In a classic "Star Trek" episode, Mr. Spock's brain is implanted with devices that allow remote control-by-thought of the master computer regulating life-support systems in the underground world of Sigma Dracona 6. "It's not possible!" Dr. "Bones" McCoy exclaims with breathless skeptical awe. Apparently, the 23rd-century chief medical officer was unaware of Dr. Philip R. Kennedy's pioneering work at Georgia Tech in the 20th century. Kennedy, a clinical assistant professor of neurology at Emory, leads a research project he started 13 years ago while working as a neural prosthetics researcher at Tech. His idea is that the brain's electrical signals can be recorded and amplified to efficiently operate a computer. Through the combination of a "neurotrophic electrode" invented by Kennedy while at Tech, customized microelectronics and software applications, the brain's neural signals become, in effect, a computer mouse to move a cursor and select icons on the screen-a computer system controlled by the power of thought. "It's actually not very high-tech," says Kennedy. "One thing that has made it possible is that small computers can do so much. It's amazing what they can do."
Dr. Phillip Kennedy holds a model of the human brain. Through his research, Kennedy hopes to allow disabled people to use brainwaves to run computers, thereby giving them the ability to communicate and perform basic functions for themselves.
At Emory University Hospital, Kennedy and Dr. Roy A. E. Bakay, a professor of neurosurgery at Emory and Kennedy's principal co-researcher, are preparing for their third clinical human trial. A pair of the patented electrodes will be surgically implanted inside the brain of a patient identified only as "T.T." Several weeks later, T.T. will be linked to the other components in the system.
Doctors Kennedy and Bakay won't know if the electrodes will perform as expected until the end of summer, but they have ample reason for optimism.
While computers have been helping paralysis victims for years through various kinds of adaptive interfaces, Kennedy's project is the first to establish a direct connection between the brain and a computer.
The collaborative, multi-disciplinary effort involves researchers at Tech, Emory and Georgia State. Their short-term goal is to devise new and more efficient means of human-computer interaction, thereby opening a communications window to the outside world for severely paralyzed individuals. Eventually the technology could enable many other interactive functions as well.
For victims of paralysis, the ability to manipulate a computer holds implications far greater than the simple ability to communicate wants and needs. "You can run businesses off the Internet," Kennedy says. "So why couldn't these people do that? All they have to do is run the computer. The technology opens up that possibility."
Kennedy is also convinced that his neurotrophic electrode portends many possibilities of its own, including operating complex robotic prosthetics or muscle stimulators.
A native of County Limerick, Ireland, Kennedy earned a medical degree at the National University of Ireland and trained as a surgeon in Dublin. In 1976, he emigrated to Canada to study neurosurgery, then moved to Chicago and earned a doctorate at Northwestern, studying neurophysiology and neuroanatomy. A naturalized U.S. citizen, Kennedy joined Georgia Tech in 1986 as a research scientist, when he also started developing his neurotrophic electrode.
From 1990 to 1997, he served as director of Tech's Neuroscience Laboratory. For the past two years Kennedy has divided his time among a private neurology practice and his research, the latter facilitated by an affiliation with Emory's School of Medicine.
Kennedy and his co-researchers must be very selective for the human trials. "This will not help people in a coma," Kennedy explains. "People have to be cognitively intact and know what's going on, but be unable to communicate." The best candidates at this stage of the experiment are individuals with amyotrophic lateral sclerosis-ALS, also known as Lou Gehrig's disease-or those with high brain stem or high spinal cord injuries, or patients with advanced degenerative muscle disease, he says.
The latest patient has been bedridden for the past four years and in a severely weakened state for the past 10. The metabolic muscle disease afflicting T.T. has left him with only slight eye movement left and right, and slight head movement, says Kennedy.
While a professor at Georgia Tech, Kennedy began exploring ways to use computers to harness brainwaves. Advances in computer minaturization have made possible much of his progress over the years.
"His brain is not affected," Kennedy adds, "and that makes him a good candidate for the procedure."
The technique's key component is the hollow glass, cone-shaped neurotrophic electrode. About the size of a ballpoint pen tip, the device contains a pair of microscopic gold wires and is coated with a biocompatible substance. That coating encourages neurites-tentacle-like structures extending from neurons-to migrate into the electrode, thereby ensuring a solid electrical connection and holding the device firmly in place.
Electrical signals traveling across the local cells pass through the electrode, which relays the impulses to a tiny amplifier and transmitter inserted just under the scalp. Those signals, in turn, are broadcast to a computer, where a special interface translates the signals to cursor movement.
Two electrodes are employed because basic computer operation is a two-step process. The first requires moving a cursor among a number of options; the second involves selecting one of those options.
If the electrode is implanted in the motor cortex in an area associated with, say, finger movement, the patient can generate electrical signals to move the cursor by concentrating on moving a finger. Another electrode, implanted in an area associated with a different kind of movement, can facilitate the computer's "select" function.
Because the location of movement-specific cells vary from person to person, a magnetic resonance imaging scan performed prior to implantation helps identify the best location for the electrodes.
The implant has been tested on humans twice before. The first patient, a woman suffering from ALS, died from the disease 77 days after surgery and before she could master the computer-control technique. The second patient, who received an implant last spring, achieved a place in medical history--and continues to amaze his doctors and family.
Georgia State Professor Melody Moore and a team of her computer students have written programs that help stroke victim Johnny Ray communicate via electrodes connected to his brain. "We are actually having conversations with him," she says.
Johnny Ray, a 53-year-old paralyzed stroke victim at the Veterans Administration Hospital in Decatur, Ga., became the first human to communicate via a computer controlled only by his brain power.
That simple word may never achieve the legend of "Come here, Mr. Watson, I need you," but it went a long way to vindicate Kennedy's determined effort. It was Ray's response to the question: How many children do you have? By focusing his thoughts to control the cursor, Ray spelled out the correct answer using a virtual keyboard displayed on the computer monitor. He then carefully, painstakingly, spelled out each of his children's names.
The breakthrough followed several months of trial and error as Ray learned which imagined movements best controlled the cursor, says Dr. Melody Moore, MS ICS '88, Ph.D. CS '98, an assistant professor in the Computer Information Systems Department at Georgia State who is helping Ray learn to manipulate the computer.
"Project manager" is probably the best overall description of Moore's role, which started about 18 months ago while she was pursuing her doctorate and teaching software engineering at Tech's College of Computing. She still works with students at Tech, and involves both them and her GSU students in the research.
"My students wrote a communications program that allows him to choose an icon that stands for critical phrases like, 'I'm too cold' or 'I need the nurse,'" says Moore. "By selecting one button, he can communicate a whole phrase instead of having to spell everything out."
As Ray's proficiency has increased, so has the sophistication of the communication, says Moore.
"We're actually having conversations with him," she explains. "Instead of asking him to spell Phil or Mel, we're asking things like, 'What's the best book you've read? What's your favorite movie?' He moves the cursor around and selects the letters to go into a writing program, and then he's able to speak them because we added a voice synthesizer.
"He's definitely improving. It's such a thrill for all of us, and it has improved his motivation, too."
Tech research engineers Andy Hopper (left) and Barry Sudduth built the electronics that interface with the electrodes implanted in Johnny Ray's brain. They are among a number of Tech researchers involved in Kennedy's project.
Hopper and Sudduth recently changed the design of the electronics to a "more robust PC board-based design using surface-mount components."
Ray may soon begin navigating the Web with a browser built by Moore and her students especially for him. The group is also perfecting a virtual "dart game" to help future patients learn to control the cursor, and analysis software to track the learning curves of patients.
"We're trying everything we can think of," Moore says. "Nobody's ever done this before-this is a totally new area. It's definitely cutting-edge, very futuristic technology-but the neatest thing about it is that it works."
Ray's recent progress is all the more gratifying because it follows a long period of health troubles.
"Anybody with a complete paralysis has health problems, but they are exacerbated by things like skin problems, bed sores and infections," Moore explains. "Sometimes it's hard to work with him because he's on so many painkillers, the brain signals don't happen. But lately he's been feeling better; he's off the ventilator, and he is really doing well."
In addition to Moore, several other Georgia Tech researchers provide extensive and ongoing contributions as the system is refined.
Andy Hopper and Barry Sudduth, research engineers at the Biomedical Interactive Tech Center, built the electronics that interface with the electrode.
"We have recently changed the design of the electronics from surface-mount components that were soldered to each other to a more robust PC board-based design using surface-mount components," says Hopper.
At the Center for Rehabilitation Technology, graduate student Kim Adams and research scientist John Goldthwaite have provided valuable though unofficial assistance.
"We're trying to help with the rehab engineering part-technical equipment, assisted technology, recommending software and things like that," Goldthwaite says, adding that he hopes the center can take a more active role in the future.
"We're trying to stay in it, but we don't have the funding to participate as much as we'd like to," he explains. "At some point, we would like to work with the patients and help them use computer-based augmented communications."
Also, Dr. Steven Sharpe and Neal Hollenbeck of the Georgia Tech Research Institute were deeply involved in the early work to develop a telemetry device for transmitting brain signals to a receiver.
Johnny Ray's electrode implant and subsequent direct brain-computer interaction have brought world-wide media coverage to the research. Kennedy's assessment of his newfound fame is mixed.
On the down side, the attention "puts incredible pressure on me," he says. "I still have to make a living in my neurology practice, and yet I feel more pressure to do more work on my research."
On the other hand, ongoing funding needs may be mitigated as a result of the publicity the project receives. In May, Kennedy received the Health Care Heroes Award for Innovation presented by the Atlanta Business Chronicle. And though the prize did not come with a cash award, "it did include a very nice punch bowl," says Moore.
For all its promise, Kennedy's research has been beset with frustrating funding problems throughout its history. At one point several years ago, when Kennedy was making the transition from basic research to application of his electrode, there were fears the work would have to be put on hold for lack of money.
With typical determination, he decided to raise research money by obtaining dollar pledges for each mile he ran in the Atlanta Track Club's Thanksgiving Day Marathon. The Georgia Tech Research Corp. matched the pledges.
The National Institutes of Health provided a grant for his first three human trials, but that support does not extend beyond T.T.'s implantation.
"The technique works, and I knew it would work," Kennedy says. "But it's hard to persuade people because everyone's going a different way" with respect to assistive computer technology.
Holding up Johnny Ray as an example, Kennedy notes that 14 months after implantation, "We're still getting strong signals-and that's incredible, very hopeful."
Various grant proposals are in the hopper, and while there's nothing concrete to report yet, Kennedy remains determined.
"I'm never going to give up." GT
Gary Goettling is a freelance science and technology writer in Tucker, Ga.
Dr. Phillip Kennedy flew to Florida with high hopes. And though he didn't return to Atlanta with $100,000 for his research, at least he brought home a crystal sculpture from Tiffany's.
The occasion was the announcement of winners of the 1999 Discover Magazine Awards for Technological Innovation. Billed as a "gala Academy Awards-style televised ceremony," the event was held June 5 at Epcot Center in Orlando, Fla. Kennedy's futuristic work in brain-electrode implants won first place in the Assistive Technology category.
The annual awards recognize potentially revolutionary new technologies. Nominations are solicited by the Discover staff from among universities and research institutions across the country. An independent panel of experts selects the winners in each category.
This year, 27 finalists in nine categories vied for honors and in particular for a $100,000 grand prize.
Kennedy's work and that of the other award finalists will be featured in the July edition of Discover magazine.