The patient, a 34-year-old man living in Germany, is the first to be able to communicate without any voluntary muscle movement. He first consented to receiving the experimental implant back in March 2019, when he’d lost the ability to walk or talk but could still communicate with his eyes. Since losing the ability to fix his gaze shortly afterward, the patient has been unable to “talk” to family or caregivers.
To make this possible, a team of neuroscientists at the Wyss Center for Bio and Neuroengineering in Geneva, Switzerland pioneered a brain-computer interface with a chip that can be fitted to a patient’s motor cortex. The BCI’s 64 electrodes detect impulses that would otherwise be intended to prompt voluntary muscle movement. These impulses are then sent to a computer with a neural signal processor and decoder application, which can translate each impulse into a “yes” or “no” signal.
According to the study published in the journal Nature Communications last week, the patient underwent extensive training three months after implantation in order to learn how to use the BCI system. The patient learned over time to modulate his neural firing rate using audio feedback; once this was accomplished, he could begin selecting letters to “free spell” and express his thoughts and wishes.
(Image: Wyss Center for Bio Neuroengineering/ Nature Communications)
The first thing the patient spelled out was a thank you message to the lead neurobiologist on the project, Niels Birbaumer. Within a matter of weeks, the patient was asking for a beer, to listen to Tool, to have his head propped up in the presence of company, and to watch a Disney movie on Amazon with his son. He even provided suggestions on how to improve the BCI system, asking that the scientists add a bank of phrases to select from and “turn on word recognition.”
“One time when I was there, he said, ‘thank you for everything, sister,’” research co-lead Dr. Ujwal Chaudhary told The Guardian, adding that the patient’s sister is one of his caregivers. “It was an emotional moment.”
The neuroscientists say this is the first time a paralyzed patient in a “locked-in state” (meaning they have lost all voluntary muscle control) has been able to freely communicate with caregivers or loved ones. The BCI system can be used in the patient’s own home via remote connection with a laptop. As of now, the patient is capable of forming words and sentences at a rate of approximately one character per minute. “If you have a choice of no communication, and a communication of one character per minute, the choice is very obvious,” Chaudhary said.
The team is currently seeking $500,000 in funding to offer implants to others with ALS over the next two years.
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