Long-Term Training with a Brain-Machine Interface-Based Gait Protocol Induces Partial Neurological Recovery in Paraplegic Patients

• DOI: 10.1038/srep30383
• Publication Date: 2016-08-11T13:14:50Z
• Authors: Ana R. C. Donati; Solaiman Shokur; Edgard Morya; Debora S. F. Campos; Renan C. Moioli; Claudia M. Gitti; Patricia B. Augusto; Sandra Tripodi; Cristhiane G. Pires; Gislaine A. Pereira; Fabricio L. Brasil; Simone Gallo; Anthony A. Lin; Angelo K. Takigami; Maria A. Aratanha; Sanjay Joshi; Hannes Bleuler; Gordon Cheng; Alan Rudolph; Miguel A. L. Nico...
• Keywords: Neurorehabilitation; Proprioception; Paraplegia; Gait training; Powered exoskeleton

Brain-machine interfaces (BMIs) provide a new assistive strategy aimed at restoring mobility in severely paralyzed patients. Yet, no study animals or human subjects has indicated that long-term BMI training could induce any type of clinical recovery. Eight chronic (3-13 years) spinal cord injury (SCI) paraplegics were subjected to (12 months) with multi-stage BMI-based gait neurorehabilitation paradigm locomotion. This combined intense immersive virtual reality training, enriched visual-tactile feedback, and walking two EEG-controlled robotic actuators, including custom-designed lower limb exoskeleton capable delivering tactile feedback subjects. Following 12 months this paradigm, all eight patients experienced neurological improvements somatic sensation (pain localization, fine/crude touch, proprioceptive sensing) multiple dermatomes. Patients also regained voluntary motor control key muscles below the SCI level, as measured by EMGs, resulting marked improvement their index. As result, 50% these upgraded an incomplete paraplegia classification. Neurological recovery was paralleled reemergence imagery cortical level. We hypothesize unprecedented results from both plasticity triggered usage.