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Thinking and Moving

Reprinted from PN August 2017

The first recipient of implanted brain-recording and muscle-stimulating systems reanimates a limb that has been stilled for eight years.

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Navy veteran Bill Kochevar grabbed a mug of water, drew it to his lips and drank through the straw. His motions were slow and deliberate, but then Kochevar hadn’t moved his right arm or hand for eight years. And it took some practice to reach and grasp just by thinking about it. Kochevar, who was paralyzed below his shoulders in a bicycling accident, is believed to be the first person with quadriplegia in the world to have arm and hand movements restored with the help of two temporarily implanted technologies.

Breaking Ground

A brain-computer interface with recording electrodes under his skull and a functional electrical stimulation (FES) system activating his arm and hand reconnect his brain to paralyzed muscles. Holding a makeshift handle pierced through a dry sponge, Kochevar scratched the side of his nose with the sponge. He scooped forkfuls of mashed potatoes from a bowl — perhaps his top goal — and savored each mouthful.


Bill Kochevar prepares to take a bite of food with the help of an implanted brain-computer interface system.

“For somebody who’s been injured eight years and couldn’t move, being able to move just that little bit is awesome to me,” says the 56-year-old from Cleveland. “It’s better than I thought it would be.”

Kochevar is the focal point of research led by Case Western Reserve University (Cleveland), the Cleveland Functional Electrical Stimulation (FES) Center at the Louis Stokes Cleveland Department of Veterans Affairs (VA) Medical Center and University Hospitals (UH) Cleveland Medical Center. A study of the work was published in the March 28 issue of British medical journal The Lancet.

“He’s really breaking ground for the spinal-cord injury community,” says Bob Kirsch, chair of Case Western Reserve’s Department of Biomedical Engineering, executive director of the FES Center and principal investigator (PI) and senior author of the research. “This is a major step toward restoring some independence.”

When asked, most people with quadriplegia say their first priority is to scratch an itch, feed themselves or perform other simple functions with their arm and hand instead of relying on caregivers.

“By taking the brain signals generated when Bill attempts to move and using them to control the stimulation of his arm and hand, he was able to perform personal functions that were important to him,” says Bolu Ajiboye, assistant professor of biomedical engineering and lead study author.

Technology & Training

The research with Kochevar is part of the ongoing BrainGate2 (braingate.org) pilot clinical trial being conducted by a consortium of academic and VA institutions assessing the safety and feasibility of the implanted brain-computer interface (BCI) system in people with paralysis.

Other investigational BrainGate research has shown that people with paralysis can control a cursor on a computer screen or a robotic arm.

For more information, visit case.edu

 

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Thinking and Moving

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