Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News 

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Swiss and German researchers have created an implantable device that has helped patients with locked-in syndrome regain the ability to communicate with others. Locked-in syndrome, or pseudo coma, is a condition that develops from amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease. This progressive neurodegenerative disease leaves patients unable to move or speak due to paralysis while remaining completely conscious. 

The team’s research was published in Nature Communications this week and helped to shed some light about the cognitive status of patients with locked-in syndrome. This is important because patients with this condition have completely lost the ability to move their voluntary muscles, which includes moving the eyes or mouth. In 2017 researchers used technology called “functional near-infrared spectroscopy” to help patients with this condition communicate yes-or-no answers through analyzing brain activity.  However, that process was slow and only about 70% accurate.

This new research involves surgically implanting two electrodes into a patient’s brain that detects neural signals and allows him to control a keyboard with his mind. The man was able to communicate a series of phrases to his family, including a request for soup and beer and asking if his son would like to watch a movie with him.

This brain-computer interface allows patients to generate brain activity by telling their body to move, even though it no longer can; however, this brain activity is used to create a yes-or-no signal and is fed through a computer program. This process is still slow, generating one letter per minute, but “if you have a choice of no communication and a communication of one character per minute, the choice is very obvious,” Ujwal Chaudhary, who co-authored the study said.

This will give patients the ability to communicate with family and caregivers in a way that was previously not possible. While there are other treatments and interfaces available, once the patient loses the control over voluntary movement, they also lose their ability to communicate effectively with those other methods.

This technology is extremely expensive and requires time, dedication, and extensive training for caregivers. Jonas Zimmermann, a senior neuroscientist with the Wyss Center for Bio and Neuroengineering in Geneva, Switzerland, and co-author of the study explains that proper training is essential in making sure that patients and caregivers can effectively communicate with one another. 

The device is still in the pre-clinical verification process, but the team hopes to conduct clinical trials “in the near future.” Zimmerman added that this device could potentially allow speech decoding directly from the brain as the patient imagines speaking, leading to more effective and efficient communication. 

In the U.S. there are about 30,000 people living with ALS and about 5 per 100,000 people globally. It is estimated that this disease will increase by 69% by 2040, leading researchers to search for better treatments for this progressive and incurable disease. Brain-computer interface implants can help to restore function to patients, as well as improve quality of life and the ability for patients to make their needs known. There is also the potential for this technology to be used for other neurological disorders affecting muscles, such as stroke, spinal cord injuries and cerebral palsy.