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by simply implanting electrode chips in the brain and spinal cord and building a "nerve bypass" between the brain and spinal cord, it is possible for paralyzed patients to regain independent control of their muscles and regain the ability to stand and walk in their lower limbs.

on october 5, a reporter from the paper (www.thepaper.cn) learned from fudan university that a team of young teachers from the fudan institute of brain-inspired intelligence science and technology and fumin developed a new generation of implantable cerebrospinal interface for patients with spinal cord injuries. equipment that brings hope to patients with spinal cord injuries who can stand and walk. recently, the related project "development of key technologies and systems for implantable brain-spinal interfaces" stood out among approximately 1,400 entries and won the 2024 national disruptive technology innovation competition. the first clinical trial is expected to be carried out by the end of the year.

with minimally invasive electrodes implanted, paralyzed patients may be able to walk smoothly

as the "information highway" connecting the brain and the peripheral nervous system, if the spinal cord is damaged, instructions from the brain cannot be transmitted to the muscles, and the patient loses the ability to move independently. how to makespinal cord injuryrestoring movement ability for paralyzed patients has always been a major problem in the medical community.

due to the irreversibility of nerve damage, current treatments for patients with spinal cord injury have limited effectiveness. until recent years, studies have confirmed that epidural electrical stimulation of the spinal cord can reactivate neuromuscular activity and significantly promote motor rehabilitation after spinal cord injury. in 2023, the team of dr. grégoire courtine of the ecole polytechnique fédérale de lausanne in switzerland conducted research on cerebrospinal interfaces. it decodes brain signals and electrically stimulates the relevant areas of the lower limbs of the spinal cord, connecting the brain and spinal cord neural pathways, allowing patients with quadriplegia to walk autonomously, and even reshapes synapses in spinal cord injury areas, allowing patients to walk without stimulation. ability to voluntarily control paralyzed muscles.

although the swiss team has initially verified the possibility of cerebrospinal interface to achieve functional recovery in patients with spinal cord injury, there are still many shortcomings in aspects such as brain electrical movement decoding, personalized reconstruction of spinal nerve roots, system integration and clinical application. in response to these problems, jiafumin's team carried out research and development of a new generation of brain-spinal interface technology, which has the characteristics of "high precision, high throughput, high integration, and low latency".

how to accurately stimulate the spinal nerve roots and alternately activate the corresponding muscle groups of the lower limbs to reconstruct walking gait is the first core challenge. to address this issue, jia fumin's team used the 3t magnetic resonance imaging equipment of zhangjiang imaging center to innovatively design an imaging scheme that includes multiple scanning sequences, and built an automated reconstruction algorithm model based on artificial labels to accurately capture the spinal nerve root structure of the lumbosacral segment. feature. relevant data and the generated individualized spinal nerve root model have recently been open sourced, providing support for experts in the field of neurological rehabilitation to carry out basic research on spinal cord neuroregulation.

3d model of spinal nerve root image reconstruction. the pictures in this article are all from "fudan university"wechat official account

in addition, the ideal walking process requires real-time optimization and adjustment of spinal cord spatiotemporal stimulation parameters based on the movement results of the lower limb posture, which requires real-time monitoring of gait. the jiafumin team uses multi-modal technologies such as infrared motion capture, electromyography, inertial sensors, and plantar pressure pads to build healthy gait and various abnormal gait data sets, and establish algorithm models to achieve cross-population, cross-modality, and cross- type of continuous gait trajectory high-performance tracking, laying the foundation for brain-spinal interface technology.

multi-modal real-time monitoring of gait trajectory

the existing brain-spinal interface solution adopts a multi-device implantation model, which requires the implantation of two eeg acquisition devices in the left and right motor cortex of the brain and a spinal cord stimulation device in the spinal cord. the jiafumin team proposed a "three-in-one" system design plan, integrating three devices into one cranial implantable micro-device, which not only reduces the patient's postoperative wounds, but also enables the integration of collection and stimulation, allowing the patient to independently movement is controlled in a closed loop. this solution can transfer the decoding process from outside the body into the body, improve the stability and efficiency of eeg signal collection, and ultimately achieve a decoding speed and stimulation instruction output of 100 milliseconds - the reaction time of a normal person is about 200 milliseconds, which means that in in the future, patients with spinal cord injuries will have a more natural and smooth walking gait.

ten years of sharpening the sword, "creeping forward" in the face of the world's problems

from 2010 to 2020, as one of the core members of the national engineering research center for neuromodulation led by academician li luming, jia fumin participated in the research and development and clinical transformation of my country's first generation of implantable neuromodulation equipment, and under the guidance of academician li luming, he developed international the first variable-frequency brain pacemaker solves the clinical problem of controlling the complex symptoms of parkinson's disease. as someone who has witnessed the entire process of my country's neuromodulation industry from "tracking", "paralleling" to "leading", jia fumin has a deep understanding of the hardships of transforming clinical needs into scientific research results.

"in life, you should choose to do difficult and right things, and write your thesis on the motherland." deeply influenced by this concept, jia fumin turned his attention to the field of brain-spinal interface research, which is also a "world problem", hoping to bring the past to the forefront. experience applied to patients with spinal cord injury.

the "2023 survey report on the quality of life and disease burden of people with spinal cord injury in china" shows that there are 3.74 million patients with spinal cord injury in china, and about 90,000 new patients with spinal cord injury are added every year. "if paralyzed patients can stand up, it will be a breakthrough from 0 to 1." however, it is not easy to break through this major problem. jia fumin predicts that it will take at least ten years for brain-spinal interface technology to move from basic research to clinical translation, and he is ready for a protracted battle.

professor jia fumin

fudan university institute of brain-inspired intelligence science and technology (referred to as "brain-inspired institute") is one of the earliest cross-research institutions on brain science and brain-inspired cutting-edge research established by domestic universities. it aims to carry out brain and brain-inspired research in the face of major global scientific and technological frontiers and national strategies. major original innovations in basic brain-inspired theories, cutting-edge technology research and application transformation. in 2020, jia fumin joined the brain institute full-time and continued to carry out research in an international academic environment that encourages originality, free exploration, and multidisciplinary cooperation. “i have benefited a lot from fudan’s profound foundation in basic medicine, artificial intelligence, and neuroimaging,” said jia fumin.

at the supervisor selection meeting, liu jionghui, a 2022 doctoral candidate in biomedical engineering, chose to join the jiafumin team and became the first student in the team. "i hope to do something meaningful to society during my phd and realize my own value in the process." liu jionghui is currently mainly responsible for mri image reconstruction of spinal nerve roots, individualized modeling, and neuromusculoskeletal model simulation calculations , providing patients with high-precision nerve root construction and personalized stimulation programs.

liu jionghui, a 2022 doctoral candidate in biomedical engineering, joins the jiafumin team

since then, jia fumin has quietly "tinkered" with the brain-spinal interface with one or two students. now, the industry-university-research team has nearly 30 people. he called his research process over the years "creeping forward", "staying away from outside sounds and studying silently until he saw paralyzed patients walking again." with the strong support of fudan-baoshan science and technology innovation center and the brain institute, jia fumin actively established a cerebrospinal interface laboratory. the main research direction is the recovery and reconstruction of lower limb walking function in patients with spinal cord injury, and on this basis, it explores neuromodulation technology. potential for application in multiple indications.

over the past four years, the team has simultaneously carried out basic research, software development, algorithm iteration, experimental verification and other work. at present, it has initially completed the accumulation of key technologies for spinal cord spatiotemporal stimulation and brain-spinal interface, and has achieved proof of concept in animals, meeting the necessary conditions for clinical application. . it is expected that by the end of this year, the team will cooperate with relevant experts from domestic tertiary hospitals to conduct the first clinical trial.

in the next stage, jiafumin plans to complete product development and clinical transformation of key technologies for implantable cerebrospinal interfaces. at the same time, we continue to develop a series of new neuromodulation methods and technologies for patients with spinal cord injuries, such as the development of wearable neuromodulation equipment and multi-modal motion monitoring systems for patients with mild symptoms, to alleviate the pain of spinal cord injury patients’ families and their families on a larger scale. social medical burden.

in the longer term, with the vision of "original technology serving the world", the jiafumin team hopes to establish an independent intellectual property system for intelligent brain-spinal interfaces through the development of three types of active implantable innovative medical devices, so that 20 million spinal cord injury patients around the world can benefit from it. beneficial.