NeuroX Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland.
Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
Nature. 2023 Jun;618(7963):126-133. doi: 10.1038/s41586-023-06094-5. Epub 2023 May 24.
A spinal cord injury interrupts the communication between the brain and the region of the spinal cord that produces walking, leading to paralysis. Here, we restored this communication with a digital bridge between the brain and spinal cord that enabled an individual with chronic tetraplegia to stand and walk naturally in community settings. This brain-spine interface (BSI) consists of fully implanted recording and stimulation systems that establish a direct link between cortical signals and the analogue modulation of epidural electrical stimulation targeting the spinal cord regions involved in the production of walking. A highly reliable BSI is calibrated within a few minutes. This reliability has remained stable over one year, including during independent use at home. The participant reports that the BSI enables natural control over the movements of his legs to stand, walk, climb stairs and even traverse complex terrains. 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.
脊髓损伤会中断大脑与产生行走功能的脊髓区域之间的通讯,导致瘫痪。在这里,我们通过大脑和脊髓之间的数字桥梁恢复了这种通讯,使一位患有慢性四肢瘫痪的患者能够在社区环境中自然站立和行走。这种脑-脊髓接口(BSI)由完全植入的记录和刺激系统组成,在大脑皮层信号和针对参与行走产生的脊髓区域的硬膜外电刺激的模拟调制之间建立直接联系。一个高度可靠的 BSI 可以在几分钟内进行校准。这种可靠性在一年多的时间里保持稳定,包括在家中独立使用时。参与者报告说,BSI 能够自然控制腿部的运动,从而实现站立、行走、爬楼梯甚至穿越复杂地形。此外,BSI 支持的神经康复促进了神经恢复。即使关闭 BSI,参与者也能够使用拐杖在地面上行走。这种数字桥梁为瘫痪后恢复自然运动控制建立了框架。