Miguel Nicolelis: "Beyond Boundaries" (Rebroadcast)

MS. DIANE REHM

10:06:55
Thanks for joining us. I'm Diane Rehm. The late actor Christopher Reeve once said of his paralysis, I am positive I will walk again. While he never saw his dream realized, new research is bringing hope to severely paralyzed patients and those with neurological disorders like Parkinson's disease. Scientist Miguel Nicolelis has written a new book about his ground-breaking research. He explains how living brains can interface with machines. His book is titled, "Beyond Boundaries." And Miguel Nicolelis joins me in the studio.

MS. DIANE REHM

10:07:47
Dr. Nicolelis is professor of Neuroscience at Duke University and founder of Duke University Center for Neuroengineering. Do join us, 800-433-8850. Send us your email to drshow@wamu.org. Feel free to send us a message on Facebook or a tweet. Good morning to you, sir. It's good to have you here.

DR. MIGUEL NICOLELIS

10:08:25
Good morning. Thank you for having me.

REHM

10:08:27
This research sounds like something right out of science fiction.

NICOLELIS

10:08:33
Well, I guess so. It was a little bit of science fiction about 20 years ago, but it's becoming reality now.

REHM

10:08:40
When you say it's becoming reality now, how far has it progressed?

NICOLELIS

10:08:47
Yes. We have now been able to read large scale brain activity, electrical signals coming from the brain and decode messages that are imbedded in these signals and transform them in digital commands that can be used by robotic devices or even virtual devices to enact a voluntary motor wheel of our subjects and...

REHM

10:09:09
Didn't it used to be that you would think of a particular part of the brain as doing a particular task, and now there is a whole new set of ideas about that?

NICOLELIS

10:09:27
Yeah, you just mentioned the greatest dogma of neuroscience for the last hundred years, the belief that particular parts of the brain were very highly specialized for a particular function. And, well, what we have found in the last decade in this research is that's not quite what goes on. There is more of a neuronal democracy. You know, neurons all over the brain are voting, albeit in different ways, to perform a particular behavior, to generate a particular behavior.

REHM

10:09:57
And I guess that the confirmation of that might be that when a particular part of the brain stops working, you have another part of the brain that could take over?

NICOLELIS

10:10:12
Exactly, exactly. There are a variety of studies for the last 20 years showing that the brain is very plastic, that he can adapt almost instantaneously to a lesion, either a central or a peripheral lesion. And the moment that lesion happens, the brain's trying to reroute the signals, these electrical signals, to restore the best possible solution, next solution for the problem that has emerged.

REHM

10:10:39
So is it possible that when one has a serious brain injury, say, one is in automobile accident or has a terrific spinal injury, as did Christopher Reeve, that the kind of experimentation you're doing could actually sort of push these neurons into activity?

NICOLELIS

10:11:10
Oh, absolutely. We are trying to take advantage of plasticity, brain plasticity. We are -- the whole idea of this research is to create a bypass, a bypass through the lesion using an interface between the brain and machines, using a computation of electronic and robotic interfaces that will allow what is left of the brain that is working properly to try to generate the signals that are necessary for the -- you know, this interface to restore function and behaviors, particularly motor behaviors.

REHM

10:11:43
Well, take motor behaviors, such as Parkinson's disease, how would you imagine your work might go on to help those people?

NICOLELIS

10:11:59
Yeah, we have recently, about two years ago, published a study showing a potential new therapy for Parkinson's disease that takes advantage of an interface with the brain. Today, as you know, patients that reach a very high or important level of motor impairment due to Parkinson's disease have very few options. One of them is a surgical procedure called deep brain stimulation that, you know, improves, in a great number of patients, the symptoms, but is an invasive procedure and is a tough procedure. Not every patient can take it. It's a small percentage of the patients that can have it.

REHM

10:12:34
And not every patient improves with it, yeah.

NICOLELIS

10:12:36
And not every patient improves, exactly. And, of course, the effects can go down with time. You know, the improvement can decline over time. Well, we discovered, because of this new view of the brain, this distributed view of the brain, this collective view of the brain, that we could come in the back, in the spinal cord in animals -- animals that have Parkinson-like Syndrome.

NICOLELIS

10:12:59
And we stimulate the surface of the spinal cord here where you have a million fibers going up to the brain to take a message to the brain and get the same effects that you get going deep into the brain with the deep brain stimulation technique. So in our animals, in rodents, we are able to basically alleviate all the Parkinson symptoms by doing the same stimulation, same electrical stimulation that today we do deep in the brain right here.

REHM

10:13:24
But what you're saying is your approach is non-invasive?

NICOLELIS

10:13:30
Well, it's semi-invasive because you just need to go under the bone.

REHM

10:13:33
Okay.

NICOLELIS

10:13:34
But it's so simple, and it's so easy. And it's so inexpensive that it could be affordable pretty much by everybody, and it could be done if it proves to be, you know, appropriate. And we already have primate data suggesting that it works in primates, too, preliminary data supporting the same results that we got in rodents that that surgery could be done almost at the moment of diagnosis.

NICOLELIS

10:13:57
So you could have a patient that could receive this stimulator. And that's an interface, a brain interface that could basically keep the patient from degrading. At least the symptoms would be under control much earlier on together with the pharmacological therapy or a much smaller dose of what is used today.

REHM

10:14:20
Interesting. Tell me about these trials with monkeys, planting small electrodes that record these signals from the neurons.

NICOLELIS

10:14:33
Yes. You mentioned Mr. Reeves. And I met him way back, you know, when we were starting this research, and that was a very moving day because I mentioned to him that my dream was like his. I had seen so many patients when I was in medical school back in Brazil, before joining Duke, with paralysis that, for a long time, we thought about an idea. And that's exactly what he mentioned.

NICOLELIS

10:14:54
We discovered that if we can record the electrical brainstorms that are generated in the brain, in the cortex, the motor cortex, you know, where the plans for us to move, are generated half a second before we even start moving. That's what the brain does.

REHM

10:15:11
Yeah.

NICOLELIS

10:15:11
The brain is about the future. It plans the future of our motion. And, during that window, half a second or so, we discovered, in the last 10 years, that we could record this electrical signals that encode a motor behavior, decode this message, translate this message into digital commands and send these digital commands to a robotic arm, a robotic leg, a virtual body or a computation or two so that that subject, a monkey in this case, could control just by thinking the movements of these devices, these artificial devices. So, basically, the monkey could enact its voluntary motor will just by thinking.

REHM

10:15:55
Just by thinking.

NICOLELIS

10:15:57
Yes. That's the -- one of the sentences that I think is the key of all this work.

REHM

10:16:03
Miguel Nicolelis, he is a professor of neuroscience at Duke University, founder of Duke Center for Neuroengineering. His new book is titled, "Beyond Boundaries: The New Neuroscience Of Connecting Brains With Machines and How It Will Change Our Lives." Do call, 800-433-8850. Send us your email to drshow@wamu.org. Join us on Facebook or Twitter. Now, you had another experiment with a monkey, a rhesus monkey, called Aurora.

NICOLELIS

10:16:55
Yes.

REHM

10:16:56
Tell us about her.

NICOLELIS

10:16:57
Now, Aurora has become perhaps the most famous actress or monkey in this research field. She's known all over the world because she was one of the first primates to actually do what we just discussed. She was able to control a robotic arm that played a video game for her, and she first learned to play this video game with her own arm, controlling a joystick. And every time she got the game right, she would get a drop of fruit juice. And she would do anything for that fruit juice. She loved it, and she drank, you know, liters of it per day.

NICOLELIS

10:17:30
And once she learned to play the video game -- and the same time that she was learning, we were recording her brain activity and making our computers learn to reproduce her arm movements into a robotic device that was in another room. So, after a few weeks, we just, you know, kindly removed the joystick and let Aurora realize that, now to play the game, she didn't need to move her body at all. She just had to imagine the movements that she had to make.

REHM

10:17:58
And that would move...

NICOLELIS

10:17:59
And the robotic arm would move and would control the computer cursor that would play the game for her. So I have these videos, and I have played these videos all over the world. And in our website, too, you know, we are putting these videos, beyondboundariesnicolelis.net. And it's one of the most amazing moments of my life because you see the monkey just relaxing, and, all a sudden, the cursor continues to move. And we see the robotic arm moving as she would her arm.

REHM

10:18:25
And we will have that website attached to our own at drshow.org. Right now, join us, 800-433-8850.

REHM

10:20:52
"Can you speak a little about how this research could point to new ways to rewire the brains of these children? I'm thinking of neurofeedback in particular."

NICOLELIS

10:21:36
And that somehow died out for a long time and, because of this research on brain machine interface and because we realized that the feedback that you send from these devices back to the brain is so important, the issue of how you handle feedback to retrain the central nervous system has acquired tremendous new interest. So I don't particularly work on these fields, in these particular disorders...

NICOLELIS

10:22:41
The brain acquires information and statistics of the world as we are growing up and creates a whole model of who we are and the model of reality that is out there. So the brain has a point of view, continuous point of view of everything that is about to happen. So when you accept that, you change the way you interact to the brain.

NICOLELIS

10:24:48
So we could have a quadriplegic patient dressed up in this robotic vest, that I call an exoskeleton, that you have with you.

NICOLELIS

10:27:42
So after a few months of use, that will be a natural thing, as much natural -- as natural as if we were, both of us, walking out in the street.

NICOLELIS

10:29:28
You cannot really just stop everything. You'll go to St. Louis. You'll go to other places. That's what the brain does dynamically all the time, in a much larger scale, of course.

NICOLELIS

10:31:35
So Parkinson's disease, for instance, we discovered, with the studies that we just mentioned in the beginning, that Parkinson's -- if you look at the brain activity of animals with Parkinson's and now with patients, what you see is the neurons are all firing together in these regions, in the basal ganglia and even in the cortex. They are very synchronous. They are all firing at the same time.

NICOLELIS

10:35:24
And that was very encouraging, but I wouldn't, you know, move to say what type of patient would benefit right now because we simply don't know.

REHM

10:40:03
And we're back talking with Miguel Nicolelis about his new and fascinating work, a very thorough description of which is entered into his new book, "Beyond Boundaries." He is professor of neuroscience at Duke University, founder of Duke Center for Neuroengineering. Stuart is listening from WMFE in St. Petersburg, Fla. He says, "Do the brain storms that are transmitted as signals differ between species or individuals? And if they do, do they differ with age and wisdom?"

NICOLELIS

10:40:56
Oh, that's pretty interesting.

REHM

10:40:57
That's a good question.

NICOLELIS

10:40:58
That's a very good question, yes. The principles of these brain storms are very similar. So the principles in mammals and primates and humans, the generated storms are very similar because they are electrical storms that liberate some chemicals that allow neurons to interact with each other. But the details of these storms, from person to person, differ. So the general principles -- and we have listed here 10 principles in the book that, over 25 years, we have experimentally demonstrated.

NICOLELIS

10:41:30
They seem to be valid from species to species, from rodents to primates to -- and now we are about to test these in humans, of course. But within these principles, there is this uniqueness of each of us. You know, what I like to say is that, at the same time -- the brain tells us that, at the same time that each of us is unique, it shows that each of us belongs to the same thing. You know, we have a common language of interacting and thinking and generating our feelings and emotions and predictions of the future and memories of the past.

NICOLELIS

10:42:04
And yet, within these common principles, there is room for each of us to be a unique brain history that will never ever repeat itself in the universe. There is no chance that a life like any of ours is going to be repeated.

REHM

10:42:24
Well, we may actually be able to voice our thoughts. But what about whales, what about dolphins, what about these rhesus monkeys who cannot relay to you orally...

NICOLELIS

10:42:45
Orally, yes.

REHM

10:42:46
...what they are thinking, but can in other ways?

NICOLELIS

10:42:51
That's another very interesting question. I think, verbally, we, as you said, that we can relate our thoughts. We can relate just a very small fraction...

REHM

10:42:59
Of what's going on up here.

NICOLELIS

10:43:00
...of what is going on, and it's in very precise ways. You know, language -- in fact, I discuss the views of few philosophers and neuroscientists from way back, and some contemporary neurophysiologists, that language -- our problems interpreting the brain is that the way we have to describe the brain is either language or written language. So we really don't have words to describe the functions, the probabilistic functions that go on in our heads. So that's a very nice point.

NICOLELIS

10:43:28
I actually propose that, way ahead in the future, we may be able to express ourselves beyond language. We may be able to express ourselves by actually broadcasting our thoughts and communicating our impressions, emotions and views in a very different way.

REHM

10:43:45
And perhaps those whales are communicating their thoughts in ways that we simply don't understand.

NICOLELIS

10:43:56
Well, they certainly have ways to communicate among themselves...

REHM

10:43:59
Of course.

NICOLELIS

10:44:00
...that people have been studying for a long time.

REHM

10:44:01
Of course, right.

NICOLELIS

10:44:02
But what is -- what I'd like to say is that this research -- this -- the possibility of reading electrical signals from the brain and interfacing these with machines, we'll actually liberate the brain. We'll liberate the brain from the constraints of language, of the constraints of the body. And our thoughts will have, you know, a free access to, you know, very different ways to express to express themselves.

REHM

10:44:23
In your lifetime?

NICOLELIS

10:44:25
I think so. I actually think so, that, in the next 30 years -- I hope to reach that at 80 -- we will see things that amaze us.

REHM

10:44:34
All right. Let's go to Jeremy. He's in Seattle, Wash. Good morning.

JEREMY

10:44:41
Good morning.

REHM

10:44:42
Go right ahead, sir.

JEREMY

10:44:44
Yes. The question -- and even as you were talking about the language barriers there -- is, how is it that you isolate the neurons that are firing in the brain and the connection there to translate that abstractness to the point where you can, without hardwire connection to the central nervous system, maintain some sort of control over a machine? How is it that you overcome those challenges to the point where -- with, you know, distracted focus that the brain has, is it that the subject simply has to, with determined focus, think about what they're trying to do?

JEREMY

10:45:26
Or is it that you're really able to isolate the neurons that are the ones that are responsible for achieving the command that you -- and the operation of the machine that you're trying to do? So I was wondering if the doctor could speak to those and other challenges in that regard.

REHM

10:45:44
Thanks, Jeremy.

NICOLELIS

10:45:45
Well, that's a wonderful question because it touches directly on the issue that prevented most people of doing the kind of experiments that we did, you know, because people thought that you had to find the precise neurons, those right cells in the middle of that huge ocean -- huge forest, find the trees that actually had the goods to produce these motor behaviors. We found out that is not the case. You just go generally to areas that we know are involved in motor coding -- or generating motor commands.

NICOLELIS

10:46:15
You draw up these electrodes. They are hair-like sensors, very thin sensors that you just introduce a few millimeters in the brain. In the future, it's going to be like a heart pacemaker, very similar. You just introduce these hairs into the brain a few millimeters, and what we realize is that if you sample enough neurons, hundreds of them, you don't need to fish for the cardinal...

REHM

10:46:40
The right one.

NICOLELIS

10:46:40
No. The right -- no. The message is widely distributed across all these cells. That's the reason I call it a neuronal democracy. Things are all over the place. They're floating all over the place, and then you record them. If you have enough mass of neurons being recorded, you will get the signals you need.

REHM

10:46:58
Prof. Nicolelis, we've had a number of emails asking about what about fears of Big Brother.

NICOLELIS

10:47:07
Oh, yeah. This is always the case when new technology comes, and it's up to society, of course, to regulate the use of a new technology. I like to say that when I was in medical school back in Brazil and I worked on the busiest emergency room that exists in the world every night when I was an intern, that my teachers used to come to me and say, you know, if everything fails, here you have a Bic pen, and the cap of the pen has this little tip. You can use this to make a tracheostomy and save someone's life.

NICOLELIS

10:47:38
So you can use any tool, anything for good and for bad things, and that's the reason science and scientists have to inform society continuously of the details of what they're discovering and what are the limits and what are the potential harmful ways in which that technology could be used. That's the reason -- one of the reasons I wrote this book because I thought it was very important to diffuse these fears because there's so much good that can come out of this technology and to help millions of people.

REHM

10:48:07
But would you also agree that there is a fair amount of ill use, too, which it could be put?

NICOLELIS

10:48:14
Oh, certainly. It could happen, of course. It could -- although the technology that we have today available right now would not allow the science fiction scenarios to happen.

REHM

10:48:26
All right. Let's go to the Tampa, Fla. Good morning, Maurice.

MAURICE

10:48:32
Good morning. You know, Doctor, I have a question for you, and I agree with ethics. I mean, you're always going to have a question of ethics, and, like you said, there's always something that could be used for good or for bad. But, hopefully, we err on the side of good. But two questions, Doc. When -- at what age did you become interested in neuroscience, and what was the stimulus that caused that to happen?

MAURICE

10:48:52
And then the second question is, children -- are there programs out there for our future neuroscientists, whether they're in the United States, whether they're in Brazil, whether in Japan? Where -- are there programs that children that are in grade school and high school can get involved in, organized programs that would pique their curiosity and hopefully drive our youth into the neuroscience sector? Because it just seems like our country right now, the United States, is not producing as much scientists. There's not so much interest, and I just think that there should be something...

REHM

10:49:28
Sure.

MAURICE

10:49:28
...out there, something more prevalent that's organized from an early stage.

REHM

10:49:33
You know, Maurice, we did a program just a couple of weeks ago on robotics and how high school children are getting involved in building robots for class projects and competing on a national and even a world stage. Now, high school may be too late for what you're talking about. What about younger children?

NICOLELIS

10:50:05
Yeah. No, that's a wonderful question. I got involved into -- I knew that I would be a scientist when I was growing up in Brazil watching the Apollo program. And when I was 5, 6 years old...

REHM

10:50:15
Interesting.

NICOLELIS

10:50:16
...and I was following every single mission -- I was plotting it on atlases. I was watching as much as I could. There was no Internet, but, you know, I was reading every drop of it.

REHM

10:50:27
With the help of parents.

NICOLELIS

10:50:29
My grandmother.

REHM

10:50:30
Your grandmother.

NICOLELIS

10:50:31
My grandmother and I knew when Neil Armstrong was about to land before he landed there, you know. And we amazed the Brazilians, you know, in our neighborhood by saying, oh, we knew that would happen.

REHM

10:50:40
Mm hmm.

NICOLELIS

10:50:41
In any event, I was seven, and I read a book at that time by Isaac Asimov called, "The Brain." And there was somewhere there...

REHM

10:50:48
Fascinating man.

NICOLELIS

10:50:49
Yeah, fascinating man.

REHM

10:50:50
Yeah.

NICOLELIS

10:50:51
He was one of my heroes at that time. And he said, there's only one thing that compares to the universe. That is the brain. And that got me, you know, forever. Well, it's very nice that you mentioned this because, for the last 10 years, I have been running a program in Brazil for children, a science education program that is really becoming a major initiative in Brazil. And I think that could be extremely useful here in the United States because I agree totally what we've said -- high school is too late. Scientists, they are groomed in the cradle and in the early days of childhood.

REHM

10:51:26
How did you get them involved?

NICOLELIS

10:51:27
Passion. Passion. Science is about passion. It's about being a child forever. It's about being paid to be a child forever, and it's one of the greatest professions you can have because people trust you. Society, the taxpayer, trust you to come up with solutions for humanity while you are there really acting like a kid.

REHM

10:51:45
But, you know, when I was -- again, this is a little later, a freshman in high school, what did we do in science but start cutting up frogs?

NICOLELIS

10:51:57
Yeah.

REHM

10:51:57
Please.

NICOLELIS

10:51:58
Yes. No, no. That's not what I'm talking about. Our kids, they start -- this program is called Education for Life in Brazil, and it started with 1,000 kids in the poorest part of the country and is now going to become a curriculum for more than a million kids in Brazil.

REHM

10:52:12
Give me an idea of what's contained in the program.

NICOLELIS

10:52:15
It's all -- yeah. We start at elementary school level, and we are going all the way back to four years old. We are -- we discovered that we can start as early as you can imagine, and it's playful. You learn science by doing science. You learn the big concepts of science in laboratories for children, created for children, in which children get engaged into demonstrating the scientific method at work by doing scientific work like I do in my lab. And that is a revolution. You get people engaged into this, and math and science, chemistry and physics becomes playful.

REHM

10:52:47
And you're listening to "The Diane Rehm Show." And now to Severna Park, Md. Good morning, Sheila.

SHEILA

10:52:57
Good morning, Diane. I didn't hear any discussion about lesions from brain tumors. I have a granddaughter and a daughter who have suffered some motor impairment, some cognitive impairment. And I was just wondering if there's any research being done in that area.

NICOLELIS

10:53:18
Yes. I'll do -- in our animals -- in animal work, we have not simulated these type of lesions. One of the future applications, we hope, of course, to use brain machine interfaces for is to rehabilitation -- for rehabilitation of patients that have lost brain tissue or have exactly what you described, a tumor, that destroys areas of the brain. So a solution -- one of the solutions that is envisioned is to use the other hemisphere but retrain other areas of the brain to try to restore some of the functions that have been lost through the disease.

REHM

10:53:53
You know, that takes me to a question about things like hip replacement or broken arms or, you know, something that happens to a lot of people. Is there any indication, in your mind or in your work, that the brain does have the ability to heal the body?

NICOLELIS

10:54:21
Well, certainly, the brain remaps the body. So once you have -- for instance, there's one phenomenon that you may have heard of that is one of the most prevalent phenomenon in neurology that is called phantom limb pain. So you have missed a part of your body through an amputation, let's say, traumatic or because of, you know, your clinical need. In 80 to 90 percent of the patients, that part of the body is still felt.

NICOLELIS

10:54:48
The patient reports not only that he can feel that limb that is gone, moving or sensations coming from the hand that doesn't exist anymore or even pain. And imagine having pain -- excruciating pain that cannot be treated by almost anything -- in a part of you that doesn't exist anymore. So that's one of the most terrifying things that I have seen way back in medical school, and it has been with us since the medieval ages, you know.

NICOLELIS

10:55:17
And, only recently, a few scientists have realized -- Dr. Ramachandran, University of San Diego, for instance, is the pioneer on this -- that to -- perhaps to treat that excruciating pain and that phantom sensation, you have to fool the brain. So he has shown that if you project with mirrors an image of the other limb that is still present in the stump, that -- you know, so that the person has the feeling if you put both of your arms in a box and the box has mirrors that project the image...

REHM

10:55:46
The other arm...

NICOLELIS

10:55:47
...on the other, and the person sees the arm back there, the pain goes away. The phantom sensation goes away. The brain thinks, okay, I have the missing part back. It's there, so I don't need to generate this weird sensation, this alarm that something is -- you know, is wrong. Or these memories of that part of the body that...

REHM

10:56:07
So the brain can be tricked?

NICOLELIS

10:56:10
Yes, because the brain is a simulator. And if you trick the way the brain creates the simulation, you may be able to treat a lot of things that we couldn't because we are treating the brain not properly.

REHM

10:56:24
Well, I'm sure you and I could go on for hours. Fascinating discussion.

NICOLELIS

10:56:29
Thank you very much.

REHM

10:56:30
Thank you so much for being here.

NICOLELIS

10:56:33
My pleasure.

REHM

10:56:34
There's a link at drshow.org to Dr. Miguel Nicolelis. His new book is titled, "Beyond Boundaries." Congratulations. Come back and see us when the work continues.

NICOLELIS

10:56:52
Thank you very much.

REHM

10:56:53
Thank you. Thanks for listening, all. I'm Diane Rehm.

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10:56:56
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