Unlocking Voices Of The "Locked In"


FLORIDA - BACKGROUND:  There are over 2 million people in the U.S. with some level of functional LIS. (Source: www.ohsu.edu/xd/research)  Locked-In Syndrome is a rare neurological disorder characterized by paralysis of voluntary muscles in all parts of the body except for the muscles that control eye movement.  The disease will leave the person completely paralyzed and mute.  Communication is possible through blinking of the eyes.  Patients are able to reason and are conscious; they just cannot move or speak.  It could be a result from traumatic brain injury, diseases that destroy the myelin sheath surrounding nerve cells, diseases of the circulatory system, or medication overdose. There are three classifications of Locked-In Syndrome:  complete LIS (quadriplegia), classic LIS (preserved vertical eye movement), and Incomplete LIS (recovery of some voluntary movements). (Source: www.ninds.nih.gov)

CAUSES:  Locked-In Syndrome is most commonly caused by any condition that affects an area of the brain called the ventral pons.  This part of the brain is where all of the nerve tracts that are responsible for voluntary movement pass through.  The area of the brain that is responsible for consciousness is preserved above the ventral pons; therefore, allowing the person to be able to think.  Diagnosis for a conscious individual with no muscle functioning means they respond to questions by blinking.  Doctors will diagnose further by CT or MRI scans to reveal if there is a presence of stroke or aneurysm that could have caused the condition. (Source: www.ninds.nih.gov)

TREATMENT:  Unfortunately, there is no cure or a standard treatment plan.  A therapy called functional neuromuscular stimulation, which uses electrodes to stimulate muscle reflexes, might help to activate paralyzed muscles.  There are also several devices to help with communication.  The most important goal of rehabilitation is finding devices to assist the patient with communicating.  (Source: www.ninds.nih.gov)

NEW TECHNOLOGY:  A new device called noninvasive brain-computer interface (BCI) can allow people who are locked-in to communicate by operating a computer cursor.  This type of technology was invented originally to be assistive technology and now it can be used for controlling video games, automating sailboats, robotics, and military tasks. Early studies of the BCI involved implantable sensors.   Now the new BCI system can detect the brain’s activities through the scalp, from the surface of the brain, and then it can be processed by a computer to extract certain patterns.  Patterns are then translated into commands for a device.  Technology substitutes for the loss of typical neuromuscular outputs so that people can interact with their environments through brain signals rather than through muscle. (Source: www.ohsu.edu/xd/research)