Quadriplegic moves objects with thoughts

A brain implant allows a paralyzed man to open his email, move a prosthetic hand or adjust a TV setThe thought-capturing technology offers hope for people with spinal cord injuries, Joseph Hall writes
Jul. 13, 2006. 05:54 AM
JOSEPH HALL
STAFF REPORTER

In a medical breakthrough worthy of an illusionist's act, a U.S. quadriplegic has been able to move objects around him through the power of thought.
Usng a tiny sensor implanted on his brain, the paralyzed Massachusetts man was able to open email, control a prosthetic hand and adjust the volume on a television just by thinking about doing so, according to a cover article in this week's edition of the journal Nature.
And researchers say the thought-capturing technology could soon lead to profound improvements in the lives of people with spinal cord injuries — even to the point where arms and legs could be made to move at will.
"We've found that merely imagining action is sufficient to cause a particular activity," says John Donoghue, a neuroscientist at Rhode Island's Brown University and a lead study author.
"We're reading the neural activity related to that imagined action ... and using it to control devices."
Known as BrainGate, the technology includes an electrode array, about the size of a baby Aspirin, that's implanted on the surface of the brain's motor cortex. Located directly beneath the top of the skull, the motor cortex controls voluntary limb and body movements.
Brain impulses detected by the BrainGate array are sent up via a set of fine wires that pierce the skull and scalp. These are attached by cable to a computerized system that can amplify these neurological impulses or "spikes" and translate them, in real time, into the desired actions.
"Brain cells have a language called spikes, which are basically impulses," Donoghue says.
"And the change in the number of those impulses over time is really the way the brain carries around information from one spot to another."
For example, Donoghue says, neurons in the part of the motor cortex regulating hand movements might fire a series of 10 rapid spikes to indicate right and 20 spikes to indicate left.
"What we're trying to do is read the impulses when they occur and count them up," he says.
"And in the future, if we saw 10 impulses (from the hand centre of the cortex), we'd know that means right."
Paper co-author Leigh Hochberg, a neurologist at Massachusetts General Hospital, says that simply imagining a movement in your mind creates these neurological spikes.
And importantly, the study found, the motor cortex spikes continue to operate properly long after the signal path to their target limbs have been severed, through spinal injuries, amputations or disease.
"One of the very encouraging aspects of these initial findings is that this part of the brain, which normally sends its signals down through the spinal cord and ultimately out through the muscles, can still be used," says Hochberg.
As well, Hochberg says, the BrainGate equipment was able to learn the meaning of the test subject's spike sequences rapidly — often within minutes — and translate them accurately into external action commands.
"It was encouraging to see how quickly he (the test subject) was able to gain control over these physical alternative devices," he says.
Matthew Nagle, the main test subject in the Nature paper, is a quadriplegic who was stabbed in the neck in the summer of 2001 after coming to the defence of a friend in a fight.
The 6-foot-2 Boston-area native, a former high school football standout, was paralyzed from the neck down after the 20-centimetre blade severed his spinal cord.
So far, the 26-year-old man has been able to open and close a prosthetic hand, move a robotic arm and play Pong on a computer screen by simply thinking the necessary movements.
Currently, however, the BrainGate electronics Nagle used to run these devices are the size of a small refrigerator. As well, it's attached by wires to a penny-sized plug on his skull, so his mobility and the activities he can participate in are severely limited when he's hooked up.
But Donoghue says the equipment's Foxborough, Mass., manufacturer, Cyberkinetics Neurotechnology Systems Inc., is working to miniaturize the device and give it remote-control functions.
"We're taking something that's larger than two or three desk-top computers and reducing it down to something that's the size of a cellphone," says Donoghue, who is also Cyberkinetics' chief scientific officer.
Ultimately, Donoghue says, the technology, which has shown a 70 to 90 per cent thought-to-movement accuracy, could reconnect the motor cortex to muscle nerves, allowing people to use their own hands to grasp or move things.
Already, he says, there are devices that can allow paralyzed people to open and close their hands through electronic impulses.
Donoghue says such devices might be integrated into his thought-controlled system to create a virtual neurological connection.
Kevin Rogers, a spokesman for the Canadian Paraplegic Association, says the technology has enormous potential to improve the lives of people with spinal cord injuries.
"It's huge, especially for somebody who is a high-level quadriplegic," says Rogers, who himself has only limited movement in his arms. "That you could think, and it reads your thought patterns, you could have so much more independence."
While Rogers says the idea of a brain implant might give many people pause, he also sees possibilities for the technology to help people beyond those with spinal injuries.
He says people suffering from spastic disorders like cerebral palsy, for example, might use the system to gain easier access to computers and other electronic devices.
And Cyberkinetics president Tim Surgenor foresees many applications beyond prosthetic and rehabilitation functions — including some with military potential.
"There is an opportunity down the road ... to have people be able to use these products who are not disabled," Surgenor says.
"People who want to be able to control a computer by thinking, or who want to have an extra output that they don't have today."
He says military applications "are not a fantasy" and could, for example, allow pilots to plug their minds into their planes.
As well, he says, the system might be able to monitor brain signals for such things as epilepsy, pain or depression, as well as to bring signals into the brain to compensate for the loss of a particular function.

Toronto's hidden charm

This morning, as I walked to work amid rumbling streetcars, blackberry-wielding pedestrians and bad drivers, I was surprised to stumble upon stalls and stalls of fresh berries and fruit. Maybe its just me, but I thought Nathan Philips Square was a most unlikely spot for such an abundant farmer's market. Fruits and berries are not all either! They had vegetables, honey, pies, and even fresh cut flowers. I asked one of the girls at the first stand and it turns out that this charming gathering of deliciously tempting wares appears every Wednesday morning. I am now serving notice that I intend to be late for work next Wednesday: I have shopping to do.

Supermarketing

A crusading nutritionist helps confused consumers decide what to eat and how to get the most out of a trip to the grocery store

Jul. 5, 2006. 01:00 AM
SUSAN SAMPSON
FOOD EDITOR & WRITER


Marion Nestle is reading labels. She's always reading labels.

This morning, she is browsing through box after box of breakfast cereals lining aisle four of a Toronto supermarket.

"All of these cereal companies are doing health self-endorsements," she points out.

General Mills, for example, has the Goodness Corner. Post has the Sensible Solutions logo. They state the obvious about fat, fibre and added vitamins and minerals.

"Of course it's low in fat, a source of fibre. That's what cereal is," Nestle says, holding a box of Multi-Grain Cheerios.

She spots what looks like a brand of approval from the Heart and Stroke Foundation at the bottom of the package. So she puts on her glasses to read the fine print and finds that Cheerios financially supports the foundation's Health Check education program. "This is not an endorsement," the text warns.

"How shocking!" Nestle says.

She begins sorting through other packages. She prefers to buy the Honey Nut Cheerios.

"Do you want to eat that one instead?" she is asked.

"Certainly not!" she replies.

It's just that the Honey Nut box is more colourful and Nestle wants to add this example to her slide show of shame.

New York University professor, scientist, nutritionist and crusader, Nestle is famous for chewing out the food industry. She chastises corporations for encouraging gluttony and running ads that prompt kids to pester their folks for junk food.

Relentless attacks in print and in person, along with a 30-page resume that includes a doctorate in molecular biology and a master's in public health nutrition, have made her a tough opponent. She angers CEOs and makes life hard for lobbyists. The U.S. Sugar Association even threatened to sue her in 2002. Her critics say she puts politics ahead of hard science and gives not enough weight to personal responsibility for the obesity epidemic.

Nestle's views are captured in the books Food Politics: How the Food Industry Influences Nutrition and Health; Safe Food: Bacteria, Biotechnology, and Bioterrorism; and What to Eat: An Aisle-by-Aisle Guide to Savvy Food Choices and Good Eating.

What to Eat is new — a hardcover, 611-page, $39.95 table thumper. It has a lot of irrelevant (to us) references to American rules. It also talks universal sense.

The question of healthy eating is a minefield. And consumers are tiptoeing around in it. They remain confused about what to put in their carts and fear some foods are "poison," Nestle says.

"People are terrified of making a mistake," she says, navigating the aisles of the bright, shiny Dominion in Liberty Village during a visit to Toronto last week. "Everyone is looking for a simple solution."

And that is how she tries to keep it. One of her favourite sayings is: "It's just a food." Describing any one food as nutritious is easy. Proving it is difficult because diets are so varied, as are people, their genetic backgrounds and their lifestyles.

So Nestle espouses four easy principles: eat less, move more, eat lots of fruit and vegetables, go easy on junk foods.

These are bad for business. The most lucrative foods are not necessarily the best for the body. Basic ingredients are cheap. Processing adds value and ups profits. The shelf price of a potato chip by weight can be 10 times that of a potato, Nestle notes in her book. Advertising billions are spent encouraging us to buy the chip, but we don't hear much about the potato.

On the plus side, supermarkets do sell plenty of good-for-you stuff. That's why Nestle checks labels. And ingredient lists. The latter should be short, with items recognizable as food. (That, she says, leaves out a big portion of the frozen food section.)

Despite her reputation, Nestle appears positive, not strident. She prefers to linger amid the pretty produce than complain in the potato chip aisle.

A gorgeous selection of heirloom tomatoes — unusual for a supermarket — puts a smile on her face.

She is also pleased to see fruit and vegetables here labelled with place of origin, unlike the situation south of the border. "You're way ahead on this one," she says.

Local is best, she advises. Imported produce is often picked unripe and travel time by truck can be up to 10 days. "Fresh is relative," she says. In fact, Nestle believes flash-frozen fruit and vegetables are underrated. In winter, they may be better than what passes for fresh.

As for organics, she tells us to choose them not for what they might have (nutritional superiority — worth debating, hard to prove) but for what they don't have (like pesticides).

We all, by now, know the rule about sticking to the perimeter of the supermarket for the healthiest choices. But even that has its perils as the produce department stretches into the bakery, bakery into meat, meat into dairy.

Is yogurt health food or dessert? So many yogurts are sugar-laden, often in tubes and neon hues to please kids. Plain, unflavoured types with live cultures are in the minority.

A closer look at a package of hot dogs reveals that each one bears a quarter of the average person's fat and sodium allotment for the day. "That's a lot," Nestle says sadly.

At the in-house bakery, she picks up a packet of cinnamon buns. Hmmm, no nutrition label. "I'd have to guess about the calories," Nestle says. Her hunch: 500 each.

But calories are a tough call, she says, even for pros. "I don't think anyone can estimate calories. The only way to regulate intake is by weighing yourself."

If you maintain the same weight, you are in calorie balance. If you gain weight, she says, you are eating too much.

The latter is becoming the norm. In North America, life is a constant buffet. And the Law of Portion Size says the more food there is in front of you, the more you will eat.

Large supermarkets may display 40,000 edible products, Nestle writes. Food companies pay "slotting fees" for prime display space. Markets are designed with long aisles with no gaps that could allow you to escape before you impulse-buy your way to the other end.

"Supermarket retailers know more than you could possibly imagine about how to push your `buy' buttons," Nestle writes.

It all adds up to a plate piled high. What to put on that plate is the consumer's choice. Which brings us back to nutrition labels.

"The first thing I look at is calories, then portion size," Nestle says. "These are always smaller than you would actually eat. We've become accustomed to enormous quantities of food and people wonder why they are gaining weight."

Beware of the serving size trick on labels, she says. They are as small as possible to minimize the impact of calorie and fat content.

Staring down an entire aisle crammed with snacks and that liquid candy otherwise known as pop, Nestle says her first piece of advice for people who want to lose weight is "Lose the Coke."

In the buffet that is the supermarket, an enormous amount of shelf space is devoted to sugary foods: pastries, candy, cake mixes, juices and fruit "drinks," breakfast cereals (some "so thoroughly processed and sugared and filled with additives that they might as well be cookies," Nestle writes). Chocolate bars at the register make one last assault on your willpower.

Of late, manufacturers have been trying to make sugars look healthier. Hence the gummies with "real fruit juice" and those granola bars that give people a false sense of virtue.

For the record: one tablespoon of sugar is about 15 grams.

As Nestle waits in the checkout line, she talks proudly of influencing the American Diabetes Association to stop sponsoring sweet products.

No wonder she leaves Sugar Association executives with sour tastes in their mouths.

Nestle realized she was messing with powerful forces back in the 1980s. She had gotten a government job in the health department in Washington, editing a report on diet and the prevention of chronic disease. On her first day, she was told the report could never say eat less meat or the mad cattlemen would be hard to handle. She was soon beset by every food lobbyist in town — for sugar people, dairy farmers, salt sellers. And she was disillusioned to discover that a government document based on science could be strongly influenced by politics.

"All of them gave factual information and made veiled threats," she recalls. "It was very shocking."

Nestle (pronounced "Nessel") is no relation to the Nestlé food empire. ("It's a hilarious and ironic name for a nutritionist," she says.) She has relatives in Toronto (funny, one is a supermarket consultant) and has come here for a wedding.

Time is short. The supermarket tour is over. In the end, in an ideal world, this is what she'd like to see in our carts: vegetables and fruit; nuts, seeds and beans; whole grains; lean meats (in moderation, as opposed to the meat-centric plate); low-fat dairy foods; unprocessed or minimally processed foods.

But don't put these in your cart: foods with added sugar, added saturated fat or trans fat; refined grains; high-fat meat and cold cuts; whole milk and whole milk foods; highly processed foods.

And remember, shopping is about power and politics. Who has it? The consumer or the corporation?

"The choices you make about food are as much about the kind of world you want to live in as they are about what to have for dinner," Nestle writes.