Hope through innovation: Brain-computer interfaces may aid paralyzed individuals

 Study participant Tim Hemmes (right) reaching out to his researcher, Wei Wang, M.D., Ph.D. (left), using a brain-controlled prosthetic arm. Also pictured: Research team member Jennifer L. Collinger, Ph.D. and Katie Schaffer.

Robotic-mind control, popularized in the 2009 epic science fiction film, “Avatar,” may not be as far off as we imagine it to be. Scientists have already been researching brain-computer interfaces [BCI] for years.

 A Nov. 11 article in MIT Technology Review shows that a newly developed carbon microthread may be the kind of long-lasting electrode needed to improve BCI. In preliminary studies, BCI have allowed paralyzed people to control robotic limbs or a computer mouse.

The new microthread, designed at the University of Michigan’s Neural Engineering lab, is only seven micrometers thick, about 100 times thinner than traditional electrodes used to study animal brains.

Andrew Schwartz, a researcher at the University of Pittsburgh who was not involved in the work, said in the article that it’s widely believed small fibers are “a good thing, because they seem to be ‘ignored’ by the brain.” But he also cautioned “that it could be difficult to insert such fine, flexible electrodes into brain tissue, and to secure them,” noting that recordings broke down in many of the animals studied.

Though these innovations are not exactly solid yet, they are breaking new ground, and it’s exciting to think about their potential for people suffering from spinal cord injuries that have left them paralyzed.

Back in 2008, a monkey at the University of Pittsburgh was able to feed himself a marshmallow using his brain to directly control a robotic arm. Since then, this research has expanded to human beings.

A little over a year ago, the Pitt Chronicle of the University of Pittsburgh showed how a BCI impacted 30-year old Tim Hemmes, who had been paralyzed due to a SCI from a motorcycle accident in 2004. With a mind-controlled prosthetic arm, he was able to reach up and touch the hand of his girlfriend, Katie Schaffer, “in a painstaking and tender high five,” the article published on Oct. 17 of last year stated. 

Surgeons placed a grid the size of a stamp on the motor cortex surface of Hemmes’ brain to control a robotic arm for the four-week trial period. The BCI picks up neural activity that can be translated by a computer processor to control computer cursors or assistive devices such as a prosthetic hand.

The research project funded by the National Institutes of Health in early 2011 received Popular Mechanics magazine’s 2012 Breakthrough Award. The magazine honored Hemmes, and the research team led by Wei Wang, M.D., Ph.D., assistant professor, Department of Physical Medicine and Rehabilitation, Pitt School of Medicine, at an invitation-only conference and gala awards ceremony in New York City last month. The project is also featured in the November issue of Popular Mechanics.

Gene required for nerve regeneration identified

Photo Credit: Rolls lab, Penn State University

Scientists at Penn State and Duke University have identified a gene that is associated with the regeneration of injured nerve cells. The journal Cell Reports published an online early copy of their findings on Nov. 1, and will also include the paper in the monthly issue of the journal on Nov. 29. 

The team of researchers found that a mutation in a single gene can entirely shut down the process by which axons – the parts of the nerve cell that are responsible for sending signals to other cells –re-grow themselves after being cut or damaged.

"We are hopeful that this discovery will open the door to new research related to spinal-cord and other neurological disorders in humans," said Melissa Rolls, an assistant professor of biochemistry and molecular biology at Penn State, who led the research team, in a Penn State news release. 

“Axons, which form long bundles extending out from nerve cells, ideally survive throughout an animal's lifetime,” Rolls explained. “To be able to survive, nerve cells need to be resilient and, in the event of injury or simple wear and tear, some can repair damage by growing new axons.”

Earlier research suggests that microtubules, intracellular "highways" along which basic building blocks are transported might need to be rebuilt as an important step in this type of repair. "In many ways this idea makes sense,” Rolls said. “In order to grow a new part of a nerve, raw materials will be needed and the microtubule highways will need to be organized to take the new materials to the site of growth.”

Based on this research the team investigated the role of microtubule-remodeling proteins in axon re-growth after injury, focusing on a set of proteins that sever microtubules into small pieces. A protein named spastin emerged to play a critical role.

The team used fruit flies as their model organism to test the role of spastin. They found that in fruit flies with two normal copies of the spastin gene, severed axons were able to regenerate. However, in fruit flies with two or even only one abnormal spastin gene, the severed axons were not able to regenerate.

"Now that we know that spastin plays an important role in axon regeneration and also that this gene is dominant, we have opened up a possible path toward the study of human diseases involving nerve-cell impairment," Rolls said. "In fact, our next step is to probe the link between hereditary spastic paraplegia (HSP) and axon regeneration."
 

Hope through research: New TBI studies uncovered

As of May 2010, the Defense and Veterans Brain Injury Center counted 178,876 traumatic brain injuries in the U.S. Military since 2000. Though the number of these injuries may seem devastating, scientists working on new discoveries to help prevent, detect, and treat blast injuries provide some hopeful news.

From mice trained to sniff out landmines, to new technology to detect blast injuries, to a dietary supplement derived from tobacco leaves that may help retain memory skills, scientists are finding new ways to combat these injuries. Researchers presented these findings at Neuroscience 2012, the annual meeting of the Society for Neuroscience, which was held in New Orleans, Louisiana, last month.

A widely acclaimed program that deployed specially trained rats to sniff out landmines inspired scientists to work on developing a genetic modification of mice, “transgenic mice,” that could increase their capacity to smell landmine explosives by 500 fold. This initiative is part of The MouSensor Project, to build a “biosensor” for landmine detection, which researchers presented at the annual meeting.

Funds from the National Institutes of Health supported this research.

A different study that looked at blast injuries came out of the United Kingdom where around 60 percent of the injuries to soldiers sustained in Afghanistan have been the result of explosive devices.

This study, which looked at the brains of 20 U.K. soldiers recently exposed to a blast, 40 non-blast TBI patients, and 40 age-matched controls, found that blast-related injuries appear more likely than non-blast injuries to damage the back lower region of the brain, which is responsible for motor control and other essential life functions. Since these injuries sustained in the brain’s “white matter,” which helps nerve cells communicate, cannot be accurately detected by conventional magnetic resonance imaging, scientists used an advanced form of MRI, known as diffusion tensor imaging, for this research.

In another study, supported by funds from the Department of Defense and the Roskamp Foundation, based in Sarasota, Florida, scientists found that a dietary supplement may improve spatial memory, which is the part of the memory responsible for recording information about one’s environment.

Fiona Crawford, PhD, the study’s senior author, and her colleagues studied a group of 96 mice, half of which had suffered TBI and half of which had not. Among the injured mice, half received a placebo and half received anatabine, which is an anti-inflammatory dietary supplement derived from tobacco leaves, or an experimental Alzheimer’s drug. After two weeks, the mice that received either the drug or the dietary supplement performed as well as the uninjured mice on a test that evaluates spatial memory.

“These studies are particularly outstanding for how they take some of the most complex and cutting edge science of our time and translate it into practical applications that can have an enormous, visible impact on people’s lives,” said Jane Roskams, PhD, University of British Columbia, an expert on brain repair, in a recent media release. “That one day a mere mouse might save a child from losing a limb while walking across an old mine field, or a simple dietary supplement could make life more bearable for a brain injury victim shows why the field of neuroscience is attracting so much interest these days.”

Underwear wired to prevent bed sores

Superman star Christopher Reeve, who had a spinal cord injury, died in 2004 after suffering a system-wide infection from a bed sore that led to heart failure and a coma.  These sores are common due to the immobilization SCI causes. But researchers are working on new technology to help end this epidemic.

Researchers presented Smart-e-Pants, underwear that looks like bike shorts, with a “built-in electronic system” that shocks the bottom to prevent the development of these bed sores, at Neuroscience 2012, the Society for Neuroscience conference’s recent annual meeting in New Orleans, Louisiana.

Bed sores, also called pressure ulcers, are painful open wounds, usually over bony areas of the body. The prototype underwear delivers tiny, intermittent electrical shocks, contracting the buttock muscles.

“The mini-muscle contractions generated by the underwear mimics the subconscious fidgeting of able-bodied individuals, stimulating blood flow and redistributing pressure away from the sitting bones,” according to the Oct. 15 media release that came out on the same day as the scientific presentation.

Of the 33 clinical care patients, none developed pressure ulcers during the two-month study period, Sean Dukelow, MD, PhD, of the University of Calgary in Canada, reported. The underwear delivered muscle-contracting stimulation four days per week for 10 seconds every 10 minutes, 12 hours a day.

Researchers plan to follow up this clinical trial with further efficacy studies. Funds from Alberta Innovates – Health Solutions in the Canadian province of Alberta supported the research.

This research is important because of the devastating human and economic cost of these wounds.

One in three people with SCI develop a pressure sore during the early days after the injury and between 50 and 80 percent at some later point, according to the Christopher and Dana Reeve Foundation.

These pressure ulcers can lead to increased risk of infection, hospitalization, and death. In the United States alone, 60,000 people each year die from complications related to pressure ulcers, statistics show. The economic cost is also staggering, estimated at $11 billion in the U.S. and $3.5 billion in Canada.

“Pressure ulcers can be terribly debilitating. Their incidence has not changed since the 1940’s, indicating that the current methods of prevention simply are not working,” Robyn Warwaruk Rogers, a research nurse at the University of Calgary, said in the media release. “Our hope is that this innovative, clinically friendly system will eventually make a difference in the lives of millions of people.”

Stewart Midwinter, who broke his neck paragliding last year, has noticed the added protection while sitting in a wheelchair for long periods of time as one the of the first patients to test the device, according to an Alberta feature story by Colin Zak published earlier this year. “I now face many challenges I hadn’t expected, and Smart-e-Pants give me some added peace of mind,” Midwinter said.

Scientists develop ‘brain-on-a-chip’ prototype

Technology is changing how scientists look at brain injuries. A “brain-on-a-chip” that looks like it came out of a sci-fi adventure movie may eventually show promise for studying the effects of brain injury.

On Oct. 22, Draper Laboratory announced that scientists at its nonprofit research and development laboratory located in Tampa along with the University of South Florida are working to develop a “brain-on-a-chip,” that may one day be used to study neurodegenerative diseases like Alzheimer’s or stroke.

A stroke or Alzheimer’s disease is not considered a traumatic brain injury because the term traumatic refers to the cause of the injury being traumatic such as a blast from a war zone, a gunshot, or a car accident, instead of the trauma people feel after being diagnosed with any brain injury. But this research may still be relevant for those who suffer TBI because research has shown that it is a risk factor for both.

It’s interesting that the impact of a small chip could be so far reaching. “Our device is designed to be the most biologically realistic model of brain tissue developed in the lab thus far,” said Anil Achyuta, principal investigator.  “We have the potential to revolutionize how scientists study the effects of drugs, vaccines, and specialized therapies like stem cells on the brain . . . In addition to screening drugs, we could potentially block vascular channels and mimic stroke or atherosclerotic plaque.”

Perhaps, even more intriguing for those with a TBI is that it could one day be used to study TBIs directly. “Furthermore, this platform could eventually be used for neurotoxicology, to study the effects of brain injury like concussions, blast injuries, and implantable medical devices such as in neuroprosthetics.”

The neurovascular unit is made up the specific brain and vascular cells that exchange nutrients, oxygen, and dispose of chemical waste to keep the brain functioning. Neurodegenerative diseases typically involve a dysfunction in the interaction between the brain and the circulatory system.

The “brain-on-a-chip” prototype attempts to mimic the neurovascular unit and represent a biologically realistic model of brain tissue by combining innovations in cellular brain science, tissue engineering, and microfluidics (microminiaturized devices with chambers for the containment and flow of fluids.)

Photo Credit: Draper Laboratory

As part of the research, basic brain cell types and vascular cells from rats were cultured on two specially designed micro-fabricated layers. Eventually, researchers plan on switching from rat embryonic cells to human cells. Their work will be under the umbrella of the Draper’s BIO-MIMETICS program, a DARPA funded project undertaken in collaboration with MIT, which aims to one day combine a networked system of micro-devices into a “human-on-a-chip” for the rapid testing of new drugs and vaccines.

“Severe traumatic brain injury remains a major health-care problem worldwide,” according to the Lancet, Volume 380, Issue 9847, Pages 1088 - 1098, 22 September 2012. “Although major progress has been made in understanding of the pathophysiology [the functional changes] of this injury, this has not yet led to substantial improvements in outcome.”

Hopefully, this new technology will lead to not only better understanding, but also development of new therapies to improve quality of life for those whose lives are catastrophically altered from brain injury.

Society for Neuroscience unveils new SCI treatments

“New findings could help speed recovery, alleviate pain associated with spinal cord injury,” according to the Society for Neuroscience. Their findings were revealed at Neuroscience 2012, their annual meeting.

The Society for Neuroscience is a nonprofit membership organization of scientists and physicians that study the brain and nervous system. The meeting was held in New Orleans, Louisiana earlier this month.

To understand their findings, it may help to know what neuroscience means. Neuroscience is the study of the nervous system to advance the understanding of human thought, emotion and behavior. It may also be helpful to look at the role that the spinal cord plays in the body. The spinal cord is a thick bundle of nerve tissue that is responsible for transmission of electrical signals sent to and from the brain. 

A SCI is any injury to the spinal cord caused by trauma which may range from car crashes to violent acts. No one expects a SCI, but research from the Shepherd Center, a nonprofit hospital based in Atlanta, GA, shows that each year an estimated 12,000 people sustain new SCI – that’s 30 new injuries a day.

“Spinal cord damage is debilitating and life-altering, limiting or preventing movement and feeling for millions worldwide, and leading to chronic health conditions and pain,” an Oct. 15 release from the Society for Neuroscience states. “The initial injury is usually compounded by a wave of immune activity that can extend the initial nervous system damage, and complications of SCI may include pain and pressure sores that compromise the quality of life.”

The new studies suggest innovative ways to ease complications of SCI and to hasten recovery:

• Nervous system tracts that are left intact but non-functioning following SCI appear to be reactivated through deep brain stimulation, speeding recovery of walking in a rodent model (Brian Noga, PhD, abstract 678.12).
• Painful and sometime life-threatening pressure sores due to immobilizing nervous system injuries may be prevented by underwear wired to deliver tiny electrical currents that contract the paralyzed buttocks muscles, mimicking the natural fidgeting of able-bodied people (Sean Dukelow, MD, PhD, abstract 475.09).
• Carbon monoxide’s anti-inflammatory effects appear to accelerate healing in rats with spinal cord injury, possibly by altering the balance of immune cells and limiting the damage caused by molecules called free radicals (Yang Teng, MD, PhD, abstract 450.11).
• Social contact appears to lessen the pain that follows peripheral nerve injury. A new mouse study correlates the healing social behavior with biochemicals in the brain and spinal cord (Adam Hinzey, abstract 786.04).

 “While the damage of SCI can appear to be immediate and dramatic, the biological events that lead to extensive nerve and tissue damage are complex, and injuries evolve over time,” said press conference moderator Jacqueline Bresnahan, PhD, of the University of California, San Francisco, an expert on nervous system trauma caused by SCI. “Today researchers are finding ways to intervene in the cascade of molecular changes that follow SCI. From understanding immune cell responses to the healing power of social contact, researchers are finding new ways to treat and rehabilitate patients.”

National Institutes of Health, as well as private and philanthropic organizations, supported this research.

The average person living with SCI may not want to get their hopes up too soon, but the history of science is marked by a long chain of advances that once seemed improbable if not impossible. 

Wounded soldier walks again without prosthetics

Specialist Christopher Burke served with his dad as a soldier in Operation Iraqi Freedom and Operation New Dawn, but his catastrophic injuries didn’t come on the battlefield. Instead he was immediately paralyzed from a sporting accident at home.

On a mid-tour break, he did a back flip while doing gymnastics that propelled him head forward inside the foam pit. The top of his head collided with the concrete wall inside the foam pit splitting his head open and paralyzing him by bursting his sixth cervical vertebra.

He is a survivor of a C-6 injury, a traumatic brain injury, and Brown-Sequard Syndrome, a rare incomplete lesion to one side of the spinal cord that results in impaired or loss of movement to the injured side.

A neurosurgeon told him he would never walk again without full prosthetics, but several months later he was walking short distances with only a cane. And two years later he was walking without any help. Lynda Burke, his mom, shared this inspiring story about her oldest son with brainandspinalcord.org.

“I believe that the spinal cord area along with the body as a whole is still a mystery and that what works for one person may not work for another,” Lynda wrote in an Oct. 4 email where she was asked her feelings about hope for recovery from spinal cord injuries.

When asked what the key was to her son’s recovery, she wrote: “Fighting every day to make something work, to make something move, to stay healthy and strong.”

Mindset was a critical part of this fight. “I believe the patients mental outlook has the most to do with them recovering, I say this because my son did not want to spend the rest of his life in a wheelchair, and thus he pushed himself every day and every moment to try to get something to move. We did not wait for therapy to come work with him, I stretched his hands, arms, legs and feet several times during the day . . . and he mentally knew he did not want to spend his whole life in a wheelchair.”

Lynda added: “Christopher’s hand therapist wrote his hand off in December 2010, but we were not happy with that, both of us refused to give up, and we continued to try to stimulate that hand and although it is still not back a 100 percent to what it was before his injury and may never be, he has more use of his hand than the therapist thought he would ever get and can hold a cup in it now.”

Christopher got his rehabilitation therapy on base at Fort Riley, KS. His therapy included pool therapy, twice a week, physical therapy, three times per week, occupational therapy, twice a week, and hand therapy, three times per week then twice per week until December when hand therapy ended.

He was in the U.S. Army since Aug. 2007, and he was medically discharged in May 2012. Since he’s been out of the Army he has moved to California with plans of beginning college this coming year at California State University, Northridge. In the meantime, he continues to rebuild the physical strength he lost from his injuries through physical therapy exercises to strengthen his left leg and work with flexibility and range of motion in his left hand. When asked how he’s doing today, Lynda wrote: “Amazingly well. He is walking full time now which is a true miracle. He still has bad days, but all in all he is doing wonderful.”