Health

Brain Implant Enables Completely 'Locked-In' Man to Communicate Again – ScienceAlert

Published

2 years ago

March 23, 2022

A pair of brain microchips could one day allow those in ‘pseudocomas‘ to communicate whatever they want, a new breakthrough suggests.

In a first, a 34-year-old patient who lacked even the most subtle of muscle twitches has used the technology to share a few precious words with his family, using little more than an intent to move his eyes.

Similar devices have previously given patients with the fast-progressing condition amyotrophic lateral sclerosis (ALS) the means to send simple messages with extremely limited movements, but researchers say the severity of the man’s condition here represents a significant advancement for the technology.

“To our knowledge, ours is the first study to achieve communication by someone who has no remaining voluntary movement and hence for whom the BCI is now the sole means of communication,” says neuroscientist Jonas Zimmermann from the Wyss Center in Switzerland.

A pseudocoma is also known as ‘locked-in’ syndrome, because while these patients cannot walk or talk, they are still very much conscious, capable of seeing, hearing, tasting, smelling, thinking, and feeling.

Without the ability to move the mouth or the tongue, however, communication is severely limited. If the eyes can still move, patients can sometimes blink or ‘point’ with their pupils to make themselves understood, but in some advanced cases, even that basic form of communication is out of reach.

The man in this case was one such patient. Within months of diagnosis with the condition, he had already lost the ability to walk and talk. A year later, the patient was placed on a ventilator to help him breathe. A year after that, he lost the ability to fix his gaze.

The extreme isolation ultimately led the patient and his family to agree to a cutting-edge experiment.

Before the patient lost the ability to move his eyes, he consented to a surgical procedure that would implant two microchips into the part of his brain that controls muscle movement.

Each chip was equipped with 64 needle-like electrodes, which could pick up on his conscious attempts to move. That brain activity was then sent to a computer, which translated the impulses into a ‘yes’ or ‘no’ signal.

In the past, similar brain implants have allowed some patients with ALS to communicate via a computer typing program. But this is the first time an ALS patient without the ability to so much as use their eyes has been able to do something similar.

“People have really doubted whether this was even feasible,” Mariska Vansteensel, a brain-computer interface researcher who was not involved in the study, told Science.

(Chaudhary et al., Nature Communications, 2022)

Above: The experimental setup of the brain implants, plus the biofeedback device and the spelling program.

The technique took months of training, but once the patient learned how to control the firing rates of his brain signals, he was able to respond to a spelling program and select specific letters, spoken out loud by the program, to form words and even sentences.

Each letter the patient heard took about a minute for the patient to respond to, making for slow progress, but nonetheless, for the first time in a long time, the device allowed this man to express himself.

The accuracy of the technology is still not perfect. The patient could only signal ‘yes’ or ‘no’ about 80 percent of the time, with about 80 percent accuracy. Some days he could only generate words, not sentences.

“These apparent poor performances are primarily due to the completely auditory nature of these systems, which are intrinsically slower than a system based on visual feedback,” the authors write in their study.

The first phrase the ALS patient successfully spelled out was a ‘thank you’ to the lead neurobiologist on his case, Niels Birbaumer.

Then, came a slew of requests for his care, like “Mom head massage” and “I would like to listen to the album by Tool [a band] loud”.

Then, 247 days after the surgical procedure, the patient gave his verdict on the device: “Boys, it works so effortlessly”.

On day 251 he sent a message to his kid: “I love my cool son”. He then asked his child to watch a Disney film with him.

On day 462, the patient expressed that his “biggest wish is a new bed”, and that the next day he could go with his loved ones to a barbecue.

“If someone is forming sentences like this, I would say it is positive. Even if it is not positive, it is not negative,” first author of the study Ujwal Chaudhary told The Guardian.

“One time when I was there, he said, ‘Thank you for everything, sister’ [to his sister, who helps care for him]. It was an emotional moment.”

The ability for someone in a pseudocoma to communicate obviously comes with a whole slew of ethical considerations.

After all, who condones the initial insertion? And once a person has learned to communicate again, can they speak for themselves and the future of their care? How accurate do these systems need to be before we can adequately interpret what patients are telling us?

We don’t have rules or outlines for this type of technology quite yet, but if the device turns out to be useful for other patients, we will need to start confronting these quandaries.

Giving advanced ALS patients their voices back could be a huge medical breakthrough and a great relief for individuals and their families. How we respond to those voices is up to us.

The study was published in Nature Communications.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

Published

1 day ago

September 13, 2024

Anne Joseph

The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

Published

3 days ago

September 11, 2024

Anne Joseph

HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

Published

4 days ago

September 10, 2024

Anne Joseph

ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

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