Brain implant in ALS: a “very sensitive area” for Professor Laureys

Belgium An experimental human-machine interface, in the form of a brain implant, has enabled a man unable to speak or move due to amyotrophic lateral sclerosis (ALS) to communicate (read our article ALS: a brain implant allows a patient to communicate )[1]. Our colleagues from the Belgian medical site Mediquality interviewed the Professor Steven Laureysworld specialist in altered states of consciousness, neurologist at the Center du Cerveau and director of the GIGA Consciousness research unit at the CHU and University of Liège, on this progress.

What do you think of this technological and medical feat?

Professor Steven Laureys : I find it very interesting to advance technologies that help patients regain a voice and an impact in terms of autonomy and their self-determination. As we have shown in our center for 25 years now, the cognitive capacities of these handicapped patients have historically been underestimated. Here, it is a progressive disease, it is different from our patients who are struck suddenly by an accident. But it illustrates how this technology, with super-electrodes and advanced artificial intelligence algorithms, can constitute progress for these patients. I’d rather use technology for this kind of progress than to set up the Metaverse and the natural brain upgrade efforts started by Elon Musk*. This vision that technology will turn us into superhumans seems very complicated to me. Here, it helps people and it’s extraordinary.

*As part of his company Neuralink, Elon Musk wants to implant chips in the human brain to control digital devices or even reduce movement disabilities.

Do you still have reservations?

Professor Steven Laureys : Yes, it is mainly because it is research and at this stage it does not necessarily change the everyday life of these patients. It is for this reason that I co-founded Mind Care International Foundation with the King Baudouin Foundation, to help these patients, and those who suffer from mild or severe head trauma, and to promote research. I think that’s the big challenge in this area, because these patients are a bit neglected. There is also the ethical question. What are we going to do with this patient who communicates? Will this change the course of care? What about the rights to benefit from care but also the rights to euthanasia? Can a machine be trusted? The patient certainly formulates sentences that do not seem to be random, but he may have an enthusiastic researcher bias that makes sense of what is in fact the “noise” of technology.

At this point, it doesn’t necessarily change the day-to-day lives of these patients.

Is it a complicated technique?

Professor Steven Laureys : Yes. The technique here is invasive, with a surgical operation. In our center, we do not practice this technique, we stick electrodes on the surface of the skull. The main thing is to translate the recorded results. We work in many European projects and also for the Human Brain project with “plug and play” devices like ‘MindBeagle’. Because it takes an army of engineers to operate the device mentioned here. It’s complicated to implement it in our different centers or with patients who live at home. The trick this team uses is that the patient imagines moving their eyes and the artificial intelligence learns which neurons are engaged at that moment and “translates” that neural activity.

Does this technology raise ethical questions? There was talk of fraud…

Professor Steven Laureys : Certainly. And the passage of time makes the electrodes work less well. The ethical discussion concerns the replacement of these electrodes. There has also been controversy over the quality of this work. The pioneer that is Niels Birbaumer from the University of Tübingen was challenged for his work, he received sanctions, but seems to have won the lawsuit which was to annul these sanctions. It is also an illustration of the difficulties encountered by researchers working on these subjects within a very harsh academic world, quick to judge the work of others. Certainly, there are researchers who cheat, but the prejudice should be benevolent and favorable to the researcher instead of indicting him sometimes too quickly, and redoing the research in chambers “after the fact”.

The families of patients with locked-in syndrome are very happy that research is being carried out.

Anyway, it always ends up emerging since in science we constantly build in symbiosis with the work of other researchers. A fraud therefore always ends up emerging. In addition, the ethics committee is there to protect patients. You have to find the middle ground. The families of patients with locked-in syndrome are very happy that research is being carried out. When we are at the end of life, we want to give meaning and we are happy to be able to participate in this type of study. Yes, it’s complicated, yes, you have to be careful, but the team here did it transparently. There is no gold standard for studies of states of consciousness. No scan, no biopsy, no autopsy. But we cannot ignore thoughts, perceptions, emotions. Or else the researcher self-censors out of conformity. We are here in a very sensitive area, which deserves a multidimensional and fundamental debate.

Originally published on Mediquality.

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Brain implant in ALS: a “very sensitive area” for Professor Laureys

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