Walking naturally after spinal cord injury using a brain–spine interface

A spinal cord injury interrupts the communication between the brain and the region of the spinal cord that produces walking, leading to paralysis. Here, we restored this communication with a digital bridge between the brain and spinal cord that enabled an individual with chronic tetraplegia to stand and walk naturally in community settings. This brain–spine interface (BSI) consists of fully implanted recording and stimulation systems that establish a direct link between cortical signals and the analogue modulation of epidural electrical stimulation targeting the spinal cord regions involved in the production of walking. A highly reliable BSI is calibrated within a few minutes. This reliability has remained stable over one year, including during independent use at home. The participant reports that the BSI enables natural control over the movements of his legs to stand, walk, climb stairs and even traverse complex terrains. Moreover, neurorehabilitation supported by the BSI improved neurological recovery. The participant regained the ability to walk with crutches overground even when the BSI was switched off. This digital bridge establishes a framework to restore natural control of movement after paralysis.

Henri Lorach, Andrea Galvez, Valeria Spagnolo, Felix Martel, Serpil Karakas, Nadine Intering, Molywan Vat, Olivier Faivre, Cathal Harte, Salif Komi, Jimmy Ravier, Thibault Collin, Laure Coquoz, Icare Sakr, Edeny Baaklini, Sergio Daniel Hernandez-Charpak, Gregory Dumont, Rik Buschman, Nicholas Buse, Tim Denison, Ilse van Nes, Leonie Asboth, Anne Watrin, Lucas Struber, Fabien Sauter-Starace, Lilia Langar, Vincent Auboiroux, Stefano Carda, Stephan Chabardes, Tetiana Aksenova, Robin Demesmaeker, Guillaume Charvet, Jocelyne Bloch, Grégoire Courtine