Paralysed patients can train brain to let them walk again
A WOMAN who was paralysed for 13 years can walk again after a ‘brain training’ programme restored feeling in her legs.
The 32-year-old is one of eight people with spinal-cord injuries who have been able to go from full to partial paralysis.
After therapy sessions that included a virtual-reality football game and walking in a robotic exoskeleton, patients are thought to have reawakened surviving nerve fibres.
The programme creates images of walking in the brain, so it regains control of the dormant nerves.
The Walk Again Project in Sao Paulo, Brazil, showed that patients developed feeling and control of muscles in their legs that had been numb.
Four of the patients were able to move from full paralysis to partial paralysis in a year.
Scientists say it may offer hope to those who suffer spinal-cord injuries, strokes and other conditions where they need to regain strength, mobility and independence.
The 32-year-old woman, who has not been named, had the most dramatic change.
She went from being unable to stand to walking using a walker, braces and her therapist’s help. At 13 months she could move her legs voluntarily while her body was supported in a harness.
Researchers, led by neuroscientist Miguel Nicolelis of Duke University in North Carolina, gave the patients virtual-reality goggles to create the illusion that they had working legs.
Patients then spent at least two hours a week using devices controlled through their brain signals.
They were asked to imagine walking in the virtual world and it appears that, by doing so, the training created a mental image of walking in the patient’s brains.
The more they believed they were walking, the more their bodies used surviving nerves that had become dormant from disuse.
Among those who took part in the rehabilitation, five had been paralysed for at least five years, while two had been for more than a decade.
Dr Nicolelis said: ‘One previous study has shown that a large percentage of patients who are diagnosed as having complete paraplegia may still have some spinal nerves left intact. These nerves may go quiet for
‘We couldn’t have predicted this’
many years because there is no signal from the cortex to the muscles.
‘Over time, training with the brainmachine interface could have rekindled these nerves. It may be a small number of fibres that remain, but this may be enough to convey signals from the motor cortical area of the brain to the spinal cord.’
One of the biggest gains was an improvement of bladder and bowel control for all patients.
Speaking as the findings were published in Scientific Reports, Dr Nicolelis said: ‘We couldn’t have predicted this surprising clinical outcome when we began the project. What we’re showing in this paper is that patients who used a brainmachine interface for a long period of time experienced improvements in motor behaviour, tactile sensations and visceral functions below the level of the spinal cord injury.
‘Until now, nobody has seen recovery of these functions in a patient so many years after being diagnosed with complete paralysis.’
After the initial training, more challenging physical equipment was introduced to further test patients’ control over posture, balance and use of upper limbs. These included walking devices and overhead harnesses.
Successes from the Walk Again Project include Julian Pinto, a young paraplegic man, being able to kick a football in the 2014 World Cup opening ceremony by using a brain-controlled robotic exoskeleton.
Encouraged by the results so far, the research team now hopes that weekly training as part of rehabilitation could help patients re-engage spinal-cord nerves that have survived the impact of car crashes, falls and other paralysing trauma of the lower limbs.
The progress of the patients, who have now had training for more than two years, will continue to be tracked by the researchers.