A neurologist and two neurosurgeons from University Hospitals Cleveland Medical Center played vital roles in a new study reporting the first successful case in the world of a man with quadriplegia moving his paralyzed right arm through brain–controlled muscle stimulation.

Using an implanted brain sensor array and muscle stimulators, the 56–year–old man, Bill Kochevar, who had a complete traumatic high spinal cord injury from a bicycle accident, was able to extend his arm, grasp a cup and bring it to his mouth. In other tests, he was able to feed himself using a fork.

The major, multi–institutional study appears in the March 28 issue of the journal The Lancet. UH Neurological Institute physicians were part of the research team: Benjamin Walter, MD, Director of the UH Movement Disorders Program and the Clinical Principal Investigator for the study in Cleveland; Jonathan Miller, MD, Director of the Functional and Restorative Neurosurgery Center and lead surgeon, and neurosurgeon Jennifer Sweet, MD.

In the study, Dr. Miller, who is also an associate professor and vice chair of neurosurgery at Case Western Reserve University School of Medicine, led a team of surgeons who implanted two electrode arrays – each about the size of a baby aspirin – in the left motor cortex, on the surface of the patient’s brain. This part of the brain controls the right arm. The brain–computer interface (BCI) uses 96 hair–thin electrodes that sense the electromagnetic waves of neurons controlling the arm and hand.

To prepare him to use his arm again, Kochevar first learned how to use his brain signals to move a virtual reality arm on a computer screen. He was able to do this in minutes, and through four months of training, the researchers believed he would be capable of controlling his own arm and hand.

Dr. Miller then led a team that implanted the Functional Electrical Stimulation (FES) 36 electrodes to animate muscles in the upper and lower arm.

The BCI decodes the recorded brain signals into the intended movement command, which is then converted by the FES system into patterns of electrical pulses. These pulses trigger the muscles controlling the hand, wrist, arm, elbow and shoulder, turning thought into action.

“Every day most of us take for granted that when we will to move, we can move any part of our body with precision and control in multiple directions and those with traumatic spinal cord injury or any other form of paralysis cannot,” said Benjamin Walter, MD, who also is an associate professor of neurology at CWRU School of Medicine. “The ultimate hope of any of these individuals is to restore this function. By restoring the communications of the will to move from the brain directly to the body, this work will hopefully begin to restore the hope of millions of paralyzed individuals that someday will be able to move freely again.”

“This represents a major advance towards a practical FES system controlled by the individual’s own thoughts for restoring arm movements in someone with total paralysis,” said Dr. Miller.