Patient S3: The Woman Who Controlled a Robotic Arm With Her Brain

By Jessica Benko

15 years after she lost the ability to move her body, Cathy Hutchinson is learning how to use her brain to control a robotic arm.

prosthetic_atavist.jpg

A robotic hand manufactured by the German space agency (DLR).

Today scientists announced in the journal Nature the results of a landmark experiment in which paralyzed subjects were able to control a robotic arm using only their thoughts. The research, after decades of exploration, holds out promise for the future of restoring damaged bodies using robotic prostheses.

Led by researchers at Brown University, the Department of Veterans Affairs, and Massachusetts General Hospital, the study--known as BrainGate--utilized a device called the BrainGate Neural Interface System, implanted directly into the motor cortex of the participants. Wired to a bank of computers, the system was then able to decode their brain's neural signals for movement and translate them into robotic movement. "This work is a critical step," John Donoghue, the neuroscientist who developed BrainGate, said in a statement announcing the research, "toward realizing the long-term goal of creating a neurotechnology that will restore movement, control, and independence to people with paralysis or limb loss."

The two subjects--a 58-year-old woman identified as subject S3 and a 65-year-old man designated as T2, both with tetraplegia--were first able to control a cursor on a screen by thinking about its movement. They then graduated to an advanced humanoid robotic arm made by the German space agency DLR and an advanced prosthetic made by New Hampshire-based DEKA Research. When the subjects concentrated on moving the robotic appendages, their brain supplied the signals for their intent, BrainGate captured those signals, and the robotic limbs responded in turn.

The paper reports that both participants were able to "perform three-dimensional reach and grasp movements," including touching targets and grabbing a bottle. Perhaps most extraordinarily, however, "one of the study participants, implanted with the sensor five years earlier, also used a robotic arm to drink coffee from a bottle."

In the paper, that subject is S3, the female participant. Her real name is Cathy Hutchinson, and this is her story.

* * *

electricmind.jpgThe first thing Cathy Hutchinson became aware of upon waking from three weeks in the quiet of a coma, 16 years ago, was the rhythmic alternation of surge then draw: whoosh, hiss, whoosh, hiss. As the contours of a room began to resolve before her eyes, she discovered the source of the sounds--a ventilator machine beside her bed. Her eyes followed the curve of a plastic tube issuing from the noisy box until it disappeared under her chin, entering her body through the opening in her throat left by a tracheotomy. When she tried to raise her head, she discovered that she could not. No amount of effort allowed her to lift her hand or flex her feet.

Her last memories were of feeling sick, of passing out as her 18-year-old son, Brian, helped her up the stairs to her bedroom, of waking briefly on the rough carpet of the hallway, unable to move. She was 43, a healthy nonsmoker, single mother of two, post office employee.

On that spring day in 1996, it took doctors nearly 12 hours following Brian's emergency call to discover that Cathy had suffered a catastrophic brain-stem stroke. The brain stem is located at the base of the skull, a small region of primitive structures crucial to survival. It governs the critical functions of breathing, swallowing, blood-pressure regulation, and consciousness and conducts all messages between the brain and the spinal cord.

A brain-stem stroke is the sort of medical event that can result in death immediately or soon thereafter. But in Cathy, who was young and in otherwise good health, the stroke disconnected her brain from the descending motor tracts of her brain stem--the neural pathways carrying instructions to her muscles--leaving her "locked in," not only quadriplegic but also unable to speak. The ascending tracts, which carry sensory information from body to brain, remained intact, allowing her the experience of pain, itch, heat, and cold but not the possibility of addressing them. She had a sensate, lucid mind incapable of action.

What recovery her body was able to make had happened early on after the stroke. She could control her eyes, she could swallow and breathe on her own, and she could move her head slightly, which allowed her to operate the wheelchair with a button on the headrest behind her. She communicated through a system--developed by engineers at UMass Dartmouth's Center for Rehabilitation Engineering to track her eyes and convert her gaze into mouse clicks. In this way, she could slowly pick out letters on a keyboard, allowing her to use her gaze to email and do some basic Web browsing.

In 2005, a friend of Cathy's, a nurse, came across a call for participants for BrainGate, run out of Brown University. The researchers were seeking patients with quadriplegia for a pioneering experiment in which an electrode-studded implant would be embedded directly into the brain, in the hopes of identifying and decoding the neurological activity that governed physical movement. The short-term goal was to use signals from the brain to control computers and then assistive devices. The long-term goal was to bypass damaged sections of the spinal cord and restore movement.

The study's codirector, a conscientious young neuroscientist named Leigh Hochberg, was blunt with Cathy: Whatever the failures or successes of the study, she could not hope that the results would assist her in her lifetime. "There are no expected benefits this early on in the research," Hochberg told me. "What we're doing, and what Cathy knew when we were starting and what she enthusiastically joined, is an endeavor to test and develop a device we hope will help other people with paralysis in the future."

Cathy's device was implanted in 2005, and the researchers first target was for her to control a computer cursor. As Cathy concentrated on moving her hand, her efforts unspooled on screens in front of the researchers, who tried to use the information from her brain as a sort of virtual mind-controlled mouse. When the researchers turned control of the cursor over to Cathy's neurons, the cursor immediately began to move haltingly across the screen. Cathy couldn't believe her eyes. "I was numb with shock and disbelief," she wrote to me, "so I moved the cursor all over the screen."

Soon, she was navigating a rudimentary game the researchers called "neural Pong." But moving cursors on a screen involves interpretation of only two dimensions of intended movement in a digital environment. The next trials would require a great leap. The researchers wanted to give Cathy the ability to operate in physical space. They hoped to allow her to control a sophisticated robotic arm to stretch, grab, and move real objects in her surroundings--her first chance to do so in nearly 15 years.

The rest of Cathy's story can be found in The Electric Mind by Jessica Benko, out today from The Atavist. The full ebook single is available for sale through Kindle Singles, iBooks, The Atavist app, and other outlets via The Atavist website.

This article available online at:

http://www.theatlantic.com/health/archive/2012/05/patient-s3-the-woman-who-controlled-a-robotic-arm-with-her-brain/257262/