Coordinating BCIs

by James Cavuoto, editor

Over the last few years, media attention to advances in brain-computer interface technology has spiked considerably, in large part because of announcements by Elon Musk about his firm, Neuralink. Make no mistake, Neuralink’s progress has been noteworthy, particularly reports from the company’s first patient, who was able to move a computer cursor and play computer games using the company’s implanted device.

But putting aside the fact that numerous other BCI users have previously demonstrated similar capabilities, the public clamor over Neuralink’s progress seems misguided in at least one respect. And that has to do with the fact that BCIs are often touted as a means of restoring function to people paralyzed by disabling conditions such as ALS, spinal cord injury, or brainstem stroke. While BCIs can do a good job of reading a user’s intent, the much more critical tasks of animating paralyzed limbs, restoring walking or hand function, or returning sensation rely on advances in motor prosthetics, functional electrical stimulation, and neurorobotic technology.

In this regard, we were encouraged to see European firm ONWARD receive support for its ARC-BCI system, which promises integration of BCI technology with the company’s ARC-IM therapy to restore mobility after spinal cord injury. ONWARD announced that it was awarded FDA breakthrough device designation and that it has been accepted into the FDA’s new Total Product Lifecycle Advisory Program for ARC-BCI.

Also encouraging was the announcement that the Christopher & Dana Reeve Foundation recently awarded three new spinal cord injury research grants totaling $3.1 million. The grants support clinical trials and research tools aimed at accelerating the therapeutic development of SCI treatments. Two grants have been awarded to .NeuroRestore, a research, innovation and treatment center that develops and applies bioengineering strategies involving neurosurgical interventions to restore neurological functions.

Other commercial firms, including Aneuvo and SpineX, are also pursuing restoration of function to people living with paralysis and the efforts of numerous research institutions, most notably the Cleveland Functional Electrical Stimulation Center at Case Western Reserve University, have been paramount in this decades-long effort.

Observing the public fawning over Neuralink and other BCI efforts while ignoring efforts to restore motor function reminds us of a Wall Street Journal article from 2010 in which the reporter probed FES pioneer Jennifer French on the need for a BCI while sidestepping the progress she had already shown in standing and walking. Now, as back then, the public needs to fully understand that restoring function to severely disabled people cannot be accomplished with brain implants alone.

Fortunately, French has continued her efforts to educate the public and the SCI community about the full potential of neurotechnology through her work as executive director of the nonprofit Neurotech Network. She also played a role in establishing the new Implantable Brain-Computer Interface Collaborative Community, an initiative aimed at fostering collaboration among diverse stakeholders to accelerate the development, safety and accessibility of BCI technologies. The new organization brings together researchers, clinicians, medical device manufacturers, patient advocacy groups, and individuals with lived experience of neurological conditions. “Bringing diverse perspectives together, including those with lived experience, is a critical component to help address complex issues facing this field,” she said.

Hopefully, the general public and the media will catch on to the fact that progress in neurotechnology involves coordinated advances in sensing and stimulation technologies involving the brain and other key physiological systems.