The clock reads 4 a.m. as the distant sound of loud voices shouting “Tell me your name!” steadily becomes clearer. Soon, the curtain is pulled back, revealing three doctors who have come to test your neurologic function.
After several tense minutes filled with a barrage of tests and questions, the doctors depart. You’re left remembering the events leading up to your hospital admission, as you feel the stitches running along the side of your head. Rinse and repeat.
The life of a patient with neurologic injury, whether due to stroke or brain trauma, is frustrating—to say the least.
Unfortunately, for a vast number of patients suffering from brain injury, their “recovery” is markedly more challenging. In particular, patients experiencing motor loss such quadriplegia, an inability to move all four limbs, are unable to recover. They experience a drastically reduced quality of life, if one at all. Automotive accidents represent a significant source of these injuries, but are not the only source. Stroke, amyotrophic lateral sclerosis (ALS), and other neurological diseases can manifest similarly in suffering patients.
To combat this problem, scientists have been attempting to develop a brain computer interface (BCI). In essence, the technology uses direct connections between electrodes on the patient’s brain surface with an external device, such as a prosthetic limb, to allow a patient to control function of the device.
For example, take someone who suffers a motorcycle accident and loses movement of their legs due to an injured spinal cord. They still have an intact brain circuitry that knows how to generate signals normally required to move a leg. If science can harness those signals, shouldn’t it be able to convey them to a robotic limb?
The role of the smart limb is defined. That is, by fitting prosthetic limbs and connecting brain signals to processing algorithms that control prosthetics, patients could theoretically use their iron legs to complete tasks, like walking. These devices replace older technologies that repurpose muscles for more important tasks.
For example, in the case of Dr. Stephen Hawking, cheek movements were used to control cursors on his computer screen. Repurposing muscles to control computers and prosthetics would not only require motor function, which not all patients have, but are also exhaustive and seemingly unnatural for the individual.
A study by Plymouth University and the Royal Hospital for Neurodisability in London has been working with Rosemary Johnson, a former prodigal violinist. A part of the prestigious Welsh National Opera Orchestra and a rising star in the field in her early 20s, Johnson was involved in a car accident that left her in a brain injury-induced coma, which deprived her of speech and movement essential to her musical talents.
After 27 years of failed therapies and trials, Johnson was enrolled in the aforementioned study led by Professor Eduardo Miranda of Plymouth University, with the goal of converting the brain signals that underlie Johnson’s musical prowess into sound that can be heard by the audiences around the world.
Donning an electroencephalogram (EEG) cap that contains electrodes that can record intricate and dynamic brain activity, Johnson can interact with a computer screen to convey the notes, volume, and speed of a musical piece she has imagined. This music can be interpreted and played in real time by the Paramusical Ensemble, a group of able-bodied musician that creates the sounds Johnson was thinking of.
Upon hearing the fruits of her labor, Johnson’s mother noticed that her daughter was instantly injected with new hope. According to her, music is the only thing that Johnson truly enjoys.
The exciting results from this study promise to not only help those musicians who have declined in their skill or lost the ability to perform altogether, but also fosters hope for many more applications.
As recently as January, the United States’ Defense Advanced Research Projects Agency (DARPA) has recognized the potential applications of BCI, committing a reported $60 million to developing the technology. And it was not so long ago that Juliano Pinto, a paraplegic, kicked off the 2014 FIFA World Cup in Brazil by connecting his brain signals to a robotic exoskeleton.
Many of the newest BCIs harness significant potential to revolutionize the way neurologic disorders are managed. In the case of BrainGrate, a complex surgical procedure is used to implant countless small electrodes onto the surface of an injured patient’s motor cortex. Despite the fact that this technique is invasive, the study has reported the highest success rate of any BCI created up to this point.
Despite all of the technological advances with BCIs, there are challenges that may deter widespread adoption. Stability of BCI recordings is the primary concern amongst scientists. Because of electrode movement, loud noises, and commonplace wireless interference, BCI systems often need to be calibrated repeatedly over the course of the patient’s life. While some calibration devices have been pioneered to try to eliminate these problems, their effectiveness has not been consistently demonstrated.
BCI has taken great strides and as technology advances, so does the prospect for harnessing the brain’s power. In the meantime, let stories like that of Rosemary Johnson give our society hope for what will one day surely revolutionize medicine and improve the lives of those suffering from brain injury.