• Researchers with Northwell Health helped reestablish feeling and movement in the arm and hand of a man with paralysis.
• In a groundbreaking study, they implanted microchips into the man’s brain and harnessed artificial intelligence (AI) to rebuild connections between his brain, spinal cord, and body.
• The man has also experienced lasting gains in his wrist and arm outside the laboratory.
• The researchers expect their thought-driven therapy technology to help people with paralysis “live fuller, more independent lives.”

Health experts have long held that severe spinal cord injury damages central nervous system function beyond repair. However, researchers at Northwell Health in New York have been challenging this assumption with a game-changing breakthrough.

In March 2023, bioelectric medicine researchers, surgeons, and engineers at Northwell’s Feinstein Institutes for Medical Research successfully enabled a man to move and feel with his paralyzed arm and hand.

In their novel clinical trial, the team performed a 15-hour open-brain surgery to restore communication between the body and brain of Keith Thomas of Massapequa, who has been living with paralysis since 2020.

The Northwell Health colleagues developed AI algorithms, brain implants, and innovative stimulation technology to form the first-of-its-kind “double neural bypass.” This bypass forms an electronic “bridge” that facilitates the flow of information throughout the participant’s body, spinal cord, and brain.

Chad Bouton, professor in the Institute of Bioelectronic Medicine at the Feinstein Institutes, developed this technology and was the trial’s principal investigator.

“This is the first time the brain, body and spinal cord have been linked together electronically in a paralyzed human to restore lasting movement and sensation.”
— Prof. Chad Bouton

Restoring lasting movement

In a 2022 study, European researchers identified neurons associated with walking. They successfully helped nine individuals improve or regain their ability to walk.

However, the participants had to be supported by a robotic interface.

Professor Bouton has also used a single neural bypass in previous research to help people move paralyzed limbs with their thoughts. This approach only worked with a computer and could not restore feeling and movement or promote long lasting recovery.

A July 2020 diving accident caused injury at the C4 and C5 level of Thomas’s vertebrae. Thomas lost feeling and movement from the chest down.

The present clinical trial aimed to restore lasting physical movement beyond the lab. The researchers also hoped to help the subject regain his sense of touch.

Mapping the brain’s movement centers

Dr. Adam Stein, Northwell Health’s chair of physical medicine and rehabilitation, collaborated with Feinstein Institutes’ clinicians and researchers to map out Thomas’ brain.

They used functional MRIs to help locate the areas involved in arm movement and the sensation of touch in the subject’s hand. The MRIs also helped the researchers see where to insert the motor and sensory electrodes.

Brain surgery with real-time feedback

Having gathered this critical information, the surgical team performed an intense 15-hour surgery at North Shore University Hospital in Manhasset, New York.

At some points, Thomas was awake and able to tell the doctors what sensations he was feeling in his hands.

Dr. Ashesh Mehta, one of the lead surgeons in the procedure, professor at the Feinstein Institutes’ Institute of Bioelectronic Medicine, and director of Northwell’s Laboratory for Human Brain Mapping, said:

“Because we had Keith’s images and he was talking to us during parts of his surgery, we knew exactly where to place the brain implants.”

The team placed two chips in the area of the arm responsible for movement. They inserted three more in the region of the brain responsible for feeling and touch in the fingers.

Thought-driven therapy and neural bypass

Thomas was taken to the lab, where two ports connected his head to a computer that uses AI to capture and translate his thoughts into action. This thought-driven therapy is the basis of the double neural bypass approach.

The bypass picks up and reads the subject’s intentions, sending electrical signals from his brain implant to the computer. The computer then conducts signals to electrode patches placed over his spine and hand muscles in his forearm to stimulate function.

Sensors at Thomas’s fingertips and palm transmit touch and pressure information to his brain to restore sensation.

“When the study participant thinks about moving his arm or hand, we ‘supercharge’ his spinal cord and stimulate his brain and muscles to help rebuild connections, provide sensory feedback, and promote recovery,” Prof. Bouton explained.

Thanks to this double neural bypass, Thomas was able to move his arms at will. He felt his sister’s touch, which was his first time feeling anything since his accident.

New strength, continuing results

The researchers said that the double neural bypass has spurred some natural recovery from Thomas’s injuries, which might reverse some of the damage. He has gained more than double his arm strength since the study began as well.

Thomas is also feeling new sensations in his wrist and forearm, even when the system is turned off.

The Northwell clinicians hope that their novel procedure will enable the brain, spinal cord, and body to generate new communication pathways at the injury site.

Ultimately, they anticipate that bioelectronic medicine will allow people with injury and disease to be treated with their own nerves, without pharmaceutical intervention.

“This type of thought-driven therapy is a game-changer. Our goal is to use this technology one day to give people living with paralysis the ability to live fuller, more independent lives,” Prof. Bouton said.

About spinal cord injury

A spinal cord injury (SCI) can disrupt pathways between the brain and spinal cord, an intricately organized bundle of nerves running down the back. This causes temporary or permanent deficits in the spinal cord’s motor, sensory, or autonomic function.

An estimated 302,000 people in the U.S. deal with traumatic SCI every year, and 18,000 new cases arise each year. More than half of these individuals may not regain full function.

A severe or complete spinal cord injury renders the cord unable to transmit signals below the injured area. This leads to paralysis and loss of sensation below the level of injury.

More than 100 million people around the world live with paralysis or another movement impairment.

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