Ann Johnson was just 30 years old when she experienced a life-altering stroke in 2005 that left her paralyzed and unable to speak. At the time, she was a math and P.E. teacher at Luther College in Regina, had an eight-year-old stepson and had just welcomed a baby girl into the world.
The stroke left her with locked-in syndrome (LIS), a rare neurological disorder that can cause full paralysis except for the muscles that control eye movement, the National Institutes of Health writes.
Johnson, now 47, described her experience with LIS in a paper she wrote for a psychology class in 2020, painstakingly typed letter by letter.
“You’re fully cognizant, you have full sensation, all five senses work, but you are locked inside a body where no muscles work,” she wrote. “I learned to breathe on my own again, I now have full neck movement, my laugh returned, I can cry and read and over the years my smile has returned, and I am able to wink and say a few words.”
A year later, in 2021, Johnson learned of a research study that had the potential to change her life. She was selected as one of eight participants for the clinical trial, offered by the departments of neurology and neurosurgery at the University of California, San Francisco (UCSF), and was the only Canadian.
“I always knew that my injury was rare, and living in Regina was remote. My kids were young when my stroke happened, and I knew participating in a study would mean leaving them. So, I waited until this summer to volunteer – my kids are now 25 and 17,” she writes.
Now, the results of Johnson’s work with a team of U.S. neurologists and computer scientists have come to fruition.
A study published in Nature on Wednesday revealed that Johnson is the first person in the world to speak out loud via decoded brain signals.
An implant that rests on her brain records her neurological activity while an artificial intelligence (AI) model translates those signals into words. In real time, that decoded text is synthesized into speech, spoken out loud by a digital avatar that can even generate Johnson’s facial expressions.
Ann Johnson sits in front of a digital avatar, through which she can speak out loud via a brain-compter interface.
Noah Berger/UCSF
The system can translate Johnson’s brain activity into text at a rate of nearly 80 words per minute, much faster than the 14 words per minute she can achieve typing out words with her current communication device, which tracks her eye movements.
The breakthrough was demonstrated in a video released by UCSF, in which Johnson speaks to her husband for the first time using her own voice, which the AI model can mimic thanks to a recording of Johnson taken on her wedding day.
“How are you feeling about the Blue Jays today?” her husband Bill asks, wearing a cap from the Toronto baseball team.
“Anything is possible,” she responds via the avatar.
Johnson’s husband jokes that she doesn’t seem very confident in the Jays.
“You are right about that,” she says, smiling.
Ann Johnson working with researchers on a technology that allows her to speak via brain signals after a stroke left her paralyzed.
Noah Berger/UCSF
The research team behind the technology, known as a brain-computer interface, hopes it can secure approval from U.S. regulators to make this system accessible to the public.
“Our goal is to restore a full, embodied way of communicating, which is the most natural way for us to talk with others,” says Edward Chang, chair of neurological surgery at UCSF and one of the lead authors of the study. “These advancements bring us much closer to making this a real solution for patients.”
So, how did they do it?
The team surgically implanted a paper-thin grid of 253 electrodes onto the surface of Johnson’s brain, covering the areas that are important for speech.
“The electrodes intercepted the brain signals that, if not for the stroke, would have gone to muscles in Ann’s lips, tongue, jaw and larynx, as well as her face,” a news release from UCSF reads.
Those brain signals get transferred into a port that is screwed onto the outside of Johnson’s head. From there, a cable that plugs into the port can be hooked up to a bank of computers that decode the signals into text and synthesize the text into speech.
Animation of the brain implant Ann Johnson received that allows her to speak via a digital avatar.
Noah Berger/UCSF
The AI model doesn’t exactly decode Johnson’s thoughts, but interprets how Johnson’s brain would move her face to make sounds — a process that also allows the AI to generate her facial expressions and emotions.
The AI translates these muscle signals into the building blocks of speech: components called phonemes.
“These are the sub-units of speech that form spoken words in the same way that letters form written words. ‘Hello,’ for example, contains four phonemes: ‘HH,’ ‘AH,’ ‘L’ and ‘OW,’” according to the UCSF release.
“Using this approach, the computer only needed to learn 39 phonemes to decipher any word in English. This both enhanced the system’s accuracy and made it three times faster.”
Over the course of many weeks, Johnson worked with the research team to train the AI to “recognize her unique brain signals for speech.”
They did this by repeating phrases from a bank of 1,024 words over and over again until the AI learned to recognize Johnson’s brain activity associated with each phoneme.
“The accuracy, speed and vocabulary are crucial,” said Sean Metzger, who developed the AI decoder with Alex Silva, both graduate students in the joint bioengineering program at UC Berkeley and UCSF. “It’s what gives Ann the potential, in time, to communicate almost as fast as we do, and to have much more naturalistic and normal conversations.”
Ann Johnson, 47, can speak out loud again for the first time after she was paralyzed in a stroke that happened in 2005.
Noah Berger/UCSF
Johnson is still getting used to hearing her old voice again, generated by the AI. The model was trained on a recording of a speech Johnson gave on her wedding day, allowing her digital avatar to sound similar to how she spoke before the stroke.
“My brain feels funny when it hears my synthesized voice,” she told UCSF. “It’s like hearing an old friend.
“My daughter was one when I had my injury, it’s like she doesn’t know Ann.… She has no idea what Ann sounds like.”
Her daughter only knows the British-accented voice of her current communication device.
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Another bonus of the brain-computer interface is that Johnson can control the facial movements of her digital avatar, making its jaw open, lips protrude and tongue go up and down if she wishes. She can also simulate facial expressions for happiness, sadness and surprise.
“When Ann first used this system to speak and move the avatar’s face in tandem, I knew that this was going to be something that would have a real impact,” said Kaylo Littlejohn, a graduate student working with the research team.
The next steps for the researchers will be to develop a wireless version of the system that wouldn’t require Johnson to be physically hooked up to computers. Currently, she’s wired in with cables that plug into the port on the top of her head.
“Giving people like Ann the ability to freely control their own computers and phones with this technology would have profound effects on their independence and social interactions,” said study co-author David Moses, a professor in neurological surgery.
A researcher plugs a wire into a port that is screwed into Ann Johnson’s head, which is connected to the grid of electrodes resting on her brain.
Noah Berger/UCSF
Johnson says being part of a brain-computer interface study has given her “a sense of purpose.”
“I feel like I am contributing to society. It feels like I have a job again. It’s amazing I have lived this long; this study has allowed me to really live while I’m still alive!”
Johnson was inspired to become a trauma counsellor after hearing about the Humboldt Broncos bus crash that claimed the lives of 16 young hockey players in 2018. With the help of this AI interface, and the freedom and ease of communication it allows, she hopes that dream will soon become a reality.
New Brunswick‘s Liberal and Green parties are set to make announcements about health care on the campaign trail today as the provincial election race enters its second half.
Liberal leader Susan Holt is scheduled to hold her announcement this morning in Saint John, N.B., followed by lunch at the city’s market.
A spokesperson with the Progressive Conservative party shared few details about the event scheduled for leader Blaine Higgs in Fredericton this morning.
Green Party Leader David Coon will hold a news conference this morning about “local health-care decision-making” alongside deputy leader Megan Mitton in her Sackville, N.B. riding.
On Saturday, Coon said he was proud to put forward a gender-balanced slate among the party’s 46 candidates.
While the Liberals and Progressive Conservatives are running with full slates, the Greens are three candidates short and will not have full representation when the province’s residents go to the polls on Oct. 21.
This report by The Canadian Press was first published Oct. 7, 2024.
EDMONTON – The Health Quality Council of Alberta is investigating how some medical referrals weren’t properly processed, potentially affecting 14,000 patients over the last five years across the province.
The referrals were made to specialists outside of Alberta Health Services, such as physiotherapists and dietitians.
The health authority’s CEO, Athana Mentzelopoulos, says it does an average 100,000 referrals per year, but in some cases it can’t confirm if patients received referral services.
She says the problem was flagged in late September, and a preliminary estimate suggests 31 patients may have experienced a potential negative outcome due to the delays.
The provincial government requested the investigation, and the quality council is to find out how the snag occurred and how it can be prevented in the future.
The health authority says it has begun notifying patients who may have been affected by the disruption, and the cases could date back to 2019.
This report by The Canadian Press was first published Oct. 4, 2024.
WASHINGTON (AP) — If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.
But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.
These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.
It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.
On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.
Here’s what to know about veneers and how to avoid bogus providers and services:
What are dental veneers?
Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.
Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.
Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.
In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.
“Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”
What are the risks of getting veneers from someone who isn’t licensed?
Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.
Patients need to be anesthetized before the enamel is removed from their teeth.
“It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”
One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.
“If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.
Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.
How can I spot bogus veneer providers online?
One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”
Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.
Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.
Performing dental work without an appropriate license is illegal, the ADA notes.
Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.
Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.
What are the best ways to find legitimate dental providers?
The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.
“It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
