Helping the body heal, feel and move again

The diagnosis was hemimegalencephaly, a rare condition in which one half of the brain develops abnormally larger than the other. The seizures, a symptom of the condition, lasted minutes, consuming Jayna’s entire being. Medication didn’t work. The only answer, at 28 days old, was a hemispherectomy — performed on the youngest patient in the world at the time — by Seattle Children’s neurosurgeon and Center for Sensorimotor Neural Engineering (CSNE) member Dr. Jeff Ojemann. The surgery to disconnect the right hemisphere of her brain was successful, but the outlook was dim: doctors told Jayna’s family she’d likely never walk or talk. That they’d have only a few years with her, at best.

Fast-forward a decade, and Jayna — who lives life with partial blindness and hemiplegia, a weakness of the left side of her body — is the happiest walking, talking 10-year-old you’ll ever meet. And, as a participant in the College of Engineering’s Ability & Innovation Lab pioneered by assistant professor of mechanical engineering and CSNE member Kat Steele, Jayna is working with mechanical engineering students to design body-powered orthoses to enrich not just her own life, but the lives of others.

“With Jayna, we’ve been working on a simple, mechanical solution that’s easy to use in daily life, and we’re really excited by the future opportunities in neural engineering with our partners at the CSNE,” says Steele. “There, researchers are working hard to develop the future of brain-computer interfaces that will let an individual simply think and move these devices.”

For the uninitiated, it sounds like science fiction: humans using brain control to bring robotic limbs — or even their own paralyzed limbs — to life. For CSNE director Rajesh Rao and CSNE deputy director Chet Moritz, it’s the future of neural engineering — and it’s less than a decade away.

Housed in the College of Engineering, the CSNE is a cross-disciplinary hub that brings together medicine and engineering to develop novel solutions for conditions that range from stroke to spinal cord injury. It’s an ecosystem of innovation centered on a shared mission: empowering people with disabilities through connecting brains with technology.

“The CSNE has become the catalyst for almost seamless collaboration between neuroscientists, neurosurgeons, neuroethicists and engineers,” says Rao. “Together, we’re paving the way for next-generation neurotechnologies that will help the body heal, feel and move again.”

When the average able-bodied individual wants to sip a cup of coffee, for instance, they don’t think about bringing the mug to their lips — they just do it. But while the intent to move is still there for individuals who have undergone stroke or spinal cord injury and experience paralysis, there’s a missing link — say, a damaged nerve — in the loop that sends that message from the brain to the muscle. That’s where the CSNE comes in.

The brain is the control center for the nervous system, firing neurons full of information and commands through our bodies. At the CSNE, researchers are unpacking what exactly the intent to move looks like by recording brain activity through electrocorticography (ECoG), a monitoring practice in which a grid of electrodes is placed directly on the surface of the brain.

The participants in the CSNE’s ECoG studies are epilepsy patients who have volunteered to assist the CSNE with its research (ECoG is the go-to approach for mapping the origin of seizures) during their one- to two-week hospital stay. There, CSNE researchers supervised by Dr. Ojemann connect the signals measured directly from the brain to a computer translator of sorts and, without physically lifting a finger, the participants practice thinking of controlling a cursor on a screen, an avatar hand, or even a robotic arm. The researchers ask the participant to imagine completing a task — grabbing that cup of coffee, perhaps — then use those signals to enable the participant to control the electronic limb with their brain.

Researchers in Dr. Ojemann’s lab are also working with epilepsy patients to explore ways of providing sensory feedback through direct cortical stimulation. In these studies, patients learn to open and close their hand to varying degrees according to feedback they get through the ECoG grid.

“In the future, for someone like Jayna who may not have sensation in parts of the left side of her body, this research holds the potential to restore function. Even if parts of the brain aren’t there, we want to take advantage of the brain’s ability to learn and use other available parts of the brain — and the deep structures within it — to receive sensory feedback,” says Ojemann.

This feedback could mean helping patients who use a robotic limb not just open and close their palms, but apply the right amount of pressure to complete various tasks.

“Now that we know we can extract activity from the brain and control avatar hands and robotic arms and receive sensory feedback, what happens if we want to control our own paralyzed limb?” poses Moritz. “We can electrically stimulate the spinal cord below the level of the injury using an implantable device, a type of brain-computer interface (BCI).”

The concept is this: the brain activity is recorded, decoded and an algorithm is created. That information is then used to program the implantable BCI — essentially, chips and wires that act as a pseudo nervous system, creating a bridge to reconnect the brain to the spinal cord below the injury. The device listens to the brain, and then says ‘Oh, the person wants to do this — let’s help them,’” says Moritz. “We’re trying to make the algorithms smarter, to allow the device learn in real time. Just as our brain or spinal cord would learn with practice, so would this little implant.”

Another forward-thinking goal at the core of the CSNE is not to just stop at BCI-driven reanimation, but actually help brain and spinal circuits to heal themselves, bringing dormant limbs to life.

“CSNE researchers are leading the way in building bi-directional BCIs that allow two-way communication between groups of neurons. These devices can promote new or stronger connections in the brain, encouraging the nervous system to rewire around an area of injury,” says Rao. “The goal isn’t so much to use a brain signal to control a prosthetic limb as it is to allow the brain to heal itself.”

For Jayna and other survivors of brain injury, a device like this could mean improving or restoring motor function. For those with spinal cord injury and paralysis, it could even mean having the ability to move their own bodies again.

“Eventually, the device could go away because the individual has regained function,” says Moritz. “The individuals, like Jayna, who might one day benefit from what the CSNE is developing are just a wonderful, inspiring, rewarding group of people to work with. This is the kind of research that makes being at the UW so special.”

Originally published October 2016

CSNE Young Scholars Program participant Emily Boeschoten and electrical engineering postdoctoral fellow Ivana Milovanovic work on optimizing sensory feedback through novel haptic devices in Chet Moritz’ lab.

CSNE and electrical engineering Ph.D. student David Bjanes works with undergraduate and high school students in Chet Moritz’ lab.

Human test subject wearing an electroencephalogram (EEG) cap and bioengineering graduate student Dev Sarma in Rajesh Rao’s lab. In this experiment the EEG cap picks up electrical signals coming from the test subject’s brain and feeds them into a processor that controls a cursor on a video screen the subject is viewing. In effect, it allows the test subject to control the cursor on-screen through her thoughts alone.

Close-up of an electrocorticography (ECoG) grid. This ECoG grid is designed to both pick up and transmit electrical signals to and from the surface of the brain.

The CSNE offers research experiences, classroom visits and outreach events for precollege students and educators. Pictured is a demonstration at the Bloomin’ Brains Summer Camp showing how the electrical signal from muscles can power a robotic gripper.

CSNE neuroethics predoctoral fellow Tim Brown and electrical engineering graduate student Tyson Heo work with electromyography (EMG) sensing and haptic feedback in the UW BioRobotics lab.