RJ is a freelance science writer based in Glasgow. He covers biological and biomedical science, with a focus on the complexities and curiosities of the brain and emerging AI technologies. RJ has a Master’s degree in Clinical Neurosciences from the University of Cambridge.
Keith Thomas (left) who lives with paralysis, can now feel touch due to a “double neural bypass” brain-computer interface. Chad Bouton (right) of Northwell Health led the research team.
Image credit:Feinstein Institutes for Medical Research
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A neuroprosthetic system has allowed a man with paralysis to grasp and lift objects and feel touch again. The device helped 42-year-old Keith Thomas of Massapequa, New York, who was paralyzed from the chest down after a diving accident in 2020. After the accident, he couldn’t lift his hands to his face and had no sensation in his hands or wrists. But the innovation, called a “double neural bypass” system, improved his movement. In a study published in Nature Medicine, researchers found that some of Thomas’s improvements lasted for months after the system was turned off, raising hopes the device could help paralyzed patients in the long term.1
Millions of Paralysis Patients Want to Feel Sensation Again
There are roughly 15 million people worldwide living with spinal cord injury, and this patient group often ranks restoration of hand movement as a priority, above bowel and sexual function and the ability to walk.
“This research holds promise for millions of patients, opening up potential for future research and practical clinical applications that could help hundreds of thousands of people living with paralysis,” said Chad Bouton, a bioelectronic medicine researcher at Northwell Health and coauthor of the study, in a statement.
The double neural bypass system uses a brain-computer interface device. This consists of five microelectrode arrays, which can read brain activity and deliver electrical stimulation, implanted into Thomas’s brain.
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The researchers combined these arrays with electrical stimulation of the spinal cord through wearable stimulation patches placed on Thomas’s skin. The aim: to boost a natural process called neuroplasticity, which governs how well the brain and nervous system can form new connections.
The team recorded Thomas’s brain signals when he imagined the sensation of touch, and then “played” those signals to his muscles through the patches on his skin and directly onto the sensory areas of his brain.
The system incorporated a neural network computational model to decode Thomas’s brain signals. The system proved highly accurate over the study period, identifying Thomas’s intended hand movements for months without retraining on his brain data.
Strength and Dexterity Restored
With his brain-computer interface, Keith Thomas now has the dexterity to perform delicate movements like grasping and lifting empty eggshells without breaking them.
Feinstein Institutes for Medical Research
Thomas used the device for 35 weeks, during which his right arm strength increased 86 percent, and his left arm strength increased 62 percent. By the end of the study, he could wipe his nose or scratch his mouth while using the device. The system gave Thomas excellent dexterity. He could lift hollow eggshells without breaking them 87 percent of the time.
At around the six-month timepoint, Thomas regained the ability to feel touch in his right wrist. This was the first time he had felt sensation in his arms since his injury. Importantly and remarkably, some of these improvements persisted outside of the study sessions, when the device was switched off. “Remarkably, in a recent follow-up, it was found these gains were still present after more than two years. This is incredibly encouraging,” said Bouton.
“Being able to feel my sister’s hand, to pet my dog and feel her fur—these experiences that the injury took away have been restored,” said Thomas. “But beyond the study sessions, I can now scratch my face, wipe my eyes independently. The technology has given me back both connection and sense of self.”
RJ is a freelance science writer based in Glasgow. He covers biological and biomedical science, with a focus on the complexities and curiosities of the brain and emerging AI technologies. RJ was a science writer at Technology Networks for six years, where he also worked on the site’s SEO and editorial AI strategies. He created the site’s podcast, Opinionated Science, in 2020. RJ has a Master’s degree in Clinical Neurosciences from the University of Cambridge.
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Neurodegenerative diseases are a group of debilitating disorders characterized by progressive degeneration of nerve cells and a range of associated clinical symptoms, including motor, cognitive, and behavioral deficits.1 The accumulation of abnormal proteins in neurons is a key feature across many neurodegenerative disorders. The particular types of protein aggregates and their distribution across discrete neuronal populations vary between different neurodegenerative diseases and underly, in part, the clinical symptoms. Pathological protein aggregates can serve as biomarkers of disease, allowing researchers to identify and track neurodegenerative disease progression and develop novel therapeutics. For example, alpha-synuclein, amyloid-beta, and tau are some of the most widely studied for this purpose.
Among the most severe neurodegenerative disorders are amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). ALS and FTD are related to one another, sharing some of the same pathological molecular pathways, even though they are two distinct diseases. Abnormal neuronal protein accumulation in the brain occurs in both ALS and FTD, contributing to subsequent neuronal cell damage and death, as well as the associated clinical symptoms of each disease.2
ALS is characterized by progressive degeneration of motor neurons, which leads to muscle weakness that eventually affects breathing and causes death within approximately five years.3 FTD is characterized by neurodegenerative changes in brain regions that are involved in language and behavior, followed by debilitating mental, behavioral, and language deficits. ALS can occur with FTD, causing patients to deteriorate faster.
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TAR DNA-binding protein 43 (TDP-43) and progranulin are emerging biomarker and therapeutic targets for ALS and FTD. Aberrant deposition of TDP-43 is a hallmark feature in almost all ALS patients and approximately half of FTD patients.4 While mutations in the TARDBP gene that encodes the TDP-43 protein cause pathological changes, such mutations are not the only underlying contributor to ALS, FTD, or ALS with FTD. There is an intimate relationship between TDP-43 and progranulin, a commonly occurring nervous system protein, and the connection between them is a significant area of neurodegenerative disease research.
Many cells secrete progranulin, including central nervous system neurons and microglia. Under normal circumstances, this protein plays a role in inflammatory responses and orchestrating cellular growth, repair, protection, and survival. Researchers increasingly study progranulin to gain deeper insight into its role in neurodegenerative diseases such as ALS and FTD, among others, where decreased levels of progranulin are associated with an increase in pathological protein deposition, dysregulation of immune cells, and accumulation of waste products. For example, familial mutations in the GRN gene that lead to reduced progranulin production can cause an inherited form of FTD. Moreover, the severe reduction in progranulin protein production associated with GRN mutations is also related to FTD TDP-43 pathology, with a potential protective role for progranulin protein in mitigating neurodegeneration related to TDP-43 mutations.5
Pathological TDP-43 was first studied as a cerebrospinal fluid biomarker of ALS in 2008.6 Since then, researchers have assessed the potential of TDP-43 as a cerebrospinal fluid or blood plasma biomarker of ALS and FTD, with promising results.7 Progranulin is being pursued as a therapeutic target, based on research in various animal models of neurodegenerative disease that shows its protective capabilities.8 For example, researchers are interested in the potential of progranulin gene therapy for increasing progranulin expression and restoring normal levels of this protein to mitigate disease. To accomplish this, scientists use adeno-associated viruses for targeted delivery of GRN gene payloads to specific neurons in the brain.9 Various trials are underway in humans to test multiple potential therapeutic approaches to modulate progranulin levels in neurodegenerative disease, particularly FTD, with promising results that continue to substantiate the importance of this target.10
Tools for Biomarker Development and Therapeutic Targeting
Biomarker discovery and development for neurodegenerative disease is a burgeoning field. Discovering sensitive and specific biomarkers depends on access to reliable reagents and assays that scientists can use to reproducibly assess disease-associated biomarkers in tissues and fluids. Rigorously validated antibodies and immunoassays are essential tools for evaluating the clinical relevance of neurodegenerative disease biomarkers, especially low abundance biomarkers in blood and CSF.
Aviva’s recombinant antibody development pipeline maintains rigorous quality standards that help scientists advance their biomarker and therapeutic targeting research. Aviva’s repertoire of tools for studying progranulin and TDP-43 biology is expanding rapidly. This includes anti-progranulin monoclonal antibodies for use in immunocytochemistry, ELISA, and western blot, as well as off-the-shelf, semi-custom, and fully custom proteins for developing assays.
Aided by increased access to high performing reagents and assays, scientists are homing in on the role of progranulin and TDP-43 in neurodegenerative disorders and their growing potential as biomarkers for ALS and FTD diagnosis, tracking, and therapeutic targeting.11-14 Overall, these approaches are helping scientists uncover the underlying biochemical and biomolecular pathways of neurodegenerative disease and pave the way for future translational applications.
Aviva’s Custom Assay and Antibody Programs
As progranulin and TDP-43 move from emerging targets to translational biomarker programs, the limiting factor is often not scientific interest but measurement confidence. Low abundance signals in CSF and blood, multiple proteoforms, and matrix effects can make “good enough” reagents a hidden source of variability. As a result, Aviva prioritizes custom antibody discovery, development, and characterization, helping researchers generate fit for purpose binders and immunoassays, validated in relevant formats and sample types, with antibody binding kinetics measured and reported alongside performance data. The result is an approach to target specific reagent design and validation that supports reproducible data and more confident decisions as programs progress toward clinical relevance.
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