Hanneke de Bruijne, an amyotrophic lateral sclerosis (ALS) patient received in 2015 a brain implant that lets her communicate with others without using the typical eye-tracking device. The brain implant is capable of reading de Bruijne’s attempt to move her right hand, which transmits the information to her chest and then to a tablet that lets her select the letter she needs to say what she is thinking.

The new implant works with a computer interface that helps her communicate with others without medical assistance nor interference from the light. Eye-tracking devices are a great tool for ALS patients, but some of them are affected by strong lights, including the sun, and failed to recognize which words is the person trying to use. Another obstacle for ALS patients is that some of them even lose their ability to move their eyes. Thus, another option is needed for people diagnosed with the condition besides eye-tracking equipment.

Hanneke de Bruijne of the Netherlands was diagnosed with ALS in 2008. Image Credit: De Ingenieur

A study published in the New England Journal of Medicine on Saturday revealed the innovative brain implant. The paper explains the method used to make the implant work in de Bruijne’s brain and how it has improved her life and the way she communicates with her family and others.

Researchers from University Medical Center Utrecht in the Netherlands developed the implant and the technology that makes it work and set it in de Bruijne’s brain in October 2015. The implant is based solely on her brain activity, and she does not need any assistance to use it.

Nick Ramsey is a professor of neuroscience at the Brain Center Rudolf Magnus which is part of University Medical School Utrecht and explains the brain implant in de Bruijne is the first of the world. And even when is slower than an eye-tracking device, Hanneke du Bruijne says she is very happy with it and prefers it over the eye-tracking she used to use.

“The implant gives me freedom, independence, and safety. It enables me to enjoy my garden and going outdoors in nature,” de Bruijne wrote in an email composed on a tablet linked to her implant.to CNN.

Putting and implant inside an ALS patient: A technology that manages to read brain activity

The implant is completely invisible since it is surgically implanted inside de Bruijne’s body. Two electrodes were set over the motor cortex region of her brain. That area controls movement and whenever it reads a signal it sends it to a transmitter that has been implanted in de Bruijne’s chest. It is the size of a pacemaker and is the one in charge to pass the brain information to a receiver connected to a computer screen that shows letters in a grid.

The innovative device shows a square moving over the letters on the screen and when it lands on the letter the patient wants to choose, de Bruijne has to try to move her right hand to “press” the letter at that moment. ALS patients cannot move their legs, arms, and they reach the point to stop breathing by themselves. Still, their brain is healthy, and the implant is capable of reading the brain signal that is telling the body to move the right arm.

The placement of the electrodes is crucial. One has to be precisely positioned over the part of the brain responsible for moving the right hand and the other in the region where the brain is active when people want to count backward. If there is an error of calculation, the implant will not work.

De Bruijne has to spell the words she wants to use to communicate and after several months of practice, she managed to write two letters per minute. The implant is slower than an eye-tracker but Ramsay, and his colleagues, plan to make their invention faster and sophisticated.

The goal is to speed the process of the implant by adding more electrodes. Ramsay is planning between 30 to 60 new electrodes to try to decode sign language or internal speech. He told CNN that the implant could make ALS patients spell like a deaf person.

Hanneke de Bruijne was diagnosed with ALS in 2008. She has three children, and since the doctors discovered she had the disease, it took her eight years to lose movement of her entire body, being only able to move her eyes. She said that the implant makes her feel more secure and independent inside and outside because communication is better with her new additions.

brain interface
Image Credit: CNN

The brain implant in de Bruijne is encouraging, but scientists have their doubts

The study only talks about one patient, and for statistics, the research is not significant, although it is interesting. Karen Pearce, director for the Motor Neurone Disease Association, thinks that the implant would not work with people with slow processing motor neuron disease (MND) in the UK. The cost of the procedure is high, and the follow-up could be an obstacle.

Nevertheless, Pearce said that brain-computer interface technology is still developing and further research in this and similar fields are the only thing closer to create devices that can improve MND and ALS patients’ life.

Kevin Talbot, head of the clinical neurology unit and professor of motor neuron biology at the University of Oxford stressed that ALS patients degeneration happens rapidly and subjects of trials might die before improving their implants. He thinks it is vital to find treatments to slow down the process to use the implants in a wider population. Otherwise, only people with a slowly progressive disease would have the chance to use it, CNN reported.  

Source: The New England Journal of Medicine