A 42-year-old woman named Bernardeta Gómez, from Elche, Spain, was diagnosed with toxic optic neuropathy, a condition that slowly ruined the optic nerves connecting the eye to the brain in as little as two days. The rapid deterioration of her eyesight forced her to stop her teaching profession in the sciences, and changed her life ever since.
However, things are looking quite bright for Berna’s future, so to speak: a newly-developed brain implant allowed her to recognize two-dimensional shapes and some characters—a landmark first for the research field.
The study comes as part of the latest developments in the search for aiding the visually-impaired, and follows the trail led by earlier explorations into the effort; one such study was the news piece from earlier this year, which saw similar results for a patient diagnosed with retinitis pigmentosa, but was aided with the help of gene therapy and genes from algae.
The effort was a collaboration between the University of Utah’s John A. Moran Eye Center and the Miguel Hernández University from Spain, with the new implant referred to as a “prosthesis hardwired into [the patient’s] brain,” according to the University of Utah’s official Twitter account.
Gomez herself made the decision to join the groundbreaking program back in 2018, when she bravely decided to become part of the study and become the first-ever patient of the Moran|Cortivis Prosthesis support.
Unlike earlier attempts at addressing visual impairment like retinal implants, the novel method went straight at the source and decided to attach the necessary implants directly into the visual cortex, a region of the brain known as the site for visual processing.
The implant itself contained some 100 “microneedles” attached to a very tiny electrode sized at about 4 mm on each side. The procedure was designed in such a way that the implant would be placed directly on her brain, around the area of the visual cortex, then be taken out some six (6) months after being placed in it.
The six months Gómez spent with the Moran|Cortivis Prosthesis wasn’t just for naught; she spent the first two months discerning which of the bright spots she was seeing was stimulated by the implant, and which were just the usual spontaneous flashes she was occasionally seeing before.
Afterwards, much of her time was spent on proper visual challenges to determine if the implant truly had a beneficial effect for Gómez. She was asked to identify the implant-induced light patterns, called phosphenes, and was asked to discern between closely-spaced dots and straight lines. Gómez happily exclaimed “I can see something!” during one of her first tests with the implant back in 2018; these tests can be viewed in video from the John A. Moran Eye Center’s own news piece on their remarkable effort.
Gómez reportedly struggled with vertical lines the most, as they were the hardest patterns to induce using the implant; despite these challenges, however, she was able to discern between horizontal and vertical patterns with 100% accuracy. Further studies with the phosphenes Gómez saw allowed the researchers to determine that the size and appearance of the phosphenes were also affected by the spatial distribution of the active components being triggered on the implant.
During the last month of testing, Gómez was able to discern between letters like I, C, and L, among others, by activating some 16 components in the implant but in different patterns. Further studies into the matter may also allow the researchers to determine which patterns allow patients to discern the rest of the character of the alphabet using this methodology.
The last portion of the study involved Gómez wearing specially-made glasses, equipped with a small video camera, which viewed the world around her then translated the visual data into activation patterns for the implant, giving Gómez a “simple” view of the world—the first she’s had in over sixteen years.
In doing so, Gómez was able to locate and identify black and white pieces of cardboard placed in front of her, with further practice making her speed at identifying the items even faster. No negative side effects, including seizures or neural death, were also identified—an extremely good sign for the potential longevity of the implant inside patients’ bodies, and suggesting more widespread optical applications for the new device.
The electrode arrays, now termed “Utah Electrode Arrays,” have also been placed on other parts of the body to assist in controlling artificial limbs; new studies show that the device exhibits a drop in functionality over time as nerve implants in other areas of the body like muscles, though, meaning the device is far from finished, and needs more fine-tuning.
Inhibitions aside, the team remains positive about their new development. University of Utah bioengineer Richard Normann said “[the] goal of this research is to give a blind person more mobility.” “It could allow them to identify a person, doorways, or cars easily. It could increase independence and safety. That’s what we’re working toward.”
“These results are very exciting because they demonstrate both safety and efficacy,” said lead author Eduardo Fernández from Miguel Hernández University. “We have taken a significant step forward, showing the potential of these types of devices to restore functional vision for people who have lost their vision.”
Finally, Gómez herself remains happy with the concept that her bravery in trying this new technology can help out other people like her in the future. “I know I am blind, that I will always be blind. But, I felt like I could do something to help people in the future. I still feel that way.”
For her immense contributions to the pioneer study, Gómez is listed as a co-author of the very study she participated in; it is now published in The Journal of Clinical Investigation.
References
- Cassella, C. (2021, October 28). Brain implant gives blind woman artificial vision in scientific first. ScienceAlert. https://www.sciencealert.com/a-brain-implant-has-allowed-a-blind-woman-to-see-simple-2d-shapes-and-letters
- Chappell, B. (2021, October 23). Scientists used a tiny brain implant to help a blind teacher see letters again. NPR. https://www.npr.org/2021/10/23/1048699230/scientists-used-a-tiny-brain-implant-to-help-a-blind-teacher-see-letters-again
- Fernández, E., Alfaro, A., Soto-Sánchez, C., González-López, P., Ortega, A. M. L., Peña, S., Grima, M. D., Rodil, A., Gómez, B., Chen, X., Roelfsema, P. R., Rolston, J. D., Davis, T. S., & Normann, R. A. (2021). Visual percepts evoked with an Intracortical 96-channel microelectrode array inserted in human occipital cortex. The Journal of Clinical Investigation. https://doi.org/10.1172/JCI151331
- George, J. A., Page, D. M., Davis, T. S., Duncan, C. C., Hutchinson, D. T., Rieth, L. W., & Clark, G. A. (2020). Long-term performance of Utah slanted electrode arrays and intramuscular electromyographic leads implanted chronically in human arm nerves and muscles. Journal of Neural Engineering, 17(5), 056042. https://doi.org/10.1088/1741-2552/abc025
- John A. Moran Eye Center. (2021, October 20). Scientists enable blind woman to see simple shapes using brain implant. University of Utah Health. https://healthcare.utah.edu/moran/news/2021/10/publication-artificial-vision.php
- Kho, R. C., Al-Obailan, M., & Arnold, A. C. (2011). Bitemporal visual field defects in ethambutol-induced optic neuropathy. Journal of Neuro-Ophthalmology, 31(2), 121–126. https://doi.org/10.1097/WNO.0b013e318205a148
