Monday, September 28, 2015 Paralyzed Man Walks Through Use of Brain-Controlled FES A new approach that combines functional electrical stimulation (FES) technology with a brain-computer interface (BCI) has allowed a paralyzed man to walk without the use of an exoskeleton or manual controls. According to researchers at the University of California-Irvine who worked on the project, their breakthrough is the first-ever demonstration that "restoring brain-controlled overground walking after paraplegia due to [spinal cord injury] is feasible," The subject of the project was Adam Fritz, a 26-year-old man who had suffered a spinal cord injury (SCI) in 2008 that left him with no motor function in the lower extremities and, other than minimum sensation for bladder fullness, no feeling below the T6 site of the SCI. Researchers selected Fritz not only because of the nature of his injury, but because he was physically active both before and after his injury, and thus more likely to respond well to the physical training needed to prepare for the new system. Results of the project were published in the Journal of NeuroEngineering and Rehabilitation. Researchers began by connecting Fritz to a virtual reality environment (VRE) by way of an EEG cap that allowed him to engage in "motor imagery practice." The VRE helped him activate the areas of his brain needed to walk and stand as he advanced and paused in a virtual setting, which in turn counteracted the suppression of the supraspinal areas related to gait that can occur after chronic SCI. At the same time, Fritz underwent FES training on a commercially available, FDA-approved device. Once Fritz had developed proper walking using the manually controlled FES system, researchers moved to the main event: connecting the FES system to the BCI to see if Fritz could use brain impulses to stimulate overground walking movement in his legs. The work began with Fritz in a suspended, weight-bearing harness, walking a 3.66-meter linear course with 3 cones, positioned 1.83 meters apart, at which he was instructed to stop and wait for 10 to 20 seconds. Researchers soon moved Fritz to a harness that allowed him to bear almost all of his weight (and could also prevent falls), where he successfully completed the course multiple times. News of the achievement was picked up by CNET and Time magazine, which also included a video of Fritz making his way down the walking course. Researchers acknowledge that there is a still a long way to go before this approach is refined enough to be widely used, including work to move from their noninvasive to an invasive BCI system that would allow more direct links between the brain and lower extremity prostheses. The important thing about this work, they write, is in its "proof of concept." "This robustness in real-time control, together with a high level of performance sustained across months, indicates that BCI-FES mediated restoration of basic walking function after SCI is feasible," authors write. "In summary, the system reported here represents an important step toward the development of technologies that can restore or improve walking in individuals with paraplegia due to SCI."