Onward, ho! First patient implanted with BCI-equipped neurostimulator to restore arm function

Both brain-computer interfaces and spinal cord stimulation systems have been shown to potentially help restore arm and hand mobility after a stroke or other spinal cord injury—and now, a system that combines the two is betting the whole is greater than the sum of its parts.

Dutch devicemaker Onward Medical has developed the ARC-IM spinal cord stimulator with a goal of restoring movement and function—and, therefore, independence—after spinal cord injuries. The neurostimulation system is being paired with a wireless brain-computer interface, or BCI, developed by Swiss biomedical research center Clinatec, potentially allowing a patient’s own thoughts to help control the spinal cord stimulator’s output.

The first human has now been implanted with a version of that combined system that specifically aims to restore movement in the arms, hands and fingers, Onward announced Wednesday.

The implantation process took place across two separate procedures at a Swiss hospital last month: The ARC-IM device was implanted first, followed by the BCI nine days later.

“The implant procedures involving the Onward ARC-IM and Clinatec BCI went smoothly,” Jocelyne Bloch, M.D., the neurosurgeon who performed the procedures, said in the announcement. “We are now working with the patient to use this cutting-edge innovation to recover movement of his arms, hands and fingers. We look forward to sharing more information in due course.”

The ARC-IM system comprises a lead and a neurostimulator. The lead is placed along the spinal cord, where, when prompted by the neurostimulator, its electrode array sends out mild electrical pulses to stimulate the dorsal roots, which are responsible for transmitting sensory information between the peripheral and central nervous systems.

A BCI, meanwhile, collects neurological signals and transfers them to a connected computer, where a software program translates those thoughts into actions—in the form of keystrokes, an adjustment to a mechanism brace or other movement.

In this case, the BCI collects the signals put out when a paralyzed patient wants to move their upper extremities. After the system’s artificial intelligence algorithms parse out the intention behind those signals, it relays the information to the ARC-IM device, which should stimulate the nerves enough to induce the desired movement in the arms, hands or fingers.

Onward said it plans to share more information about the project in the coming months and, ultimately, to publish a peer-reviewed study detailing the entire procedure and its results.

Earlier this year, in May, researchers from Onward and a handful of other institutions published a study describing how the combined spinal cord stimulation and BCI system had been successful in restoring a quadriplegic patient’s ability to stand, walk and climb stairs.

According to the study, the resulting “digital bridge” between the brain and spine not only remained stable for over a year, but also helped improve the patient’s overall neural recovery, to the point of his being able to walk with crutches even when the mechanism was inactive.