NEURAL WARS: A NEW HOPE

HOW NEURAL BYPASS PROCEDURES ARE CHANGING THE FUTURE OF MEDICINE AND GIVING PATIENTS WITH SEVERE SPINAL CORD INJURIES AND PARALYSIS A NEW LEASE ON LIFE.

BY JIM GIBSON

Lying on the white sands of a North Carolina beach, Ian Burkhart struggled to comprehend what was happening around him… and to him. Just moments before, the athletic, fun-loving 19-year-old Ohio University student had ran and dove into a crashing wave in the nearby Atlantic waters. Now he found himself lying on the beach, face up and surrounded by his friends, unable to feel anything but the warm summer sun on his face.

When he dove into the ocean, Ian’s head was pushed down by the wave and hit a shallow sandbar, causing him to su er a severe spinal cord injury at the C5-C6 level of his spine. The medivac flight and the hustle and bustle of the emergency room were a blur as the drugs used to calm and comfort him took e ect.

“I kept thinking, ‘I’m going to be OK. I’m going to be OK,’” he says. “I just need to rest and soon it will heal up and I can go about my life again.”

He soon found out that he wasn’t going to be OK—his spinal cord injury wasn’t temporary and life would never be the same again. Doctors told Ian that from that day forward he would be a quadriplegic, unable to move any part of his body below his shoulders.

Hope In A Time Of Hopelessness

“I’d led a very active life,” he says. “I loved being outdoors, and I loved sports, but, by far, the greatest loss I su ered was my independence. I went from living a normal, healthy life to being unable to scratch my own face if it itched. It took about six months before I fully realized that I would be dependent on others for many of my needs. That was a very hard and challenging time for me.”

Ian underwent rehabilitation and physical therapy at Ohio State University in Columbus, which is only a 25-minute drive from his home in Dublin.

“I had exhausted my medical insurance and was told that I’d made all the physical progress I should make, but I wanted more,” he says. “I kept bugging my therapists and doctors, asking if there wasn’t something more I could do.”

It turns out there was something more. Physicians and neuroscientists at the Ohio State University Wexner Medical Center were actively looking for the perfect candidate for a new clinical trial that was about to get underway. The study involved a device called Neurolife that had been developed by the Battelle Memorial Institute, located just blocks from the medical center.

Battelle had spent more than a decade learning how to map the thought processes in the human brain that initiate and control certain muscle movements. After using computer software programs to map out these “thoughts,” they developed the Neurolife device.

According to Doug Boyd, the director of Battelle’s Medical Devices and Health Analytics, “The device has three fundamental components. 1. A chip that is implanted on the participant’s brain to read the participants brain signals.

2. A computer that receives those brain signals, determines the participant’s motion intent from them and establishes the needed muscle stimulation to e ect the desired motion. And 3. A stimulation sleeve that non-invasively activates the paralyzed muscles to realize the desired motion.”

Ian was their perfect candidate. He was chosen to be the first quadriplegic to wear and test the Neurolife device. A microelectrode was surgically implanted in his brain, and Ian was fitted with a neuromuscular electrical stimulation sleeve on his right arm. The microelectrode is part of the “Utah array,” a system that utilizes a “pedestal interface” to send signals from firing neurons to a computer through a cable hookup. The computer “reads” Ian’s mind and sends an electrical signal to the sleeve on his arm. The sleeve then electrically stimulates the muscles in his arms and a miracle occurs—his injured spinal cord is bypassed, and Ian moves his arm, hand and fingers by envisioning their movement in his mind.

It took several grueling months just to rebuild the atrophied muscles in his arm and hand.

“I would leave those sessions completely drained,” he says. “It took such a tremendous amount of focus in the beginning. It is hard to comprehend how much it takes out of you mentally and physically to attempt to move a paralyzed arm or hand. You have to break down the individual movement of each muscle. A healthy person doesn’t even have to think to lift a spoon to his mouth, but I can tell you, it takes a lot of e ort when you have to think about each muscle.”

Since he fi rst opened and closed his hand in June 2014, Ian has made tremendous progress. He can now pour liquid into a cup, pick up an object such as a spoon, hold a phone to his ear, swipe a credit card, play the electronic music game Guitar Hero, and he’s adding new movements to the list at a steady rate.

“It has now become almost second nature to me. It isn’t nearly as hard as it was when I started,” he says.

According to Battelle’s Boyd, they hope to soon produce a wireless, miniaturized, wearable less-invasive version of Neurolife that will be available to persons su ering from all types of spinal cord injuries, strokes