all of the brain networks back to the body systems from which they would get information or to which they would send control information. In some ways, the neural connections in the brain are a reflection of the totality of a person's (or dog's) experiences, with some limits placed by genetics, nutrition, and other things. In theory, you could replay the pattern of neural activity associated with memories, but who knows what the subjective experience of that would feel like!

fd3652 karma

Could genetics play a factor in what brains are more adaptable to which bodies?

BattelleNeuroLife2 karma

MAB: I would expect genetics to play a role in this, yes.

SupernovaScoped3 karma

Being a college computer scientist my question is about how computer algorithms come into play here. Is it something like reading for certain chemicals in the brain and then the hardware responding accordingly? Maybe the algorithms are used to refine the ‘chemical output’ of the brain into commands the hardware can follow. It may be too technical but any response would be appreciated. What languages were used? The size of the algorithms? Megabytes? Gigabytes? Run times? Thanks for doing this folks! Really amazing stuff!

BattelleNeuroLife5 karma

MAB: If you replace "chemical" with "electrical" in your question, you have a pretty close description to how it's done. But that's just because the brain sensors that we use are electrodes that pick up voltage changes as populations of neurons fire. In theory, you could do this with other types of sensors that picked up chemical signals, though there are issues you'd have to overcome to get good timing information (the time-course associated with re-uptake of chemicals back into neurons and glia, duration of binding of chemicals to cells, etc.).

It's actually simpler to follow voltage changes over time at a high sampling rate (30,000Hz) apply signal processing methods (wavelets to pull out signal power at different frequencies) then use machine learning algorithms to find patterns in the processed neural data. We initially used Matlab for everything, then have transitioned to Python and TensorFlow for some things. The algorithms that we've used most frequently are Support Vector Machine (LIBSVM) and deep neural networks with different types of updating and transfer learning. See our recent Nature Medicine and Frontiers in Neuroscience papers for the gory details: https://www.nature.com/articles/s41591-018-0171-y

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232881/

We have a total of about 8 TB of data spanning the last five years, consisting of gigabytes of data for each 3.5 hr session. We run the SVM algorithms in real time using 100ms chunks of brain data (size = 96 channels * 30,000 samples/sec * 0.1sec). For data reduction techniques, refer to these papers:

https://www.ncbi.nlm.nih.gov/pubmed/28268963

https://www.ncbi.nlm.nih.gov/pubmed/27074513

stoneberry3 karma

Can you program the chip to perform movements you were not familiar with before, i.e. can you program your hand to play the piano? How far are we from this possibility?

BattelleNeuroLife5 karma

MAB: The chip only reads the brain activity, like a microphone. Yes, you could create a program for the BCI output to do any activity. In theory, you could compose a pattern of decoder outputs that, when used to control Ian's forearm, would result in him playing a song on the piano, or gripping and swinging a baseball bat. That we could do in the lab next week.

What we can't do yet is upload into the brain the neural pattern that corresponds to skilled piano playing or hitting a fastball out of the park. The only way we know of to create those patterns, as of now, is practice -- though there are several promising neuromodulation techniques (like tDCS) that can make practice more efficient.

BattelleNeuroLife3 karma

IB: When we setup different stimulation patterns of the sleeve those are thought as one individual movement. The example of a piano is similar to our experiment where I played guitar hero. It was something that I was not that good at before my injury but with practice I was able to think about the correct movements of my individual fingers fast enough to play the game. Popular Science: Thought-reading AI helps a person with quadriplegia play Guitar Hero

Sir-Simon-Spamalot2 karma

Aside from motor, would there be other areas that this can be applied to?

I am recovering from a brain surgery myself. It was a benign tumor, but was big, growing on top of my right hemisphere. My left leg was almost completely paralyzed during the early days after the surgery. As for now I can walk like normal, though the tactile sense is still not complete.

Finally, is there a chance that people like me could help?

BattelleNeuroLife5 karma

IB: The brain computer interface portion of this project could be applied to almost anything that can be controlled through a computer. We chose muscle stimulation as the effector of our project because it gives the largest change in quality of life for individuals living with tetraplegia. Hopefully one day I’ll be able to drive a car, control a smart home, or more with this type of technology.

BattelleNeuroLife3 karma

MAB: Best wishes on your recovery!

Yes, this technology can be applied to other areas. Robert Gaunt at Pitt is looking at sensory restoration through a chip that stimulates over somatosensory cortex. It's early stage and imperfect, but promising. Others (Marc Slutzky at Northwestern) are looking at ways to restore communication and decode speech.

Yes, you can help - one way to find a trial near you is to go to ClinicalTrials.gov and search for a keyword that interests you - most people who participate are located near a center doing BCI work. And also - spread awareness of this technology to others. Neurotechnology is in its early stages, but the more people know of it, the easier it is to advocate and get funding for it.

xGugulu2 karma

So how about using this Neuron-Technology-Interface to control Robots or at least mechanical extensions via Brain Connection? Has this Idea been around as a step further beyond the healing and aiding of people in need, as a step in progressing towards a synergy between Humans and Machines?

BattelleNeuroLife3 karma

MAB: Some groups are using the technology to control robotic limbs, so controlling a whole robot is probably not far off.

Yes, people think about using neurotechnology and brain-computer interfaces as ways to augment the abilities of healthy people. People and machines already have synergy on other fronts - cell phone messaging replacing verbal communication is one example, typing on a keyboard to replace speech is another.

The current worry about using implanted neurotechnology to augment a healthy person is that the implant is high risk not just initially, but throughout the life of the implant. It involves a neurosurgery that (without getting too medical) requires cutting through scalp, skull, and tapping the chip into very fragile brain tissue. There are all kinds of possible complications associated with the surgery, e.g., infection, bleeding, stroke, brain trauma, etc., and any of these could leave the person with the implant with injuries or impairments they didn't have prior to surgery. In addition, the current technology requires a pedestal be placed on the scalp - so the brain chip has connectors that extend to the skin, and we don't have an unobtrusive fully implantable version for humans yet (though engineers have figured this out for cochlear implants and implantable pacemakers for the heart). Also, having an implant in your brain carries risks. You can't get an MRI with the current technology. So if you tear ligaments in your knee, it may be harder to diagnose the problem. Brain implants are probably not be safe for those with high blood pressure - it is a potential site where hemorrhage and stroke can occur if pressure gets too high for blood vessels. Lastly, we (unfortunately) sometimes see hardware infections after joint replacements and spinal stabilization surgeries. These can be caused by a simple break to the skin or urinary tract infection that moves to the blood stream. Something similar is possible with the brain implant, which could cause a brain infection and death. Until we have a lower risk implant or better ways to mitigate possible bad outcomes, it is hard to justify the benefit of using this technology for an otherwise healthy and fully-functional individual.

Skyhawk_Illusions2 karma

Have you ever watched the movie "Upgrade"?

BattelleNeuroLife2 karma

MAB: Not yet. I'm looking forward to it, although I'm hesitant because sometimes I have difficulty suspending my disbelief when movies get the science wrong. I feel the need to explain to the movie (and to everyone watching it with me) what's scientifically inaccurate or not probable...and how to fix it (if it can be fixed). I do much better with movies about make-believe worlds, like Wonder Woman and Lord of the Rings, or documentaries.

nosoupforyou2 karma

It's likely too late now, but if you see this, are you interacting at all with Elon Musk's Neuralink company? It seems perhaps the research between your groups would mesh reasonably well.

BattelleNeuroLife2 karma

MAB: Not yet, but we'd love to do so. Sometimes solving the big problems requires a critical mass of smart people working together.

BattelleNeuroLife2 karma

IB: Restoring movement to paralyzed limbs and brain computer interfaces as a whole are both highly technical and challenging problems. I believe solving these problems will require great collaboration from many groups. Anybody have a contact at NeuraLink? Hi Elon :)

zombie_shuffles2 karma

What implications would this have for neuromuscular conditions like cerebral palsy?

BattelleNeuroLife2 karma

MAB: Good question. Cerebral palsy, for those who don't know but are curious, has many causes, but looks a lot like a motor pathway stroke that occurs before, during, or just after birth. It is typically not a progressive condition, and therapies sometimes are able to help kids get stronger or more coordinated. However, many with CP are left with paralysis of one or more limbs.

The BCI Ian uses is a neural bridge that is able to take brain activity associated with movement intent and reliably translate it into a limb action through transcutaneous muscle stimulation. As long as there is an area of brain that encodes motor intent and is not damaged by whatever caused CP or stroke AND the limb is not contractured into immobility, a brain chip could read motor intent and be used to voluntarily control a paralyzed limb (or limbs) through an exoskeleton or muscle stimulation.

I could see two potential uses of this type of implantable neurotechnology in both CP and stroke - though it may take years to get regulatory approval to do the clinical trials to see if it would work: (1) as a therapeutic way to restore function (by use-dependent neural plasticity and creating new pathways) that might persist without needing to use the device, or (2) as an assistive device that provided an adaptive way to function in spite of body impairments.

To be maximally effective, BCI-augmented therapy would have to happen early on after the injury (especially prior to any limb contractures). Some people are already doing trials of EEG-based BCI-augmented therapies after stroke, although I do not know of any in CP. It is unknown whether there is a recovery advantage associated with using an implanted vs. a noninvasive EEG-based BCI. Certainly the EEG system is lower risk.

Anybody with reasonably normal range of motion could use an exoskeleton-based BCI as an assistive device to augment limb strength and coordination after stroke or CP. Fine motor skills with an exoskeleton are still a work in progress, though. Also, not everybody can use transcutaneous muscle stimulation to generate normal looking movements -- for example, some individuals with CP have spasticity, and while muscle stimulation might help spasticity, it may not work for everyone.

But where would you implant a chip in someone's brain who had a motor pathway stroke? It turns out there are options besides the damaged motor cortex where we can detect motor intent. (1) If the stroke is one-sided, the opposite, healthy hemisphere of the brain contains some motor intent information that could be used. At this point, studies have shown the information is there and can be detected, but no one has tried opposite-sided control. (2) Both sensory areas in the parietal lobe and motor planning areas in the frontal lobe, if still intact, contain motor intent information that could be used to reroute signals around the damaged motor pathway.

SqueezeBoxx2 karma

If you have Tourette’s and have hurt your self with that arm in the past will it still be a problem, I mean could you accidentally knock yourself out?

BattelleNeuroLife2 karma

MAB: In theory, if your brain sent the motor signal to move your arm in a way that would hurt yourself, and the chip was placed in a part of the brain that processed that motor signal, then yes, the whole system would evoke the movement encoded by the brain. In practice, who knows? We've never tried it.

pyriphlegeton2 karma

You said you'll come back so perhaps I'm not too late yet :) From your perspective, do you think neural enhancements to people without disabilities are a feasable possibility in the near future? Does the General public over- or underestimate the viability of this? Or are, in your opinion, other Technological trends coming most people wouldn't be aware of?

Congratulations and deep respect for your work, it amazes me what you have been able to do.

BattelleNeuroLife2 karma

DF: There is certainly a lot of interest in this area from big players like Facebook and Elon Musk. The biggest hurdle right now is that to get high quality signals you need highly-invasive surgical procedures to implant electrodes. Until someone figures out how to record high quality signals non-invasively I don't see this technology crossing over to the general population. I do think that someone will figure out how to do that (DARPA recently announced a program to do just that) but I don't have a good guess as to how long it will take before it becomes a reality.

BattelleNeuroLife2 karma

MAB: Regarding neural enhancements to people without disabilities...I'm copying forward a comment that I made to an earlier question because I think it's important for people to consider the risks of enhancement:

The current worry about using implanted neurotechnology to augment a healthy person is that the implant is high risk not just initially, but throughout the life of the implant. It involves a neurosurgery that (without getting too medical) requires cutting through scalp, skull, and tapping the chip into very fragile brain tissue. There are all kinds of possible complications associated with the surgery, e.g., infection, bleeding, stroke, brain trauma, etc., and any of these could leave the person with the implant with injuries or impairments they didn't have prior to surgery. In addition, the current technology requires a pedestal be placed on the scalp - so the brain chip has connectors that extend to the skin, and we don't have an unobtrusive fully implantable version for humans yet (though engineers have figured this out for cochlear implants and implantable pacemakers for the heart). Also, having an implant in your brain carries risks. You can't get an MRI with the current technology. So if you tear ligaments in your knee, it may be harder to diagnose the problem. Brain implants are probably not be safe for those with high blood pressure - it is a potential site where hemorrhage and stroke can occur if pressure gets too high for blood vessels. Lastly, we (unfortunately) sometimes see hardware infections after joint replacements and spinal stabilization surgeries. These can be caused by a simple break to the skin or urinary tract infection that moves to the blood stream. Something similar is possible with the brain implant, which could cause a brain infection and death. Until we have a lower risk implant or better ways to mitigate possible bad outcomes, it is hard to justify the benefit of using this technology for an otherwise healthy and fully-functional individual.

Chased1k2 karma

Same technology can fly drones?

BattelleNeuroLife3 karma

MAB: In theory, yes. Though we've only used it (offline) to remotely control a toy car, not a drone.

evenios2 karma

can you bend spoons with your mind yet?

BattelleNeuroLife4 karma

MAB: Totally, you just have to have the right setting on the mind-controlled spoon-bender.

RonGio12 karma

Does Battelle need chemists in Ohio?

BattelleNeuroLife3 karma

The most up to date job postings can be found at https://www.battelle.org/careers

HeavenBelowxx2 karma

So I’m not handicapped to anything but hypothetically could something similar to Spider-Man 2 occur (neglecting the arms turning you crazy) where you have multiple arms to control? And similarly could you hypothetically make wings controlled via a chip?

BattelleNeuroLife5 karma

MAB: I'm ashamed to say that I missed Spider-Man 2 (too many hours working in the hospital and lab, I guess), so I will do my best answering this question. Yes, you could control multiple arms, but it would take practice to do it with any skill - just like controlling the arms on your body. Learning to control additional arms would be a matter of "neuroplasticity" -- the process of tuning neural population firing characteristics to particular intended actions. Through practice training with the interface, your brain would learn how its activity was interpreted by the decoding algorithm and the decoding algorithm would adapt to the way brain activity changed through practice. Similarly, you could learn to control wings, wheels, or any other neuroprosthetic attachment. To be honest, controlling wings wasn't something I'd considered before...

HeavenBelowxx2 karma

Assuming you could create wings that create enough lift wings are theoretically possible and would kinda be awesome...

BattelleNeuroLife2 karma

MAB: You work on the wings, we'll work on the neural interface. Together, I think we may have something...

BattelleNeuroLife3 karma

IB: You certainly could add additional robotic arms to the system to work in tandem with my arm. However, it would be activated at the same time as I think about my current hand. For example, if we connected a sleeve to both arms I could think about moving my right hand and they would both move at the same time. This however could be changed by implanting more MEA’s in different portions of the brain. We chose to stimulate my actual arm because it provides the highest level of agency and therefore is easier to control.

electricianer2502 karma

Are there ever any glitches or undesirable/unexpected behaviour? Any funny stories related?

BattelleNeuroLife3 karma

MAB: Sometimes our hand movement calibration is WAY off and we end up with Ian making what looks like gang signs or odd baseball hand signals...

masdar12 karma

Incredible research!

What was the most challenging problem to solve when developing this prototype (?) technology, and how did your team overcome it?

BattelleNeuroLife5 karma

MAB: To be honest, the most challenging problem is finding funding to support the work. We at OSU and Battelle have invested > $15M USD of donor and internal funds to date.

In our experience, if you can get enough smart people (with different but complementary skills) in a room with the patient end-user, there are few problems that can't be solved with time and dedication. We haven't yet pushed the computational limits of what the neurotech hardware is capable of doing and we haven't yet tapped the full potential of AI/machine learning solutions. We're also still optimizing the wearable arm stimulation sleeve.

From a movement generation standpoint, it's not always easy to figure out where and how to calibrate stimulation on the forearm to generate precise finger movements without also generating unintended wrist movements. This is further complicated by the muscle atrophy and dysfunction resulting from de-innervation from spinal cord injury. To some extent, this is a difficulty associated with non-invasive, transcutaneous stimulation - where currents have to pass through multiple superficial muscles before they reach and can activate deep muscles - and it can be partially solved by implantable forearm electrodes. There is much ongoing active work in this field.

The big computational problem we're tackling next is how to build a stable and robust AI decoder that simultaneously maximizes accuracy, response time, and functionality while minimizing technical expertise and training time required by the end-user. This is probably the biggest barrier to home translation of implanted BCI systems as assistive devices.

AriesRohkell2 karma

Do you think the chip they implanted in your brain was programmed to make you want to work with the research team? Follow up, is it possible the whole research team has chips in their brains and are actually unknowingly working for our robot overlords?

BattelleNeuroLife2 karma

MAB: As a member of the research team, I have no knowledge of robot overlords or any chips located in my brain.

BattelleNeuroLife2 karma

IB: If it was programmed to make me work with the research team I’m sure they’d have a setting so I could not tell anyone about it.

bbaznjec2 karma

Can someone now hack into your chip and control your hand?

BattelleNeuroLife2 karma

MAB: The system is hardwired right now, so you'd have to be standing next to Ian to hack the code controlling his hand. While you'd have to be really sneaky about pushing the intern off his stool at the BCI workstation and uploading your own code, it could be done *if* you knew enough about how the BCI code controls Ian's hand to alter its function. This will be a bigger problem in the future if and when the system becomes wireless.

onionburgers2 karma

How far off is this technology from being distributed on a mass scale?

BattelleNeuroLife2 karma

MAB: See my response to masdar1 - there are problems to be solved to facilitate translation for mass distribution. And even then, not everyone would be a candidate, because as it stands, you need to be able to undergo fairly involved neurosurgical planning and surgery to place the implant.

The cost is probably not prohibitive (relatively speaking), and would probably pay for itself over time as the user would need fewer hours of home care support because they would be more independent for dressing, cooking, and other self care activities in their daily life. The neural interface hardware manufacturer, Blackrock Micro, believes they could scale up production to supply several thousand systems at roughly the cost of the deep brain stimulation system used for Parkinson's.

The major barrier is transitioning from a highly technical lab-based system to a user-friendly device that operates reliably without an expert present. This involves hardware upgrades, algorithm optimization, and user-interface upgrades to make operation intuitive and training automatic. At this point, the home device is prototyped and approved by the FDA for investigational testing, and we intend to start field-testing later this year. Maybe if things go well, commercialization will follow in the next 3-5 years.

Yerwun2 karma

Amazing work, guys. Just curious, do any neuropsychologists work on your project?

And Dr Bockbrader, how did you get into this line of work from medicine?

And Dr Friedenburg, what would you like to tell us about the surely crazy stats and analysis involved?

BattelleNeuroLife2 karma

MAB: Yes, we work with rehabilitation psychologists who are also neuropsychologists during the initial screening phase of participants for clinical trials.

I got into this line of work serendipitously - by being in the right place, at the right time, and having the right kind of training. Because of my training and life experiences (which I'll describe shortly), I'm able to communicate effectively with the patient-participants, computer scientists, neuroscientists, engineers, statisticians, and medical teammates needed to support such a complicated clinical trial. I didn't start out in medicine, rather my undergraduate training was in philosophy and a self-designed major in computer science, math and logic. I initially went to graduate school to study artificial intelligence and logic through my university's cognitive science program. Partway through I realized that I needed a better understanding of cognitive neuroscience to adequately model AI. I ended up with knowledge and skills in neuropsychology, psychophysics, human electrophysiology (using EEG), signal processing, coding, functional imaging, statistics and experimental design. I did my dissertation work (looking at neural signatures of mental illness) in the context of a drug trial to help treat schizophrenia. The drug didn't work, but I learned two important things: First, I valued knowledge that had direct clinical application towards making people's lives better. I knew I would be unfulfilled doing esoteric experiments to learn more about human neuroscience that were never applied. Second, I learned that many body systems contributed to function or dysfunction of the central nervous system, and especially to treatments that were meant to optimize function of the nervous system. These two insights inspired me to go to medical school after I'd already earned my PhD and completed a post-doc. (My family teased me that I'd never actually complete school.) Medical school was sometimes a struggle, because I've had a chronic illness since I was a kid (12 years old) that relapses every so often. It took me 5 years to complete the 4 year program; but coming out of medical school I knew firsthand both what it was like to be the patient in the hospital bed and that it is important for patients to find ways to do the things important to them in spite of any impairments dictated by their body. Turns out, there's a medical specialty for this - Physical Medicine & Rehabilitation. I rotated in PM&R as a medical student and ended up doing my residency in the same program. Now as a clinician, I specialize in helping people with new brain injury, spinal cord injury or other impairments transition from hospital to home through an acute inpatient hospital. While with my team, patients relearn how to do the important things in their daily lives (eat, dress, bathe, walk, toilet, communicate, leisure activities, go out in the community) and families learn how to safely help and care for their loved ones, so that once patients make it home they can rejoin their normal life activities as much as possible. It is important to me to work at the interface between cutting edge medical and technical research and innovative patient care. My patients, like Ian, inspire me to address problems that impact their ability to live their lives in the most fulfilling way possible. Lastly, the big problems, like bridging a damaged spinal cord, or developing neuromodulatory therapies to get patients better, faster -- they all require collaboration among teams of dedicated individuals with complementary, but specialized skills who can communicate well to explore solutions. As a big picture person, who can identify and articulate patient priorities as design problems requiring technical solutions, I am happy bridging the clinical, research and teaching worlds of neurotechnology. My graduate students tend to come from disparate areas like biomedical engineering, computer science, rehabilitation science, neuroscience, and rehabilitation medicine.

If a student or medical resident wanted to pursue this pathway, I'd recommend finding a mentor who does work that is appealing and ask for guidance. Physical Medicine & Rehabilitation has a training pathway for clinician scientists at the Association of Academic Physiatrists, called the Rehabilitation Medicine Scientist Training Program (RMSTP):

https://www.physiatry.org/page/RMSTP

Other medical specialties probably have similar training programs through their academic societies.

deadarmed11 karma

I have Central Cord Syndrome since 2002 as a result of a hematoma during cervical fusion surgery. My right arm has essentially no function, while in my left arm I only have a little hand function -- no biceps or deltoids. Is there a point at which this procedure will not work due to atrophy of muscle tissue? Thank you for sharing this!

BattelleNeuroLife2 karma

MAB: Depends. Every person with spinal cord injury is a little different. Our patients were 2-10 years out from their injury and had atrophy that was reversed with muscle conditioning through stimulation. At least some return of function should be possible for you, but each system has to be tailored to the specific needs of the user. Without doing testing, I'm not sure what the best solution would be for you.

If your muscles are not de-innervated (you don't have peripheral motor nerve or brachial plexus injury), we can usually reverse the atrophy to some extent and get good muscle stimulation. People who have nerve injuries that prevent muscle stimulation can still get brain-controlled hand movement or shoulder/elbow movement using exoskeletons, or mobile braces for hand grasp and arm positioning. Sometimes stimulation isn't strong enough (e.g., for shoulder muscles) to lift the arm against gravity; in those cases, an exoskeleton can be used to help support the arm while stimulation can be used to activate hand grasp.

We don't know whether a person with severe spasticity would be able to use the system - in theory, system use should reduce spasticity, but we haven't tried it. If atrophy has progressed to the point of contracture, tendon lengthening surgery or serial casting would be required to get return of range of motion before using the system.

FRlEND_A1 karma

Have you seen the movie "Upgrade"?

BattelleNeuroLife1 karma

MAB: see my response to Skyhawk

r16752501 karma

If you can get signals out to the hand, can you get signals from the hands back to the brain so that the brain can receive pressure information for grasping?

Also, exciting times!

BattelleNeuroLife3 karma

DF: There are projects that try to send sensory information back into the brain via stimulation, see Jen Collinger and Rob Gaunt's work at University of Pittsburgh for example. Our setup with Ian doesn't allow us to stimulate his brain that way. However we are actively looking into alternatives to give Ian some sensory feedback and have some promising initial results that we will be sharing in the near future!

ggrievous20051 karma

Not sure if you guys are still answering questions, but what specialty of medicine should a medical student look into for working on projects like this from a clinical side? And if developing a stronger base in engineering from a coding standpoint is recommended? Thank you, this is very exciting stuff.

BattelleNeuroLife2 karma

MAB: Depends on what you want to do. If you're interested in placing the neuroimplants, you'd need to do a residency in neurosurgery and a fellowship in functional neurosurgery. Most people who do this also do animal/primate BCI research. If you're interested in facilitating function post-implant and prescribing neuroprosthetics, consider physical medicine and rehabilitation or perhaps neurology. Try to volunteer in a lab near you, if there is one, that is doing a clinical trial using BCI.

You can look at ClinicalTrials.gov to see what BCI trials are active, where they are, and who is leading them. Use these names and locations to guide your residency search. There are many universities involved, especially in multi-site studies, e.g., BrainGate2. I would recommend contacting programs early, doing an away rotation at the site, and asking how residents can become involved in research.

There is a neurosurgery neural interface conference you could check out that is given annually through the North American Neuromodulation Society

Also consider attending the BCI Society Meeting: http://bcisociety.org/

Join the IEEEbrain community (it's free and will keep you informed): https://brain.ieee.org/

Definitely develop coding skills in Matlab and Python. You can also enroll in online courses for machine learning: https://www.coursera.org/learn/machine-learning/

Google also has some free resources: https://ai.google/research/

Regardless, I'd recommend finding a mentor now who does work that is appealing and ask for guidance. It's not too early as a medical student to enter a training pathway for clinician scientists. In PM&R, the training program is through the Association of Academic Physiatrists. It's called the Rehabilitation Medicine Scientist Training Program (RMSTP): https://www.physiatry.org/page/RMSTP

Participation in this program can help you get into a residency and eventually a career in clinical BCI. There are probably similar programs in other specialties.

friscom1 karma

Is there any way your average person contribute to or help further along this awesome research?

BattelleNeuroLife2 karma

MAB: If you'd like to support our work with donations, contact Rachel E. Heine and say you would like to support Marcie Bockbrader, Ian Burkhart, and Battelle with the NeuroLife Clinical trial. Her contact info is:

614-366-2383 Office / 614-425-9445 Mobile / [email protected]

If you'd like to support our work through advocacy, tell your friends and colleagues about this. Follow Ian's progress on twitter: @iburkhart Or write your state and congressional representatives to say you think funding this work is important. Raising awareness about the potential for neurotechnology to overcome disability is an important first step.

ModerateCoyote1 karma

Could this tech be used in the future to control mechanical limbs attached to the body?

BattelleNeuroLife2 karma

DF: Certainly. Other groups have already used signals recorded from the brain to control a robotic limb (see University of Pittsburgh's work for example). Ian has recently been controlling a driving simulator and even a RC car. The signals we are decoding could be used to control a wide array of devices.

aftokinito1 karma

Before you could use your hand again, did your parents have to help you?

BattelleNeuroLife2 karma

MAB: Before Ian started in the study, he needed about 10 hours of help every day from family, friends, or paid home care professionals.