The New York Times > Health > With Tiny Brain = Implants, Just Thinking May Make It So

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George Ruhe = for The New=20 York Times

Dr. John = P.=20 Donoghue founded Cyberkinetics, which hopes to = implant=20 devices in the brain that will allow injured = patients to=20 operate computers by thought alone.=20


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With Tiny Brain Implants, Just Thinking May Make It=20 So

By ANDREW=20 POLLACK

Published: April 13,=20 2004

3DC=20 an a machine read a person's mind? A = medical=20 device company is about to find out.

The company, Cyberkinetics Inc., plans to implant a tiny = chip in=20 the brains of five paralyzed people in an effort to enable = them to=20 operate a computer by thought alone.

The Food and Drug Administration has given approval for a = clinical trial of the implants, according to the = company.

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The implants, part of what Cyberkinetics calls its = BrainGate=20 system, could eventually help people with spinal cord = injuries,=20 strokes, Lou Gehrig's disease or other ailments to = communicate=20 better or even to operate lights and other devices through a = kind of=20 neural remote control.

"You can substitute brain control for hand control, = basically,"=20 said Dr. John P. Donoghue, chairman of the neuroscience = department=20 at Brown University and a founder of Cyberkinetics, which = hopes to=20 begin the trial as early as next month.

The melding of man and machine has long been a staple of = science=20 fiction. Indeed, the participants in Cyberkinetics's = clinical trial,=20 who have not yet been chosen, will have a cable sticking out = of=20 their heads to connect them to computers, making them look = something=20 like characters in "The Matrix."

But in real life, several research groups have already = implanted=20 devices in monkeys that allow them to control cursors on = computer=20 screens or move robot arms using their brainpower alone, = setting the=20 stage for the trial in people.

"Among many people in the field, there's a feeling now = that the=20 time is here for moving the technology to test in humans," = said Dr.=20 Richard A. Andersen, professor of neuroscience at the = California=20 Institute of Technology, who is working on his own device = for the=20 brain. Still, for the trial, there is trepidation mixed with = anticipation.

"A disaster at this early stage could set the whole field = back,"=20 said Dr. Dawn M. Taylor, a research associate at Case = Western=20 Reserve University and the Cleveland Veterans Affairs = Medical=20 Center, who is testing similar systems in monkeys.

Devices have long been implanted in the brains of = patients with=20 Parkinson's disease to deliver pulses of electricity that = reduce=20 tremors and rigidity.

But systems like BrainGate do not deliver current.

Instead, they listen to the electrical signals produced = by the=20 brain's neurons as they work. The aim is to discern a = pattern of=20 neuronal activity indicating the intention to initiate a = particular=20 physical movement.

In typical monkey trials of neural implants, the animals, = which=20 are not paralyzed, are trained to perform a task, like = moving a=20 cursor with a joystick, while a tiny subset of their neurons = is=20 monitored.

After different patterns of neuronal signals are matched = with=20 different body movements, cursor control is shifted to their = brains.

In some studies, the monkeys eventually appeared to = realize that=20 they no longer had to move their arms to perform the = tasks.

In a sense, this is a form of mind reading, scientists = say. But=20 in addition to passively letting its thoughts be read, the = brain=20 also learns to control the cursor actively, just as it = acquires any=20 new skill.

The quadriplegics in the trial will not be able to move = their=20 arms to train the system, making things a little harder. = Instead,=20 they must imagine moving their arms.

Researchers have already shown that this can be done. Dr. = Philip=20 Kennedy, a neurologist in Atlanta who started Neural Signals = Inc.,=20 implanted electrodes into several severely disabled people = starting=20 in 1996, and at least one could type through this method, = though=20 only three words a minute.

Some other implants have been tested briefly on people = undergoing=20 brain surgery for other reasons. Dr. Jonathan R. Wolpaw of = the New=20 York State Department of Health has developed a system that = does not=20 require implants but uses electroencephalography to pick up = brain=20 waves using sensors attached to the scalp.

Though Cyberkinetics is not the first to try neural = control in=20 people, it seems the most intent on bringing a product to = market,=20 perhaps by 2007 or 2008, said its chief executive, Timothy = R.=20 Surgenor.

Started in 2001 and based in Foxborough, Mass., the = company has=20 raised $9 million for the project.

Cyberkinetics argues that its system will perform better = than=20 other systems tested on people so far. Devices that use = sensors=20 outside the skull do not pick up signals as clearly as = electrodes=20 under the skull. And though Dr. Kennedy implanted two = electrodes per=20 patient, the Cyberkinetics chip has 100 electrodes. That = means more=20 neurons can be monitored, providing clearer information, the = company=20 says.

To implant the chip, a small hole will be cut in the = patient's=20 skull, above the ear. The chip, which measures about 2 = millimeters=20 (or just under one-tenth of an inch) square, will be placed = on the=20 surface of the brain at the motor cortex, which controls=20 movement.

The electrodes, which are like spikes protruding from the = chip's=20 surface, will extend into the brain to a depth of 1 = millimeter.

The surgery will be performed at Rhode Island Hospital by = Dr.=20 Gerhard Friehs, an associate professor of neuroscience at = Brown and=20 a co-founder of Cyberkinetics, who performed the operations = on the=20 monkeys. Another neurosurgeon without connection to the = company will=20 monitor the procedure to ensure that financial interests do = not=20 dictate proceeding with surgery if it is not safe.

Technicians from Cyberkinetics will later visit the = participants,=20 whose identities will not be disclosed at first, several = times a=20 week at their homes to test the system for an hour or two a = day. The=20 trial will last about a year, and then the chips will be = removed in=20 a second operation.

Some scientists question whether the benefits will = outweigh the=20 risks.

One reason is that the signals from the chip are carried = out of=20 the body by wires coming through the skull. When the system = is to be=20 used, a cable will be connected to the wires.

The cable will carry the signals to a cart full of = electronic=20 equipment that will analyze them and convey the results to = the=20 computer. The opening in the skin is permanent and poses a = risk of=20 infection.

"We don't like to hang around with wires coming out of = our head,"=20 Dr. Kennedy said. His system used brain implants that = transmitted=20 signals by radio, so no break in the skin was required.

Some experts also question Cyberkinetics's requirement = that=20 participants in the trial be able to talk. Such people, the = experts=20 say, can control computers through other options, like = speech=20 recognition systems or head or eye movements.

"If you are only talking about moving a cursor up and = down on the=20 screen, you don't need to get into the brain to do that," = said Dr.=20 Miguel Nicolelis, professor of neurobiology at Duke.

In contrast, Dr. Nicolelis said, the system he is = developing will=20 control a robot arm, making three-dimensional movements that = will be=20 too complex to do without a neural implant. Dr. Kennedy = performed=20 his experiments on people who could not talk and had = virtually no=20 other means of communicating.

Mr. Surgenor of Cyberkinetics, however, said that having=20 participants who could talk would speed development of the=20 system.

"We need the feedback of what they are imagining when it = doesn't=20 work and what they are imagining when it works," he said. =

Dr. Jon Mukand of the Sargent Rehabilitation Center in = Warwick,=20 R.I., who will be the principal investigator of the trial = and will=20 select the participants, said the system had been proved = safe in=20 tests on 18 monkeys.

Infections were rare and treatable, Dr. Mukand said, and = the=20 incidence should be even lower in people, who understand the = risk.=20

Dr. Donoghue of Cyberkinetics said the prototypes for = many=20 medical devices, including pacemakers and cochlear implants, = had=20 involved wires coming out of the body.

One uncertainty is whether the implants will move around = over=20 time or cause scarring. Either could lead to loss of the = neuron=20 signal.

Another question is whether the system, if it does work, = will=20 prove superior to more mundane methods like voice = recognition or=20 even Dr. Wolpaw's electroencephalography system.

Cyberkinetics said it expected that its system would be = faster=20 than other methods, perhaps allowing people to type 20 to 30 = words a=20 minute, as fast as a healthy person could type on a = BlackBerry=20 hand-held computer.

Marcie Roth, executive director of the National Spinal = Cord=20 Injury Association, said the needs of paralyzed people = varied. A=20 system like BrainGate "could be fantastically useful for = some=20 people," she said.

Cyberkinetics said that it did not intend to sell the = current=20 version of BrainGate, but that it hoped eventually to offer = an=20 improved model. It would use miniaturized electronics and = would be=20 fully implanted in the brain, transmitting information = without=20 wires. The price is likely to be in the tens of thousands of = dollars, the company said.

Eventually, the system may come in a form that does not = have to=20 be calibrated by technicians each time it is turned on. It = would=20 always be ready to use, as if it were a part of the = body.

"You don't wake up and turn on your hand," Mr. Surgenor = said.=20

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