Brain Implant Lets ALS Patient Communicate

Nancy Crotti

November 14, 2016

3 Min Read
Brain Implant Lets ALS Patient Communicate

A paralyzed Dutch physician implanted with Medtronic devices was able to operate a speech computer by imagining using her fingers. 

Medtronic Activa

Nancy Crotti

An implanted brain-computer interface that utilizes Medtronic components has allowed a paralyzed woman to communicate using only her thoughts.

Researchers in the Netherlands implanted deep-brain stimulation components made by Medtronic in a 58-year-old internist and late-stage ALS patient Hanneke De Bruijne, MD, in October 2015. 

Until receiving the implant, De Bruijne was able to communicate with eye movements and blinks using an eye tracker, but was otherwise completely paralyzed.

The researchers implanted Medtronic Resume II electrode strips over the hand region of De Bruijne's left motor cortex, based on previous research showing that quadriplegic patients can generate neuroelectrical activity by trying to move their hands, according to an article in the New England Journal of Medicine.  In a separate procedure, they placed a Medtronic Activa deep-brain stimulation transmitter subcutaneously beneath her left clavicle. When De Bruijne attempted to move the hand on the opposite side of the implanted electrodes, she could accurately and independently control a computer-typing program at a rate of two letters per minute 28 weeks after implantation.

The patient ultimately received a home-use system that included automated decoding, fixed settings, and a commercial spelling program all running on a tablet. On day 197, she started using the system independently. Over time, the mental effort needed during spelling declined from a patient-rated difficulty level of 5 to a mean of 2.8. The time required to spell dropped from an initial 52 seconds per letter to 33 seconds when word prediction was used.

"It's like a remote control in the brain," researcher Nick Ramsey told the New York Times. Ramsey is a professor of cognitive neuroscience at UMC Utrecht.

The system is the first of its kind that a patient has been able to use successfully in her daily life, added Jonathan Wolpaw, MD, director of the National Center for Adaptive Neurotechnologies.

De Bruijne volunteered to have the system implanted, according to a report by New Scientist.

"I want to contribute to possible improvements for people like me," the article quoted her saying.

The Activa won the CE Mark in 2013 for use in patients with Parkinson's disease, essential tremor, or epilepsy, but is only approved for research purposes in the U.S. It was designed for deep-brain stimulation and biopotential recording, and allows for long-term electrocorticography. Medtronic provided all components of the implant, plus the antenna and receiver, free of charge to the University Medical Center Utrecht, and contributed funds to the Dutch government agency that funded this study, according to the journal article. 

Nancy Crotti is a contributor to Qmed.

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[Image of Medtronic Activa courtesy of Medtronic]

About the Author(s)

Nancy Crotti

Nancy Crotti is a frequent contributor to MD+DI. Reach her at [email protected].

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