More than a billion people all around the globe got their first look at cutting edge neuroscience research in action today when a paraplegic youth wearing a thought-controlled, robotic exoskeleton kicked a ball to launch the 2014 FIFA World Cup opening ceremony in São Paulo, Brazil.
While much work remains before this or similar devices become widely available to people with paralysis, today’s moment does provide an inspiring glimpse of just one of the many things that can be achieved when science is supported over the long haul. In fact, the dramatic debut of this robotic exoskeleton was grounded in more than 20 years of scientific studies, including basic research supported by NIH and clinical research funded by the Brazilian government.
The leader of the team, Miguel Nicolelis, a Brazilian who co-directs the Duke University Center for Neuroengineering in Durham, N.C., has been working on brain-machine interfaces in various animal models for decades . In a pioneering experiment involving a monkey equipped with brain sensors that sent real-time commands associated with leg movements, Nicolelis showed that the animal could spur a computer-controlled robot located thousands of miles away to walk by simply thinking about walking .
Now, Nicolelis has shown that a similar feat is possible with humans, using a robotic exoskeleton system built in conjunction with German colleagues who are part of the non-profit Walk Again Project. The paralyzed person wears a special cap that contains electrodes that read their brainwaves. To move the plastic-and-aluminum exoskeleton, a person needs to imagine actually doing each phase of his or her desired movements; for example, “start walking,” “turn right,” “kick the ball,” “sit down,” and so on. These brain signals are sent to a computer inside a backpack worn by the person, where they are translated to commands that control the exoskeleton.
To help users keep their balance, the exoskeleton is equipped with built-in stabilizing gyros. Also, to fine-tune their movements, the exoskeleton features “artificial skin” sensors in its feet that pick up various sensations and convey them as vibrations to the person’s arms. This creates a feedback loop that people with paraplegia report makes them feel like they are walking themselves, rather than being moved by a machine. (Note: Although people with paraplegia cannot move their legs, they have use of their arms. Quadriplegics suffer from injuries even higher in the spinal cord, and lack the ability to move their arms and their legs.)
In the brain-machine interface system used at the World Cup ceremony, the backpack contains hydraulic equipment plus enough batteries to power the exoskeleton for a couple of hours. Along with the computer, it adds up to a whopping 60 pounds of gear. But that’s not as bad as it sounds, because the weight is supported by the exoskeleton’s frame, not the person wearing it.
This dramatic development should provide encouragement for people living with paralysis, including an estimated 6 million in the United States alone. Still, we must be realistic in our expectations. As compelling as today’s demonstration may have been, it was just a proof of concept. Robotic exoskeletons remain in the very earliest stages of development. Scientists need to refine their designs and test them on more people, and they need to analyze and publish the enormous amount of data they’ve already gathered.
I met with Nicolelis and his team and toured the Walk Again Project lab in Sao Paolo just two weeks ago. I watched two different paraplegics in the final stages of training for the big day. The atmosphere (and the technology) was electric! Nicolelis, winner of a 2010 NIH Director’s Pioneer award, referred to the World Cup kick-off as his “moonshot.” But we both agreed that future research advances in this field will need an even richer understanding of how the circuits in the brain carry out their remarkable array of sophisticated activities. And as of last week, we have a new blueprint for that effort—a distinguished Working Group of my Advisory Committee to the Director has delivered a bold and inspiring ten-year plan for the NIH component of the BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative. I’ll have more to say about that in future blogs—but you might want to have a look at the report right now.
 Learning to control a brain-machine interface for reaching and grasping by primates. Carmena JM, Lebedev MA, Crist RE, O’Doherty JE, Santucci DM, Dimitrov DF, Patil PG, Henriquez CS, Nicolelis MA. PLoS Biol. 2003 Nov;1(2):E42. Epub 2003 Oct 13.
 Mind Control Monkey Moves Robot in Japan. (YouTube video)
NIH support: National Institute of Neurological Disorders and Stroke; National Institute of Mental Health; Eunice Kennedy Shriver National Institute of Child Health and Human Development; Office of the Director (Common Fund); National Institute of Dental and Craniofacial Research