Non-invasive brain-machine interface for controlling neurostimulators surgically implanted in lumbosacral plexus nerves in people with spinal cord injury - LIONCEMAQ

• Grant number: 24/03628-5
• Support Opportunities: Regular Research Grants
• Start date: February 01, 2025
• End date: January 31, 2027
• Field of knowledge: Engineering - Biomedical Engineering
• Principal Investigator: Jean Faber Ferreira de Abreu
• Grantee: Jean Faber Ferreira de Abreu
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated researchers: Adenauer Girardi Casali ; Gustavo Leme Fernandes ; Nucelio Luiz de Barros Moreira Lemos

Abstract

The technique, known as Possover-LION, or simply LION ("Laparoscopic Implantation of Neuroprothesis"), consists of implanting electrodes on nerves in the pelvic region (sciatic and femoral) in people with paraplegia and tetraplegia. Based on the programmed electrical stimulation of these nerves, associated with a specific rehabilitation program, Lemos and collaborators showed a significant clinical improvement in different physiological functions in 30 patients who underwent the LION implant. These improvements include urinary control, sphincter control, improvement of the gastrointestinal system, recovery of tactile sensitivity and motor control. In addition, the majority of patients with paraplegia were able to stand up (with an appropriate stimulation program) and start training to walk on parallel bars.On the other hand, currently one of the systems of greatest clinical and academic interest are those based on Brain Computer-Interface (BCI) protocols. A BCI system uses different engineering, mathematical and computational techniques to develop protocols for translating neural activity (central and/or peripheral) into control of external devices. Therefore, a BCI system can provide an alternative communication route for people with sensorimotor dysfunctions to interact with their environment. The integration of these two techniques, LION+ICM, would enable people with SCI to activate neuromodulators based on direct intentions. This would mean that muscle movements would be activated directly by their own neural patterns and would no longer be triggered by a remote control (external to the individual). Although this remote control can also be activated by the patient (or volunteer), when activated by neural patterns directly associated with muscular activities that control the function of organs and systems of interest, patients will begin to associate the control of each organ and system of interest directly with their own intentions and no longer indirectly. Neurophysiologically, this means that the direct correspondence between cortical synchronizations, the motor planning of a specific movement and the efferent pathway of information for the execution of that movement will be preserved and reinforced. Current research has shown that preserving and reinforcing this flow optimizes neuroplasticity and the rehabilitation process. (AU)