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Special Article: A Medical Technology Proposal
2-IETSS: A Proposal For the Possible Reversal of Partial and Full Paralysis
By Alexia Vayeos
From June 23rd to June 25th, 2019, I attended the National Academy of Future Physicians Congress. While at the event, listening to some of the most distinguished figures in medical science of our time, I was particularly inspired by those working to innovate in the field of and learn about the brain, as well as neuroscience and technology. While listening to Professor of neurotechnology at MIT Edward Boyden discussing his work in applying technology to learn more about the extraordinarily-elusive nervous system, an idea popped into my head: what if you could use technology to improve brain function, or even reverse catastrophic damage with the advancements we have made in the field of technology today? I decided to delve into this idea the day after I returned from the congress with an idea I had mulled over during my day at the event: what if you could use cure paralysis by bypassing an injury in the spinal cord utilizing electricity and conduction?
The Anatomy & Physiology
The spinal cord is the second main part of the central nervous system following the brain. The spinal cord is the bridge between the brain, the main control center of the body where all sensory and motor information is processed (save for reflexes when they first occur), and the rest of the nerves of the body, which make up the peripheral nervous system, the second main division of the nervous system. All 31 nerves that compose the peripheral nervous system originate from the spinal cord, branching off to the rest of the body to receive stimuli from the environment--transported to the brain as sensory impulses--and bringing motor impulses from the brain to the muscles of the body, via, of course, the spinal cord.
Paralysis occurs when an injury of the spinal cord is obtained, most often through trauma in which the spinal cord is lacerated, incised, or severed. This most often happens when blunt force is applied to the dorsal region of the body, fracturing a vertebra or vertebrae, which can, again, lacerate, incise, or sever the spinal cord. Paralysis can also be a component of the prognosis of diseases that affect muscle function, such as a case of muscular dystrophy. No matter the origin of a spinal cord injury, the effects are detrimental. The more superior the injury in regards to the body on the spinal cord, the more of the body it will effect. Cervical, or neck, spinal injuries usually result in quadriplegia (the loss of use of most of or all four limbs and possibly the loss of all muscles below the cervical region if the injury is superior enough), while thoracic and lumbar spinal injuries usually result in paraplegia (the loss of use of the torso, legs, and/or entire lower half of the body). This is due to the fact that, because the spinal cord is a sort of bridge between the brain and peripheral nerves, when there is an injury in one place on the spinal cord, sensory and motor impulses cannot move between the brain and past the point of injury. Currently, there is no real “cure” for paralysis.
The Past Research
When I got my idea to use artificial conduction methods to correct faults and gaps in the bridge that is the spinal cord, I wanted to know if anyone else had come up with my idea. The short answer is that they indeed had. I scoured the internet for experiments regarding electrical stimulation of the spinal cord, but also the reparation of it using stem cells, either cultured or grafted from one place in the body to the location of injury. Below are the advancements I researched and built my ideas off of.
STIMO (STImulation Movement Overground); also known as Epidural Stimulation
STIMO, developed by doctors and scientists at Ecole Polytechnique Fédérale de Lausanne (EPFL) and the Lausanne University Hospital (CHUV) in Switzerland, utilizes constant targeted electrical stimulation of the lumbar spinal cord. This electrical stimulation mimics how the brain actually stimulates the spinal cord, and even persists without direct stimulation. Like normal neuron stimulation, STIMO triggers the growth of new nerve connections, thus slowly rehabilitating the patient as well as allowing them to immediately move. The machinery was calibrated in order to allow the patient to walk on their own impulse.
Similarly to STIMO, various methods of epidural stimulation--that is, stimulation on or around the dura mater of the spinal cord--have been used. However, these methods are often a single part of a cocktail treatment for paralysis.
The use of artificial intelligence has aided in the recovery of paralyzed patients. A robotic harness has been developed with an algorithm that aided in helping patients walk. It is attached to the ceiling and identifies the forces of gravity that must be applied across a patient’s body to allow them to relearn the process of walking with minimal assistance.
Lumbar Magnetic Stimulation with a Figure-Eight Coil
Delving further into epidural stimulation, electrical circuits have been developed which utilize magnetic fields to harness electricity, mimicking, once again, the brain producing the motor impulses that amalgamate to form movement. These circuits are coils that act outside of the body, and are thus non-invasive. Coils may be placed above the T12 (12th thoracic) to L1 (1st lumbar) vertebrae; intense electric fields are produced, which directly activate spinal nerve roots.
Electrical Stimulation Glove
A glove has been specially-made for patients with decreased hand function following a stroke. Low levels of electrical current within gloves are utilized to stimulate the muscles of the hand.
The New, More Effective Solution
There is an alternative to all of these solutions, utilizing much of the technology researched in their respective studies. To acknowledge this alternative, one must ask this: what if the spinal cord of a paralyzed patient could be bypassed altogether?
I had the idea of creating two paired implants: one for the motor cortex of the cerebrum, and the other for the portion of the spinal cord directly below the injury acquired. The motor cortex implant will harness natural electrical impulses from the brain; this implant will be a rectenna, or rectifying antenna, which is a type of antenna that harnesses electricity rather than producing it. This rectenna will turn electricity into alternating-current electromagnetic waves, transmitting these waves to the second implant on the inactivated portion of the spinal cord. The spinal cord will be directly stimulated by attached electrodes, and the person will be able to move as if their brain were telling their muscles directly, although, in practice, there may be a slight delay between transmission and movement. Materials the rectenna implant could be made of are the hardest part about engineering the device would be finding an alternative to molybdenum disulfide, which rectennas are usually made out of, but is irritant to human skin. Molybdenum disulfide is only 3 atoms thick, allowing it to act like a switch and rearrange electrons when it comes to converting electrical impulses to electromagnetic waves. This process would virtually turn the patient into a human bluetooth device.
Utilizing a broad range of research regarding the electrical stimulation of the peripheral nervous system, I confidently introduce a new alternative to what has, in the past, been believed to be the best alternative. We must look beyond the conventions of modern medicine and ponder new sources of information--ones that may even be hiding in plain sight.