Walking naturally after spinal cord injury using a brain–spine interface

Nature, 2023 · DOI: https://doi.org/10.1038/s41586-023-06094-5 · Published: June 1, 2023

Simple Explanation

This study introduces a brain–spine interface (BSI) as a digital bridge to restore communication between the brain and spinal cord, enabling an individual with chronic tetraplegia to stand and walk naturally. The BSI consists of implanted recording and stimulation systems that link cortical signals to the modulation of epidural electrical stimulation, targeting spinal cord regions involved in walking. The participant reported natural control over leg movements, and neurorehabilitation with the BSI improved neurological recovery, allowing walking with crutches even when the BSI was off.

Study Duration

1 year

Participants

1 male with chronic tetraplegia

Evidence Level

Level 4, Case Study

Key Findings

1
The BSI enabled volitional control over muscle activity, restoring more natural and adaptive control of standing and walking.
2
The BSI was calibrated within minutes and remained stable over one year, enabling independent use at home.
3
Neurorehabilitation supported by the BSI improved the volitional control of hip flexor muscles and sensory/motor scores, enhancing standing and walking capacities.

Research Summary

The study introduces a brain–spine interface (BSI) that restores communication between the brain and spinal cord in an individual with chronic tetraplegia, enabling natural standing and walking. The BSI consists of fully implanted recording and stimulation systems, calibrated rapidly and stably, allowing for independent use and natural control over movements. Neurorehabilitation with the BSI led to neurological improvements, including regained ability to walk with crutches even without the BSI, suggesting potential for broader application.

Practical Implications

Restoration of Natural Movement

The digital bridge establishes a framework to restore natural control of movement after paralysis.

Improved Rehabilitation Outcomes

Neurorehabilitation supported by the digital bridge mediated additional neurological improvements.

Potential for Broader Application

The concept of a digital bridge between the brain and spinal cord augurs a new era in the treatment of motor deficits due to neurological disorders.

Study Limitations

1
Validation restricted to a single individual with partial spinal cord damage.
2
Unclear if the BSI will be applicable to other injury locations and severities.
3
Miniaturization of the base station, computing unit, and antennas is needed for practical utilization.

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