“I feel like a toddler, learning to walk again,” Gert-Jan Oskam told the BBC. The 40-year-old Dutchman was paralysed in a cycling accident 12 years ago. Now electronic brain implants let him stand, climb stairs and walk, simply by thinking about it.
The work, led by Swiss researchers, was published in the journal Nature. Oskam calls it a medical first that has changed his life. “It has been a long journey, but now I can stand up and have a beer with my friend,” he said. “It’s a pleasure that many people don’t realise.”
Building on earlier patients
The brain implants extend earlier work by Prof Grégoire Courtine of the École Polytechnique Fédérale in Lausanne (EPFL). That version used only a spinal implant, which amplified weak signals from the brain to the damaged part of the spine and was boosted by pre-programmed signals from a computer.
BBC News has covered two people helped by it. In 2018 David M’Zee became the first patient treated successfully with a spinal implant, and he and his wife were later able to have a baby, which had not been possible before. Last year Michel Roccati became the first man with a completely severed spine to walk again.
Both gained a great deal. Yet their walking is pre-programmed and looks robotic, and they must keep their intended movements in step with the computer, stopping to reset if they drift out of sync.
Oskam had the spinal implant alone before the brain implants were added. The difference, he says, is control. “I felt before that the system was controlling me, but now I am controlling it.”
Courtine says Oskam’s movement is slow but smooth. “Seeing him walk so naturally is so moving,” he said. “It is a paradigm shift in what was available before.”
A long road to the clinic
Prof Jocelyne Bloch, the Lausanne neurosurgeon who carried out the surgery, was blunt about the timeline. The system is at a basic research stage and many years from being offered to paralysed patients. Her aim, she told BBC News, is to get it out of the lab and into the clinic as soon as possible. “The important thing for us is not just to have a scientific trial, but eventually to give more access to more people with spinal cord injuries who are used to hearing from doctors that they have to get used to the fact that they will never move again.”
Harvey Sihota, chief executive of the UK charity Spinal Research, was not involved in the study. He called the development “very encouraging” while noting there was a long way to go.
Neither the older system nor the new one can run all day. Both are bulky and experimental, so patients use them for an hour or so a few times a week during recuperation. Walking trains the muscles, and some movement has returned even with the system off, which suggests damaged nerves may be regrowing.
The eventual goal is to make the equipment smaller. Courtine’s spin-out company, Onward Medical, is working to commercialise it for everyday use. “It’s coming,” Courtine says.
