In order to walk, signals from the brain are sent to neurons in the lumbosacral part of the spinal cord. When a spinal cord injury occurs, it cuts off this essential communication between the brain and the area of the spinal cord responsible for walking, leading to paralysis. Even if the neurons themselves aren't directly damaged, the disruption of the descending pathways breaks the chain of commands needed for these neurons to enable walking. Now, in a pioneering procedure, physicians have paired an implantable spinal cord stimulator with a brain-computer interface (BCI) to restore arm, hand, and finger function in patients with spinal cord injury.

ONWARD Medical (Eindhoven, The Netherlands) has announced the first-in-human implant of its investigational ARC-IM implantable spinal cord stimulator, to restore upper extremity function after spinal cord injury. Along with the implant, the patient was equipped with an investigational BCI, designed to enable thought-controlled movements when used in conjunction with ARC-IM. ARC-IM administers specific, pre-programmed therapy directly to the spinal cord to revive movement and other functionalities after a spinal cord injury. Previously tested for its potential to restore mobility and stabilize blood pressure, ARC-IM Therapy is now, for the first time, being used to help spinal cord injury patients regain upper limb movement and function.

In conjunction with the ARC-IM implant, the BCI is designed to identify a paralyzed individual's intent to move their upper limbs. The BCI employs artificial intelligence to interpret these thoughts, which ARC-IM then transforms into targeted spinal cord stimulation, enabling movement driven by thought alone. This advancement is part of a continuing clinical trial exploring the safety and efficacy of using thought to stimulate the spinal cord after an injury. The innovation builds upon ONWARD's May 2023 announcement that combining ARC Therapy with a BCI implant allowed a person to achieve enhanced control over his paralyzed legs. Further details about this groundbreaking research are expected to be released in the near future, along with a scientific paper detailing the procedure and its outcomes.

“We are excited to learn how ARC-IM Therapy may restore upper extremity function after SCI, and we are eager to see how the addition of a BCI might augment our therapy,” said Dave Marver, CEO of ONWARD. 

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