Recently, a group of researchers from the Swiss Federal Institutes of Technology (EPFL), Lausanne University Hospital (CHUV) and The Foundation for Research on Information Technologies in Society (IT’IS) had facilitated three spinal cord injury (SCI) patients to stand and walk again with the use of assistive tools.
Wireless electrodes were placed at the lower back of these patients so that electrical impulses which synchronize with their intended movements will be sent to the muscles. Researchers believe nerves around the injured area will adapt and form new pathways which strengthens patients’ muscle control.
Technology behind the targeted neurotechnology – EES
Epidural Electrical Stimulation (EES) has been around for decades and it was initially adopted for pain relief. In fact, this September, two separate groups of researchers from Mayo Clinic and Kentucky spinal cord injury research center had found multimodal rehabilitation, which coupled continuous EES with locomotor training improved movements of SCI patients.
So what went unmentioned was the targeted technology which the Swiss research team had employed. The team used Sim4Life, a simulation platform with models to give researchers a patient-oriented guideline on where to position the electrodes and how much stimulation is to be given. To accompanied their findings, the team also released a paper on the same day, hypothesizing the reason why EES is often less effective as compared to rats.
The team believes EES hinders a substantial amount of position-movement sensation. This proprioception hiatus affects one’s locomotive reciprocal inhibition and completely removes or reduces their knowledge of leg position. Thus, a longer training period is required to see improvements. This made targeted EES an even more distinct achievement because instead of stimulating everything within the area, it enables researchers to activate preferential areas when the patient is trying to walk.
Questions on ethics of neurotechnology again
Last May, the Morningside Group had come together to discuss the ethics revolving around neurotechnology, stating that the present ethics principles from Declaration of Helsinki, the Belmont Report, and the Asilomar AI statement of cautionary principles may not be updated enough to keep up on our present technology progress. The discussion put a specific emphasis on brain-computer interface, something which researchers had tested on paralyzed primates two years ago to bypass injured area and form new neural pathways for leg muscles.
One of the concerns the group had raised was augmentation, whether SCI individuals will develop non-realistic feeling in the process of gaining abilities to walk again with the help of electrical or machine stimulation, just like individuals who are learning to gain control of their robotic arms. Conversely, will healthy individuals employed similar methods to enhance their existing capabilities.
Both targeted EES and the discussion of neurotechnology ethics are still in their infancy. While the success of the Swiss team gives researchers a head start to further explore if the method works for new SCI patients and expand on the evidence to classify SCI severity; the debate on ethics will eventually goes into the regulation for widespread usage.