Future Tense

A Brain Implant Allowed a Quadriplegic Man to Play Guitar Hero. But He Can’t Keep It.

For two years, Ian Burkhart has worked with a brain-computer interface to regain control of his hand. Soon the experiment will end.

Image courtesy of The Ohio State University Wexner Medical Center

Ian Burkhart was paralyzed from the shoulders down at age 19. Now he’s playing Guitar Hero and swiping credit cards.

I wrote about Burkhart in June 2014, when he was just beginning to regain control of his hand thanks to an array of electrodes implanted in his brain, which connects via a computer to a sleeve that can activate the muscles in his wrist.

What has happened since is both inspiring and a little poignant.

At first, Burkhart could execute only a few rudimentary actions, such as opening and closing his hand or moving it up and down. But nearly two years of practice by Burkhart, now 24, and improvements to the system have made a big difference. Using the device, called NeuroLife, in a laboratory at Ohio State University, he can now control individual fingers and pull off relatively complex maneuvers like pouring water from a bottle.

On Wednesday, researchers at Ohio State and the nonprofit Battelle Memorial Institute published a letter in Nature presenting what they claim is the first demonstration of “successful control of muscle activation using intracortically recorded signals in a paralyzed human.” They describe the device as an “electronic neural bypass” for people with spinal cord injuries, in which machine-learning software translates the brain’s signals to activate particular muscles in the arm.

“It’s gone terrific,” said Ohio State neurosurgeon Ali Rezai, who co-authored the study, in a phone interview Tuesday. “We’ve seen Ian make huge strides since initially in June of 2014 when he was just able to get some very rough gross movements with his hands.”

Rezai credits much of the success to Burkhart’s own patience and determination. When he first got the implants, he had to concentrate with all his might just to make a single muscle fire. Now, Rezai says, “he just thinks about the movements, and boom, the machine takes over.”

Burkhart was equally upbeat when I spoke with him by phone on Wednesday. “It feels great,” he said of his ever-improving dexterity.

Other teams around the country are working on similar systems, called brain-computer interfaces, to help restore various physical capacities to patients with different degrees of paralysis. Last year a team at Case Western Reserve University connected a patient’s brain implant to electrodes implanted directly in his arm.

As uplifiting as Burkhart’s story is, it’s unlikely to have a fairy-tale ending.

The technology today works in a high-tech laboratory setting, but Burkhart can’t take it home with him: NeuroLife requires a wired connection between the brain and the computer that controls the sleeve. A wireless system that patients can use at home is the ultimate goal, Rezai says, but it’s many years away. “My hope is we’ll see it within a decade.”

Meanwhile, the clock is ticking on Burkhart’s participation in the program. He received the implant under a one-year FDA approval, which has since been extended to two years. The team is seeking another extension, but if they don’t get it, Burkhart’s implant will have to come out this summer. He’s not looking forward to it.

“I understand the FDA is trying to protect my health,” Burkhart said. (Because the device physically connects the brain to the outside world, there is some risk of infection.) “But from my point of view, the fact that I’ve already had the brain surgery, and had all this investment of time and resources and everything—there’s no reason to stop as long as we’re still getting good data and good signals,” Burkhart said.

Yet Burkhart knows the device was never meant to last forever. The brain implant’s efficacy gradually degrades over time due to scarring in the brain tissue, and eventually that hardware degradation will start to undo the progress that Burkhart and the software have made together.

He told me he has accepted that his newfound mobility is temporary, and that the progress he has made is likely to benefit posterity more than it benefits him. “I now know that when I’m connected to the system I can do all these great things. It won’t be too much of a shock to me [when it’s over], because even now I can only use the system for a few hours a week when I’m down in the lab. But it will be something I’ll certainly miss.”

Previously in Slate: