Innovative Brain-Computer Interface for People With Spinal Cord Injury

Overview

The goal of this clinical trial is to demonstrate control of digital devices through a brain implant in people with spinal cord injury. The main question it aims to answer is efficient, independent, BCI-based control over digital devices in settings of daily living of an individual with SCI. In this project an advanced generation fully implantable BCI system will be used, the Brain InterChange (BIC) from CorTec. Participants will be implanted with an electrode grid on the surface of the brain and an amplifier/transmitter on the skull, under the skin. Participation includes visits of researchers for recording and training at home, 1-3 times per week for one year. Extension of participation after one year is possible. If successful, the participant will be able to use the BCI at home independently, without the presence of a researcher.

Spinal Cord Injury (SCI) results in motor impairments in body parts innervated by the spinal cord below the site of the lesion. In addition to loss of leg movements, individuals with high cervical SCI experience significant impairments in arm and hand function (tetraplegia), impacting their access to digital devices, with obvious consequences for their ability to communicate, participate in society and the workforce, autonomously manage their life, and benefit from the entertainment options digital devices offer these days. Current assistive technologies (AT) for control over digital devices, such as voice control, eye-tracking, and head- or mouth-controlled devices, are often unintuitive, slow, limited in functionality, aesthetically unattractive, and they often interfere with regular movement or speech. An effective Brain-Computer Interface (BCI) would enable individuals with SCI to use movement-related neural signals to directly control digital devices, taking away the disadvantages of current AT. This would dramatically improve their quality of life. The Brain InterChange from CorTec is an active implantable medical device for measurement of neuronal activity and electrical stimulation of the human nervous system, comprising an internal and an external unit. The internal unit consists of a small high-density ECoG grid with 32 contacts placed subdurally and a connected implantable amplifier/transmitter device that is placed subcutaneously. The external unit comprises a headpiece, for power transmission to the internal unit, a communication unit, that receives the data transmitted from the internal unit and controls the power transmission, and a USB cable, that connects the communication unit to the computer that has software to process and translate the brain data to a means of digital device control for SCI patients with custom in-house software developed during this study. The BCI system also allows to provide users with somatosensory feedback about their motor attempts (in addition to the visual feedback), by delivering electrocortical stimulation (ECS) to the somatosensory regions of the brain. As such, the aim is to generate a more natural relation between intent (movement attempt of a body part) and effect (sensation in the same body part), which is expected to lead to fast training and accurate BCI performance.