ALS Patient First to Communicate With Brain Implant: 'I Love My Cool Son'

For the first time, a paralyzed man has been able to communicate via neural signals due to the implementation of a brain implant.

The patient, 36, was the focus of a recent study published in Nature, which strove to understand whether or not neural-based communication remains possible in a completely "locked-in" state.

The patient has amyotrophic lateral sclerosis, or ALS, which is commonly known as Lou Gehrig's disease. Mayo Clinic describes it as a progressive nervous system disease that affects nerve cells in the brain and spinal cord causing loss of muscle control. Its cause is often unknown, although some cases can be inherited.

Brain Implant
A brain implant was inserted into a male with ALS, eventually leading to communication conducted by various tones and pitches due to neural signals. Wyss Center

Jonas Zimmermann, study co-author and senior neuroscientist at the Wyss Center in Geneva, Switzerland, told Newsweek that both the electrodes and the idea behind the neurofeedback paradigm have been well studied. He and fellow researchers spent about a year setting up this recent experiment, which included receiving all necessary regulatory and ethical approvals.

The software to decode neural signals was developed at the Wyss Center.

"This study shows that this one completely locked-in person, I.E. someone who had lost any and all means to communicate through speaking, blinking, or eye movements, etc., could communicate with this implant," Zimmermann said. "This means that possibly other patients could benefit from this kind of technology as well."

Science reported that the patient could still move his eyes in 2018 when he started working with a research team at the University of Tübingen. After inquiring with researchers about an invasive implant that would allow him to maintain communication with his family, his wife and sister provided written consent for the surgery.

"Speller sessions" were utilized in the more recent study in which the patient selected letters to form sentences, allowing him to communicate.

During the experimental period, the study's authors performed experimental sessions on 107 out of 135 days, as neurofeedback performance criterion was not reached in the remaining 28 days.

"The patient produced intelligible output, as rated independently by three observers, on 44 of 107 days when the speller was used," the study notes. "On average, 121 minutes were spent spelling and the average length of these communications was 131 characters per day."

The patient's intelligible messages comprised 5,747 characters produced over 5,338 minutes, or an average rate of 1.08 characters per minute. There was no trend in spelling speed throughout the duration of the sessions.

Researchers adhered to different tones to allow the subject to communicate. Control over neural "firing rates" was trained, as the patient was instructed to match the frequency of target tones.

Audible tones and pitches signified different groups of letters, and then individual letters, in a "yes" or "no" response system. In a period of 12 days, the patient reportedly advanced from moving the tone to matching it to a target pitch to facilitate a certain response.

On the second day of free spelling, or the 107th day following implantation, the patient spelled phrases, spelled in three-time episodes—including thanking the team of researchers, in addition to numerous communications regarding his care, such as repositioning his body, asking for a head massage, or requesting the removal of socks for the night.

Brain Implant
Real-time neural signal processing is conducted at the Wyss Center in Geneva, Switzerland, on a patient with ALS. Wyss Center

Social communication later became more common, such as a request to listen to an album by the band Tool; or requesting a beer. Between days 253 and 462, he asked for goulash soup and sweet pea soup, curry with potato, then Bolognese, and potato soup, respectively.

He also acknowledged his family.

"I love my cool son," the patient said on day 251, and two days later asked his son if he wanted to watch Disney's Robin Hood.

Zimmermann said that "especially in ALS" each patient is different. Hence, this was a single case and more work with other participants is required to see if they too achieve the same benefits.

As for the patient involved in this particular study, Zimmermann said he is not currently "communicating as richly" as he did just a year ago. "We investigate potential technical issues with the electrodes, as well as possible changes in neural activity as a result of advancement of the condition," he added.

That includes a new implant called ABILITY that was developed at the Wyss Center, which allows for patients' ease of use in addition to fluency in communication.

Similar studies were previously conducted in 2016. A female patient could reportedly spell out sentences due to a brain implant, according to a study in The New England Journal of Medicine. However, the patient reportedly had minimal control of certain eye and mouth muscles and communication was limited.

In December, President Joe Biden signed a bill into law to advance research for ALS.