He thought he could
With help from a team at Ohio State and Battelle, Ian Burkhart becomes the first quadriplegic to move a paralyzed extremity using his mind.
With that small phrase, and a very large smile, Ian Burkhart conveyed how it felt to move his hand at will for the first time in four years. That was in 2014. Today, he can grasp and swipe a credit card and play a guitar video game.
Such complex functional movements once seemed out of the question. Burkhart has been paralyzed from the mid-torso down since he dove into a wave in North Carolina and hit a sandbar the summer after his freshman year of college.
The first person ever to move a paralyzed extremity using his own thoughts, Burkhart has made astounding progress under a team of medical professionals from Ohio State’s Wexner Medical Center and scientists and engineers from Battelle.
To make his movements possible, researchers run a cord from a tiny implant in his brain to a computer with software and algorithms that interpret his thoughts and decode and recode them to instruct the muscles in his arm. And they wrap a sleeve of electrodes around his right forearm to stimulate the muscles in his fingers and hand. Then, while watching a computer simulation of a hand opening and closing, for instance, Burkhart uses visualization to make the same movement.
“I never dreamed I would ever be able to do that again,” Burkhart said after his history-making day. “To say I’m the first person to ever do this, that’s definitely pretty cool, but even more so, just the fact that it’ll help a lot of people in situations like myself and improve their quality of life.”
The 25-year-old from Dublin, Ohio, has been working with the neural bypass research team from Ohio State and Battelle for almost four years. The team’s findings were published in the journal Nature this spring, setting off an avalanche of publicity.
“We’re showing for the first time that a quadriplegic patient is able to improve his level of motor function and hand movements,” said Dr. Ali Rezai, a neurosurgeon at Wexner Medical Center and co-author of the study. “It’s amazing. We’re very excited about the potential and the possibilities of what we can do to help patients like Ian and others. This really provides hope, we believe, for many disabled patients in the future as this technology evolves and matures.”
Battelle invented the NeuroLife system and has been implementing and further developing it with the Ohio State medical team. Patients in other studies have been able to control robotics and exoskeletons with their minds, but Burkhart is the first to use thoughts to control his own arm and hand.
“It’s amazing to see what he’s accomplished,” said Nick Annetta, the Battelle team’s electrical engineering lead on the project. “Ian can grasp a bottle, pour the contents of the bottle into a jar and put the bottle back down. Then he takes a stir bar, grips that, stirs the contents of the jar that he just poured and puts it back down. He’s controlling it every step of the way.”
Those who know Burkhart aren’t surprised to see him pushing beyond expectations. That’s what he’s always done. Growing up, he was the fearless one — riding roller coasters and playing sports, especially lacrosse.
But on June 13, 2010, just about everything changed.
“We were playing around in the waves and when I dove into a wave, it pushed me down into a sandbar, so the water really wasn’t as deep as I thought,” he explained. “Immediately, I knew something was wrong because I couldn’t get myself out of the water, and I was just kind of floating there, head-down in the water.”
Burkhart had broken his neck. Doctors told him initially that he may be able to move his shoulders one day, but nothing else for the rest of his life. He was 19 years old and had just finished his first year of college at Ohio University.
After his initial hospitalization in North Carolina, Burkhart completed intense in-patient rehabilitation in Atlanta and returned home to live with his father and stepmother in Dublin. Shortly after beginning outpatient rehab at Wexner Medical Center, he started inquiring about clinical trials.
At the same time, Ohio State researchers were looking for a candidate for a neural bypass trial, and Burkhart’s intense effort during therapy impressed Dr. Jerry Mysiw, chair of the Department of Physical Medicine and Rehabilitation. The team needed someone who lived near Columbus, had a strong work ethic and would commit to three-hour research sessions two or three times a week for more than two years.
“It really is kind of a lucky thing that I was able to fit all the criteria,” Burkhart said. “I always saw myself maybe being involved in some sort of research somewhere down the line, but never anything this extreme.”
As busy outside the research sessions as in them, Burkhart earned a business degree from Columbus State Community College this year and works part-time preparing tax returns for a certified public accountant. He also helps coach his former Dublin Jerome High School lacrosse team and regularly shares his story with others, including Ohio State medical and graduate students. Earlier this year, he joined Ohio State and Battelle researchers for a panel discussion at the South by Southwest conference in Austin.
About the time Burkhart was injured, a team of Battelle researchers began collaborating with the Ohio State Neurological Institute and clinicians Rezai and Mysiw to design clinical trials and validate the feasibility of using the neural bypass technology in patients.
The Battelle team had been working for more than a decade on the technology, which combines algorithms that learn and decode the user’s brain activity and a high-definition muscle stimulation sleeve that translates neural impulses from the brain and transmits new signals to the paralyzed limb. Now they were ready to try it — this time using a patient’s own thoughts.
To begin, Burkhart and the team used the electrode sleeve over the course of several months to stimulate his forearm and rebuild his atrophied muscles. Then, during a three-hour surgery in April 2014, Rezai implanted a microchip smaller than a pea onto the motor cortex of Burkhart’s brain.
“The surgery required the precise implantation of the microchip sensor in the area of Ian’s brain that controls his arm and hand movements,” Rezai said. “If we weren’t in exactly the right spot, this wouldn’t work. We are basically linking the mind and his thoughts into actions to move his fingers and hand.”
After a couple months of healing, and some wicked headaches that eventually subsided, Burkhart successfully demonstrated the neural bypass technology.
“When we hooked everything up for the first time for me to be able to move my hand, it was a big shock,” he said. “I hadn’t been able to move my hand for almost four years.”
Now, when Burkhart is connected to the NeuroLife system, he can perform more sophisticated movements, such as picking up a spoon or holding a phone to his ear — things that can significantly improve his quality of life. And he wants to learn new ones.
“Ian has exceeded our expectations. Initially we were thrilled to see him have some basic movements,” said Rezai, who heads Ohio State’s Neurological Institute. “Watching him have such significant improvements and functional movements using this technology has really made us more hopeful for the future of other patients with spinal cord injuries, traumatic brain injuries and stroke to live more independently.”
Annetta said Burkhart is the ideal partner in this work. “His drive is relentless. He’s not just willing to do what we ask of him, he’s presenting ideas to us that push us further.”
For example, it was Burkhart who suggested they see if he could hold and swipe a credit card, because that’s something he faces in daily life and cannot do on his own.
“In the 30 years I’ve been in this field, this is the first time we’ve been able to offer realistic hope to people who have very challenging lives,” Mysiw said. “What we’re looking to do is help people regain more control over their bodies.”
The researchers believe the technology can one day help others affected by brain and spinal cord injuries to be more independent and functional. For now, the system works only in the research laboratory, where cords and wires link Burkhart with a computer and the electrode sleeve. He longs for the day when the technology has evolved to a wireless system that he can use at home, on vacation — anywhere.
The FDA has approved an extension of the clinical trial, allowing the tiny chip to remain implanted in Burkhart’s brain while research continues. Plus, another patient has been identified to start working with the team to see if these stunning results can be replicated.
“Personally, I’m going to keep doing the research as long as I can, as long as they’re still getting good data out of me. I really enjoy it. I like to see how it progresses on a day-to-day basis,” Burkhart said. “My biggest dream would be to get full function back in both my hands, because that would allow me to be a lot more independent.”
Of course, the progress he’s made — and hopes to make in the future — isn’t purely physical. “Participating in this research has changed me in the sense that I have a lot more hope for the future now,” Burkhart said. “I always did have a certain level of hope, but now I know, firsthand, that there are going to be improvements in science and technology that will make my life better.”
Battelle and Ohio State have invested more than $10 million in the neural bypass research, including donations from generous philanthropists. To watch a video about Ian Burkhart, learn more about Ohio State’s Neurological Institute or donate to the research, visit https://wexnermedical.osu.edu/neurological-institute. For more on Battelle’s NeuroLife system, visit Battelle.org/NeuroLife. For more about Ian Burkhart, visit ianburkhart.com.