[HN Gopher] Walking naturally after spinal cord injury using a b...
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Walking naturally after spinal cord injury using a brain-spine
interface
Author : Someone
Score : 225 points
Date : 2023-05-24 15:26 UTC (7 hours ago)
(HTM) web link (www.nature.com)
(TXT) w3m dump (www.nature.com)
| belter wrote:
| "A quadriplegic man walks again, thanks to a digital bridge
| between his brain and spinal cord" -
| https://english.elpais.com/science-tech/2023-05-24/a-quadrip...
| _joel wrote:
| Saw this on the news just now https://www.bbc.co.uk/news/science-
| environment-65689580
| phobotics wrote:
| I'm very excited to see how this progresses and how A.I. can help
| solve medical issues that have up to now stumped us.
|
| One really interesting thing they've reported about this is that
| it requires a head set to connect the brain implants to the spine
| electrodes, but after a while the patient was able to walk using
| a stroller without the headset because the body regrew nerve
| tissue and Reenabled some connection to the brain.
| padolsey wrote:
| It's very cool, and uses the same principles as lots of other
| neurorehab electrical devices out there. I used an FES
| ('Functional Electrical Stimulation') device for a while that
| has a little accelerometer in it to figure out when I intended
| to take a step, and then stimulate (via conductive pads placed
| atop the skin) the correct muscles in the lower leg to lift the
| ankle up (dorsiflexion). Over time, when the brain correlates X
| input with Y result, even if Y is very very weak, bruised
| nerves can recover (in the case of recent brain/spinal
| injuries) and new nerves can grow. I was advised to have the
| device on its 'training' setting (where it would periodically
| activate a 'step') even when lounging on the sofa. Hebb said:
| "What fires together, wires together"...
|
| My suspicion (tho I'd love to be educated on this) is that the
| reference patient did not have a truly 'complete' spinal cord
| injury, but rather one where there were at least some
| nervecells remaining/bruised. If there was a complete section
| of nerve wiring missing, I don't see how re-growth could occur
| (but perhaps there's some stem-cell wizardry that can help with
| that???). Anyway, it wouldn't matter much; if these devices
| become small and convenient enough, it's not much burden to
| wear them forever.
| Gh0stRAT wrote:
| Yeah, if you watch the supplemental videos they mention that
| the patient had a partial injury and after 7 years of
| physical therapy was still unable to walk independently.
| After getting this implant and doing 6 months of PT, the
| patient was able to walk unassisted even with the brain
| interface not powered on.
| verisimi wrote:
| Right, another story to help us on to our knees into a begging
| position....
|
| "Please give us a neural lace!"
|
| Says no one... yet. But the priming is underway!
| 0xbadc0de5 wrote:
| Always good to see novel uses of ML. However, let's not pretend
| this will ever offer any benefit to people with spinal cord
| injuries.
|
| Any research that does not involve repairing the physical damage
| to the spinal cord itself is a distraction. Anyone who claims
| otherwise does not understand the physiology involved or is being
| deliberately disingenuous.
|
| It's hard to think of an apt analogy, but perhaps consider a
| patient who walks into a doctor's office with a broken arm.
| Instead of setting the break and applying a cast, the doctor
| offers them a referral to a psychologist to help them adjust to
| life with a broken arm.
| SpliffnCola wrote:
| I'm a paraplegic, what are you even getting at? I'd do anything
| to be able to walk again.
| _joel wrote:
| > Always good to see novel uses of ML. However, let's not
| pretend this will ever offer any benefit to people with spinal
| cord injuries.
|
| Apart from the person in their study who can now walk, that had
| the spinal injury (with the use of a crawler)...
|
| In relation to your second point, you are aware regenereative
| science and this implant approach can progress in parallel?
| This offers something tangible, plus with more refining can be
| rolled out en masse. What regenerative science can be applied
| now that would give such a quality of life improvement?
| 0xbadc0de5 wrote:
| The research subject has an incomplete C5/C6 injury and still
| cannot walk unassisted. Not to mention still has limited use
| of their hands and likely severely impacted somatosensation.
| It's not physically possible to manufacture implants dense
| enough to re-map the entirety (or even a useful fraction) of
| motor and sensory pathways. Attempting to implant a
| significant number of artificial electrodes also risks
| further damage.
|
| I'm not claiming that regenerative treatments and implants
| can't progress in parallel. I'm simply claiming implants are
| a dead-end and are distracting resources away from
| regenerative research.
| _joel wrote:
| You literally said this wouldn't help spinal injuries,
| which the PoC has and now you're changing it to
| 'unassisted'
|
| Do you have data to show funding gets moved away from
| regenerative research?
| germinalphrase wrote:
| Do eye glasses not offer any benefit to people with poor
| eyesight because the doctor can't fix their eyes?
| snapcaster wrote:
| This seems like such a bad take i'm assuming it's trolling? A
| person couldn't walk, and now they can. How is that a
| "distraction"?
| 0xbadc0de5 wrote:
| If it seems like an absurd take, please at least consider
| that perhaps I'm not the one who's missing something, that
| perhaps I have decades of experience following the research
| and its results. I understand it's a bad look to shit on what
| should be a positive story: technology fixes disabled man,
| news at 11. But these types of treatments have been around
| for at least 25 years and always end up the same - a big hype
| cycle, some funding grants for the researchers, a few grads
| get their Phd's, then everyone realizes it doesn't actually
| work, the effects were mostly placebo or attributed to other
| factors (such as the surgical installation of the implant
| alleviating undiagnosed pressure on the nerves), then it goes
| quiet for a couple years until people forget and the cycle
| repeats.
|
| People who don't actually live with or understand spinal cord
| injury often fall into the trap of thinking that "if we can
| just make their legs move, then they're fixed!" Completely
| ignoring that somatosensation (sensory feedback) is probably
| 2/3 or more of the signal and implants can't communicate that
| at all. It's difficult for many able-bodied people to
| understand that spinal cord injuries are not the same as
| needing glasses (to address another comment). Not the same
| ballpark, not even the same sport.
|
| One must ask the question of what the goal of the research
| is? Is the goal to restore spinal cord function or is the
| goal to advance BMI technology? When your funding source and
| research institution are committed to a particular path, the
| "goal" starts to take whatever shape is necessary to align
| with the former two.
|
| I suppose it's only fair for me to consider that perhaps the
| goal is better BMI's instead of restoring spinal cord
| function. To which I would have to applaud the effort.
| However, I have it on good authority that given the option,
| those suffering from spinal cord injuries would rather see
| more research going toward solving the problem and not the
| symptom.
| sfink wrote:
| I understand your take now, but it still seems like the two
| approaches are complementary. Specifically because afaik
| the only known way to restore spinal cord function is to
| get signals traveling through whatever means, so that the
| body will regrow the pathways. (I am not at all an expert,
| but my understanding is that) stem cells aren't going to do
| any good if they're just wedged in randomly. If they or
| something else carries a signal, they will organize to
| strengthen that signal and can then permanently repair
| function (at least partially). If they don't carry a
| signal, they will wither and die. So it seems to me that
| when you don't have intact nerves carrying signals from
| point A to point B, then _anything_ that carries those
| signals will delay degeneration and possibly facilitate
| repair. If you need wires or nanotubes or little strips of
| squid skin to carry those signals initially, then that 's
| what you'll want to do.
| maybelsyrup wrote:
| > If it seems like an absurd take, please at least consider
| that perhaps I'm not the one who's missing something, that
| perhaps I have decades of experience following the research
| and its results
|
| But if that's the case why are you talking like you're
| talking in your comment above?
|
| > Any research that does not involve repairing the physical
| damage to the spinal cord itself is a distraction.
|
| People think you're trolling because this is how trolling
| sounds.
|
| > please at least consider that perhaps I'm not the one
| who's missing something, that perhaps I have decades of
| experience following the research and its results
|
| The woe-is-me passive-aggression isn't helping your cause,
| dude. Share what you know, nicely, even if you're
| disagreeing with something, and people won't jump on you.
| bendbro wrote:
| > The woe-is-me passive-aggression isn't helping your
| cause, dude. Share what you know, nicely, even if you're
| disagreeing with something, and people won't jump on you
|
| Has he been not-nice?
| pdabbadabba wrote:
| From the abstract:
|
| > Moreover, neurorehabilitation supported by the BSI improved
| neurological recovery. The participant regained the ability to
| walk with crutches overground even when the BSI was switched
| off. This digital bridge establishes a framework to restore
| natural control of movement after paralysis.
|
| So, not only did the brain-spine interface ("BSI") itself allow
| the patent to walk when they couldn't before (which strikes me
| as an absolute win, even if you call it a distraction) but it
| _also_ facilitated neurological recovery over the longer term.
| Arrath wrote:
| Oh, whoa, that is pretty incredible!
| nashashmi wrote:
| The part where the patient was able to turn the device off
| and still walk with handicap was the part that knocked it out
| of the park.
|
| I am more interested in how well was the patient able to
| recover, fully or with care? And is there a possibility that
| the device can be removed entirely?
| aeturnum wrote:
| This is very exciting! One possibility that is, I think, covered
| up by all the hype around "AI works like our brains" (which I
| disagree with) is that: our brains are too complex for us to
| understand and ML may allow us to build more capable interfaces
| that we still don't understand - but which are easier to
| understand than the brain. It's an extremely promising new avenue
| for incremental progress.
| __loam wrote:
| This is genuinely incredible.
| barelyauser wrote:
| What is the practical reason to favor electrical implants over
| electromagnetic ones? One would conclude that using
| electromagnetic induction would be a no-brainer when it is very
| clear the body works against electrical probes (by fighting the
| implants). Could someone more knowledgeable than myself clarify
| this.
| __loam wrote:
| Bio-compatibility issues are not intractable. We know about
| many biomaterials that the body doesn't have a strong adverse
| reaction to. I'm sure people are developing materials that are
| both conductive and bio-compatible.
| 0xbadc0de5 wrote:
| It's very difficult (ie: impossible) to target individual nerve
| fibres with induction. Direct stimulation is the only way to
| achieve the required resolution.
| hprotagonist wrote:
| see also, MEG
| jupp0r wrote:
| I don't know the answer to your question, but I appreciate the
| "no-brainer" pun there.
| etrautmann wrote:
| The amount of current required for magnetic stimulation is much
| higher and not compatible with implantable devices. TMS
| requires large coils and currents relative to electrical
| stimulation.
| barelyauser wrote:
| Isn't TMS coil current high to compensate the distance? The
| closer to the nerve ending should reduce the necessary
| current.
| Jeff_Brown wrote:
| But if those nerve endings are anywhere but at the surface
| of the body, they'll still require an implant.
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