São Paulo, 11/06/2014
WALK AGAIN PROJECT BECOMES A REALITY
The Walk Again Project is in countdown to show the world for the first time one of the great achievements so far: during the opening ceremony of the World Cup on June 12 at Arena Corinthians in São Paulo, a paraplegic young adult will make a symbolic effort using an exoskeleton, or robotics garment, controlled by his brain activity. It will be just the beginning - as the project’s leader, neuroscientist Miguel Nicolelis, believes – of a future in which people with paralysis may abandon the wheelchair and literally walk again.
In May 2014, the testing phase was completed. In this manner, all of the scientific, clinical and technological goals of this phase of the project were achieved. The results will be presented to the scientific community through publication in scientific journals in the coming months.
The Walk Again Project is a consortium of hundreds of people from universities and research institutes around the world, under the scientific command of Brazilian neuroscientist Miguel Nicolelis. They are scientists and specialists of 25 nationalities from all continents. The project’s objective is to develop a brain-machine interface technology that enables people with restricted mobility – such as paraplegics – to walk again using the mind to control an external mechanism that would replace the lower limbs. Dozens of scientific papers published in the best journals in the world underpin the strategy chosen to run the project.
In Brazil, the Walk Again operation is led by the ELS-IINN (Edmond and Lily Safra International Institute of Neuroscience of Natal), in partnership with AACD (Association for Assistance to Disabled Children) in São Paulo. In January 2013, the project received investment from FINEP – Innovation and Research, which provided the necessary resources to carry out the clinical phase of the project at ELS-IINN, and for setting up the new facilities for a laboratory in São Paulo, where the team headed by Miguel Nicolelis works incessantly in developing a new form of neurorehabilitation, and an exoskeleton. The project also was sponsored by the Brazilian bank Itaú Unibanco.
Phase 1: development of brain-machine interface
Miguel Nicolelis has worked in the field of neuroscience since 1984. As of 2001, at the Duke University Center for Neuroengineering in North Carolina, USA, the Brazilian scientist idealized research areas that could produce new assistive technologies for restoring motor control and tactile sensitivity in patients suffering spinal or neurological injuries that generate a severe degree of paralysis.
Many tests were conducted for creating a mechanism for exchanging signals between the brain and a robotic device that could help a person move. The first stage of the project was the development of so-called brain-machine interface, i.e. a technology that would enable reading electrical signals produced by neurons in the brain and, from these signals, capture a motor control that could be used by the machine. Then it was necessary to send the signals back from the robot to the brain, completing the control cycle.
The first observations were made on rats and monkeys at Duke University. The animals were able to move robotic or virtual arms only with signals registered in the brain and use them to manipulate objects. In another development stage of the research, these animals were able to differentiate objects of different textures for the first time, through electrical stimulation of their brains.
Phase 2: the exoskeleton
The exoskeleton is the most advanced technological realization in phase 1 research, and was designed to enable real time interaction of the brain with the robotics garment. The first prototype tests were successfully completed on May 28: the exoskeleton, on command of an operator’s brain activity, performed natural and fluid movements that produced the feeling in all patients that they were walking with their own legs.
The robotics garment is the result of years of work by an international team of scientists and engineers. Research for its development began in 1999, and evolved gradually to the present stage. The robotic work was coordinated by Gordon Cheng, of the Technical University of Munich, in collaboration with a team of engineers and researchers. The system was developed in France and tested in Brazil
The size of its meaning to Brazilian science is expressed in the name chosen for the machine: BRA-Santos Dumont I, in honor of whom Miguel Nicolelis considers the biggest Brazilian scientist of all time. It works like a shared control, in which the brain generates messages that express the operator’s voluntary motor desire, such as "I want to walk", "I want to stop", or "I want to kick the ball." These mental commands interact with the controls of the exoskeleton’s articulations to generate the movements.
The exoskeleton is equipped with multiple gyroscopes that prevent falls during movement.
Phase 3: tactile sensation in walking again
For the act of walking to be as close as possible to reality, it is important for the patient to also have tactile sensation restored in the paralyzed limbs. For this to be possible, a tactile feedback technology, or artificial skin, was developed as an essential device for restoring the sense of touch and proprioception (the ability to recognize the body’s spatial location) of the lower limbs of patients who will use the exoskeleton to walk again.
The artificial skin, developed by the group of researchers led by Gordon Cheng, consists of flexible printed circuit boards, each containing pressure, temperature and speed sensors. It is applied on the soles of the feet for the patient, when walking with the exoskeleton, to receive a tactile stimulation sent to a region of the upper body such as the arms, at every touch of the foot on the floor.
With this transmission from the feet to the arms, the patient’s brain is induced to remap the tactile sensations and restore the feeling of stepping on the floor, walking as if there were no paralysis. A shirt, which the patient will wear during the demonstration at the opening ceremony of the World Cup, will enable him to receive on the surface of the arms the tactile information generated by the artificial skin. Dr. Hannes Bleuler, of EPFL group in Lausanne, Switzerland, designed this shirt.
Phase 4: tests with patients
The first clinical tests with the group of eight patients started to take place in January 2014 at the AASDAP/AACD laboratory inaugurated in São Paulo in November 2013. A clinical team led by Brazilian physician Lumy Sawaki of the University of Kentucky coordinated the clinical training procedures. Initially, these patients interacted with a computer-generated virtual simulator. In this environment, patients were able to use a robotic gait simulator that enabled them to walk on a treadmill using virtual reality goggles, through which they saw an avatar reproducing the same movements.
During this training, patients also received tactile feedback of the avatar’s steps through the artificial skin that emits mechanical vibration impulses on regions of the body that are sensitive, such as the forearms, for example. With this, their brains learned again to feel legs and feet. The tests also included simulations in a virtual environment with the same noises recorded in a football match with a packed stadium.
Upon completion of the virtual tests, training with the exoskeleton began. Brain-machine interface is achieved by means of a cap with electrodes that pick up electrical signals from the scalp using the electroencephalography (EEG) technique in a non-invasive manner. According to Miguel Nicolelis, this procedure is sufficient for driving lower limb movements with the exoskeleton. The brain signals of the patients who used the exoskeleton were processed in real time, decoded and utilized for moving hydraulic conductors.
On April 29, 2014, one of the patients managed to take the first steps with the robotics garment, using only the brain to command it. By May 20, each one of the patients had already walked 120 steps on average with the exoskeleton. The expectation now is for running tests similar to the atmosphere of the opening of the World Cup.
Demonstration at the World Cup
During the opening ceremony of the FIFA World Cup, there will be a demonstration of all technologies produced by the Walk Again project in the last 17 months. One of the eight AACD (Association for Assistance to Disabled Children) patients who participated in the clinical trials will be in charge of a "symbolic kickoff" of a Brazuca (the name of official tournament football), moving the exoskeleton solely with brain activity, just like at the laboratory during the human testing phase.
The initiative will be a presentation of the research, and is not part of the scientific study. The goal is to bring science closer to the Brazilian and global population: an estimated audience of billions of people will witness the moment that the human brain - and Brazilian science - will give one of its biggest steps.
To accomplish this feat, the entire system developed by the Walk Again project underwent numerous safety tests, one of them carried out on March 15 at the Pacaembú stadium in São Paulo. On the field, project neuro-engineers obtained records of brain electrical activity before, during and after the Palmeiras x Ponte Preta match during the São Paulo State Championship.
On April 4, 2014, FIFA secretary general Jerome Valcke expressed support for the Walk Again Project in an article published in the organization’s website. According to him, "FIFA is working closely with Professor Nicolelis’s team to show the world a person with paralysis walking on the field for the first time, during the opening ceremony of the World Cup."
The objective of the Walk Again Project is not only to make the demonstration at the opening of the 2014 FIFA World Cup. Much to the contrary, Miguel Nicolelis’s team and everyone involved will continue working to improve the technology. June 12, therefore, is only the beginning of a future in which the robotic garment will evolve to the point of becoming accessible and enabling anyone with paralysis to walk freely. And the World Cup will be a milestone to show the world that the project is moving in that direction.
Walk Again Project
The Consortium: universities and research institutes worldwide. It is led in Brazil by ELS-IINN (Edmond and Lily Safra International Institute of Neuroscience of Natal), and has a partnership with AACD (Association for Assistance to Disabled Children).
The Team: a team of more than 150 persons of25 nationalities
Miguel Nicolelis, PhD – Walk Again Project scientific leader
He graduated in Medicine from the University of São Paulo (1984), and has a PhD in Science (General Physiology) from the University of São Paulo (1988). Since 1994, he is a professor at the Department of Neurobiology, and is since 2001 a Co-Director of the Duke University Center for Neuroengineering (USA) and president of the Alberto Santos Dumont Association for Support to Research (AASDAP), which manages the Edmond and Lily Safra International Institute of Neuroscience of Natal (ELS-IINN). He has experience in the area of Physiology, with emphasis on Neurophysiology, and is involved primarily in the following topics: neurophysiology of neural circuits, chronic records of neural populations in alert animals, sensory systems, somatosensory system, brain-machine interface, and neurological prostheses.
Research Areas: Computational properties of large neuronal ensembles in primate behavior; Sensorimotor plasticity in adult animals and in sensory development; Neural basis of sensorimotor learning; Development of brain-machine interfaces for restoring the neurological function; Neural basis of tactile perception.
WALK AGAIN PROJECT ACHIEVES ALL OF ITS SCIENTIFIC, CLINICAL AND TECHNOLOGICAL OBJECTIVES
The testing phase on humans was concluded on May 28.Results will be published in scientific journals in the coming months
After 17 months of intense scientific work and hundreds of hours of clinical testing in a laboratory in São Paulo, Brazil, the Walk Again project officially announces the completion of the scientific, clinical and technological objectives of this first phase. The results will be presented to the scientific community through publication in professional journals in the coming months. On June 12, during the opening of the World Cup, there will be a public demonstration of the main objective of this research: the development of an exoskeleton controlled by the brain activity of a paraplegic patient.
The Walk Again Project is a consortium of 156 scientists, engineers, technicians and support staff from universities and research institutes around the world. Scientific coordination of the project is under Brazilian neuroscientist Miguel Nicolelis. The main objective of this international consortium is to develop technologies based on the brain-machine interface concept, introduced in the literature by Miguel Nicolelis and John Chapin in 1999, enabling people with restricted mobility - such as paraplegics – to walk again using the mind to control external equipment that would replace the lower limbs. Until the present work phase, dozens of research projects have been developed to support the Walk Again project.
In Brazil, the Walk Again operation is led by ELS-IINN (Edmond and Lily Safra International Institute of Neuroscience of Natal), in partnership with AACD (Association for Assistance to Disabled Children) in São Paulo. In January 2013, the project received investment from Finep - Innovation and Reseach, which provided the necessary resources to carry out the clinical phase of the project and the organization of the AASDAP/AACD laboratory in São Paulo, where a group of neuroscientists, engineers and clinical staff coordinated by Miguel Nicolelis works incessantly on developing a new neuro-rehabilitation technology known as exoskeleton, which is controlled by the mind.
Since January 2014, a group of eight AACD patients participated in clinical trials, all young people between 20 and 40 years with paralysis of the lower limbs caused by total spinal cord injury. On April 29, the first patient was able to walk with the exoskeleton, using only brain activity to control the equipment, captured by the cortical electroencephalography (EEG) technique. In the following days, the other seven patients were also able to walk. On average, each individual walked 120 steps during each interaction with the exoskeleton.
The equipment control by brain activity and interpretation of tactile feedback were evaluated during the testing. In this manner, the research team could conclude that all of the project’s scientific, clinical and technological objectives have been achieved with great success.
The achievement announced today concludes 30 years’ research work in neuroscience, and a decade and a half of research in devices such as brain-machine interfaces, a technology that enables the exchange of signals between the brain and robotic equipment, capturing and interpreting electrical signals from the neurons responsible for motor control and commanding the equipment.
Before human trials were completed, the development stages of the exoskeleton (a robotics suit that enables real-time interaction of the brain with all of its circuits) and of the tactile feedback (or "artificial skin", flexible integrated circuit boards with pressure, temperature and speed sensors that restore the paralyzed body’ sense of touch and the ability to recognize its spatial location). The next phases of the Walk Again project will aim at improving the technology.