[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.45,0:00:02.07,Default,,0000,0000,0000,,I am a neuroscientist
Dialogue: 0,0:00:02.07,0:00:05.88,Default,,0000,0000,0000,,with a mixed background in physics and medicine.
Dialogue: 0,0:00:05.88,0:00:10.92,Default,,0000,0000,0000,,My lab at the Swiss Federal Institute of Technology
Dialogue: 0,0:00:10.92,0:00:14.11,Default,,0000,0000,0000,,focuses on spinal cord injury,
Dialogue: 0,0:00:14.11,0:00:16.84,Default,,0000,0000,0000,,which affects more than 50,000 people
Dialogue: 0,0:00:16.84,0:00:19.53,Default,,0000,0000,0000,,around the world every year,
Dialogue: 0,0:00:19.53,0:00:23.14,Default,,0000,0000,0000,,with dramatic consequences for affected individuals,
Dialogue: 0,0:00:23.14,0:00:25.37,Default,,0000,0000,0000,,whose life literally shatters
Dialogue: 0,0:00:25.37,0:00:28.61,Default,,0000,0000,0000,,in a matter of a handful of seconds.
Dialogue: 0,0:00:28.61,0:00:31.67,Default,,0000,0000,0000,,And for me, the Man of Steel,
Dialogue: 0,0:00:31.67,0:00:33.87,Default,,0000,0000,0000,,Christopher Reeve,
Dialogue: 0,0:00:33.87,0:00:35.96,Default,,0000,0000,0000,,has best raised the awareness
Dialogue: 0,0:00:35.96,0:00:38.88,Default,,0000,0000,0000,,on the distress of spinal cord injured people.
Dialogue: 0,0:00:38.88,0:00:42.01,Default,,0000,0000,0000,,And this is how I started my own personal journey
Dialogue: 0,0:00:42.01,0:00:43.51,Default,,0000,0000,0000,,in this field of research,
Dialogue: 0,0:00:43.51,0:00:46.95,Default,,0000,0000,0000,,working with the Christopher and Dana Reeve Foundation.
Dialogue: 0,0:00:46.95,0:00:51.55,Default,,0000,0000,0000,,I still remember this decisive moment.
Dialogue: 0,0:00:51.55,0:00:53.50,Default,,0000,0000,0000,,It was just at the end of a regular day of work
Dialogue: 0,0:00:53.50,0:00:55.04,Default,,0000,0000,0000,,with the foundation.
Dialogue: 0,0:00:55.04,0:00:59.69,Default,,0000,0000,0000,,Chris addressed us, the scientists and experts,
Dialogue: 0,0:00:59.69,0:01:03.28,Default,,0000,0000,0000,,"You have to be more pragmatic.
Dialogue: 0,0:01:03.28,0:01:05.64,Default,,0000,0000,0000,,When leaving your laboratory tomorrow,
Dialogue: 0,0:01:05.64,0:01:08.54,Default,,0000,0000,0000,,I want you to stop by the rehabilitation center
Dialogue: 0,0:01:08.54,0:01:10.15,Default,,0000,0000,0000,,to watch injured people
Dialogue: 0,0:01:10.15,0:01:12.18,Default,,0000,0000,0000,,fighting to take a step,
Dialogue: 0,0:01:12.18,0:01:14.82,Default,,0000,0000,0000,,struggling to maintain their trunk.
Dialogue: 0,0:01:14.82,0:01:16.23,Default,,0000,0000,0000,,And when you go home,
Dialogue: 0,0:01:16.23,0:01:18.64,Default,,0000,0000,0000,,think of what you are going to change in your research
Dialogue: 0,0:01:18.64,0:01:22.21,Default,,0000,0000,0000,,on the following day to make their lives better."
Dialogue: 0,0:01:22.21,0:01:26.26,Default,,0000,0000,0000,,These words, they stuck with me.
Dialogue: 0,0:01:26.26,0:01:28.65,Default,,0000,0000,0000,,This was more than 10 years ago,
Dialogue: 0,0:01:28.65,0:01:31.42,Default,,0000,0000,0000,,but ever since, my laboratory has followed
Dialogue: 0,0:01:31.42,0:01:33.38,Default,,0000,0000,0000,,the pragmatic approach to recovery
Dialogue: 0,0:01:33.38,0:01:35.79,Default,,0000,0000,0000,,after spinal cord injury.
Dialogue: 0,0:01:35.79,0:01:37.83,Default,,0000,0000,0000,,And my first step in this direction
Dialogue: 0,0:01:37.83,0:01:41.12,Default,,0000,0000,0000,,was to develop a new model of spinal cord injury
Dialogue: 0,0:01:41.12,0:01:44.77,Default,,0000,0000,0000,,that would more closely mimic some of the key features of human injury
Dialogue: 0,0:01:44.77,0:01:48.14,Default,,0000,0000,0000,,while offering well-controlled experimental conditions.
Dialogue: 0,0:01:48.14,0:01:50.71,Default,,0000,0000,0000,,And for this purpose, we placed two hemisections
Dialogue: 0,0:01:50.71,0:01:52.12,Default,,0000,0000,0000,,on opposite sides of the body.
Dialogue: 0,0:01:52.12,0:01:54.27,Default,,0000,0000,0000,,They completely interrupt the communication
Dialogue: 0,0:01:54.27,0:01:56.85,Default,,0000,0000,0000,,between the brain and the spinal cord,
Dialogue: 0,0:01:56.85,0:01:59.56,Default,,0000,0000,0000,,thus leading to complete and permanent paralysis
Dialogue: 0,0:01:59.56,0:02:01.33,Default,,0000,0000,0000,,of the leg.
Dialogue: 0,0:02:01.33,0:02:05.22,Default,,0000,0000,0000,,But, as observed, after most injuries in humans,
Dialogue: 0,0:02:05.22,0:02:08.17,Default,,0000,0000,0000,,there is this intervening gap of intact neural tissue
Dialogue: 0,0:02:08.17,0:02:10.87,Default,,0000,0000,0000,,through which recovery can occur.
Dialogue: 0,0:02:10.87,0:02:13.91,Default,,0000,0000,0000,,But how to make it happen?
Dialogue: 0,0:02:13.91,0:02:17.27,Default,,0000,0000,0000,,Well, the classical approach
Dialogue: 0,0:02:17.27,0:02:19.91,Default,,0000,0000,0000,,consists of applying intervention
Dialogue: 0,0:02:19.91,0:02:22.82,Default,,0000,0000,0000,,that would promote the growth of the severed fiber
Dialogue: 0,0:02:22.82,0:02:24.93,Default,,0000,0000,0000,,to the original target.
Dialogue: 0,0:02:24.93,0:02:28.68,Default,,0000,0000,0000,,And while this certainly remained the key for a cure,
Dialogue: 0,0:02:28.68,0:02:32.19,Default,,0000,0000,0000,,this seemed extraordinarily complicated to me.
Dialogue: 0,0:02:32.19,0:02:34.92,Default,,0000,0000,0000,,To reach clinical fruition rapidly,
Dialogue: 0,0:02:34.92,0:02:36.48,Default,,0000,0000,0000,,it was obvious:
Dialogue: 0,0:02:36.48,0:02:40.40,Default,,0000,0000,0000,,I had to think about the problem differently.
Dialogue: 0,0:02:40.40,0:02:43.51,Default,,0000,0000,0000,,It turned out that more than 100 years of research
Dialogue: 0,0:02:43.51,0:02:45.15,Default,,0000,0000,0000,,on spinal cord physiology,
Dialogue: 0,0:02:45.15,0:02:47.47,Default,,0000,0000,0000,,starting with the Nobel Prize Sherrington,
Dialogue: 0,0:02:47.47,0:02:49.28,Default,,0000,0000,0000,,had shown that
Dialogue: 0,0:02:49.28,0:02:51.51,Default,,0000,0000,0000,,the spinal cord, below most injuries,
Dialogue: 0,0:02:51.51,0:02:54.77,Default,,0000,0000,0000,,contained all the necessary and sufficient neural networks
Dialogue: 0,0:02:54.77,0:02:57.09,Default,,0000,0000,0000,,to coordinate locomotion,
Dialogue: 0,0:02:57.09,0:03:00.05,Default,,0000,0000,0000,,but because input from the brain is interrupted,
Dialogue: 0,0:03:00.05,0:03:03.21,Default,,0000,0000,0000,,they are in a nonfunctional state, like kind of dormant.
Dialogue: 0,0:03:03.21,0:03:07.55,Default,,0000,0000,0000,,My idea: We awaken this network.
Dialogue: 0,0:03:07.55,0:03:11.83,Default,,0000,0000,0000,,And at the time, I was a post-doctoral fellow in Los Angeles,
Dialogue: 0,0:03:11.83,0:03:14.40,Default,,0000,0000,0000,,after completing my Ph.D. in France,
Dialogue: 0,0:03:14.40,0:03:16.31,Default,,0000,0000,0000,,where independent thinking
Dialogue: 0,0:03:16.31,0:03:19.42,Default,,0000,0000,0000,,is not necessarily promoted.
Dialogue: 0,0:03:19.42,0:03:21.24,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:03:21.24,0:03:24.100,Default,,0000,0000,0000,,I was afraid to talk to my new boss,
Dialogue: 0,0:03:24.100,0:03:27.39,Default,,0000,0000,0000,,but decided to muster up my courage.
Dialogue: 0,0:03:27.39,0:03:30.04,Default,,0000,0000,0000,,I knocked at the door of my wonderful advisor,
Dialogue: 0,0:03:30.04,0:03:34.04,Default,,0000,0000,0000,,Reggie Edgerton, to share my new idea.
Dialogue: 0,0:03:34.04,0:03:36.29,Default,,0000,0000,0000,,He listened to me carefully,
Dialogue: 0,0:03:36.29,0:03:39.23,Default,,0000,0000,0000,,and responded with a grin.
Dialogue: 0,0:03:39.23,0:03:41.27,Default,,0000,0000,0000,,"Why don't you try?"
Dialogue: 0,0:03:41.27,0:03:43.40,Default,,0000,0000,0000,,And I promise to you,
Dialogue: 0,0:03:43.40,0:03:46.75,Default,,0000,0000,0000,,this was such an important moment in my career,
Dialogue: 0,0:03:46.75,0:03:49.18,Default,,0000,0000,0000,,when I realized that the great leader
Dialogue: 0,0:03:49.18,0:03:52.18,Default,,0000,0000,0000,,believed in young people and new ideas.
Dialogue: 0,0:03:52.18,0:03:53.79,Default,,0000,0000,0000,,And this was the idea:
Dialogue: 0,0:03:53.79,0:03:56.45,Default,,0000,0000,0000,,I'm going to use a simplistic metaphor
Dialogue: 0,0:03:56.45,0:03:58.58,Default,,0000,0000,0000,,to explain to you this complicated concept.
Dialogue: 0,0:03:58.58,0:04:03.34,Default,,0000,0000,0000,,Imagine that the locomotor system is a car.
Dialogue: 0,0:04:03.34,0:04:05.59,Default,,0000,0000,0000,,The engine is the spinal cord.
Dialogue: 0,0:04:05.59,0:04:08.85,Default,,0000,0000,0000,,The transmission is interrupted. The engine is turned off.
Dialogue: 0,0:04:08.85,0:04:11.86,Default,,0000,0000,0000,,How could we re-engage the engine?
Dialogue: 0,0:04:11.86,0:04:14.100,Default,,0000,0000,0000,,First, we have to provide the fuel;
Dialogue: 0,0:04:14.100,0:04:17.34,Default,,0000,0000,0000,,second, press the accelerator pedal;
Dialogue: 0,0:04:17.34,0:04:19.28,Default,,0000,0000,0000,,third, steer the car.
Dialogue: 0,0:04:19.28,0:04:21.04,Default,,0000,0000,0000,,It turned out that there are known neural pathways
Dialogue: 0,0:04:21.04,0:04:23.99,Default,,0000,0000,0000,,coming from the brain that play this very function
Dialogue: 0,0:04:23.99,0:04:25.38,Default,,0000,0000,0000,,during locomotion.
Dialogue: 0,0:04:25.38,0:04:28.09,Default,,0000,0000,0000,,My idea: Replace this missing input
Dialogue: 0,0:04:28.09,0:04:29.49,Default,,0000,0000,0000,,to provide the spinal cord
Dialogue: 0,0:04:29.49,0:04:30.89,Default,,0000,0000,0000,,with the kind of intervention
Dialogue: 0,0:04:30.89,0:04:35.62,Default,,0000,0000,0000,,that the brain would deliver naturally in order to walk.
Dialogue: 0,0:04:35.62,0:04:40.06,Default,,0000,0000,0000,,For this, I leveraged 20 years of past research in neuroscience,
Dialogue: 0,0:04:40.06,0:04:42.82,Default,,0000,0000,0000,,first to replace the missing fuel
Dialogue: 0,0:04:42.82,0:04:44.89,Default,,0000,0000,0000,,with pharmacological agents
Dialogue: 0,0:04:44.89,0:04:48.37,Default,,0000,0000,0000,,that prepare the neurons in the spinal cord to fire,
Dialogue: 0,0:04:48.37,0:04:52.42,Default,,0000,0000,0000,,and second, to mimic the accelerator pedal
Dialogue: 0,0:04:52.42,0:04:53.90,Default,,0000,0000,0000,,with electrical stimulation.
Dialogue: 0,0:04:53.90,0:04:56.07,Default,,0000,0000,0000,,So here imagine an electrode
Dialogue: 0,0:04:56.07,0:04:58.48,Default,,0000,0000,0000,,implanted on the back of the spinal cord
Dialogue: 0,0:04:58.48,0:05:00.74,Default,,0000,0000,0000,,to deliver painless stimulation.
Dialogue: 0,0:05:00.74,0:05:03.57,Default,,0000,0000,0000,,It took many years, but eventually we developed
Dialogue: 0,0:05:03.57,0:05:06.13,Default,,0000,0000,0000,,an electrochemical neuroprosthesis
Dialogue: 0,0:05:06.13,0:05:07.90,Default,,0000,0000,0000,,that transformed the neural network
Dialogue: 0,0:05:07.90,0:05:12.90,Default,,0000,0000,0000,,in the spinal cord from dormant to a highly functional state.
Dialogue: 0,0:05:12.90,0:05:19.18,Default,,0000,0000,0000,,Immediately, the paralyzed rat can stand.
Dialogue: 0,0:05:19.18,0:05:21.51,Default,,0000,0000,0000,,As soon as the treadmill belt starts moving,
Dialogue: 0,0:05:21.51,0:05:25.32,Default,,0000,0000,0000,,the animal shows coordinated movement of the leg,
Dialogue: 0,0:05:25.32,0:05:27.29,Default,,0000,0000,0000,,but without the brain.
Dialogue: 0,0:05:27.29,0:05:29.28,Default,,0000,0000,0000,,Here what I call "the spinal brain"
Dialogue: 0,0:05:29.28,0:05:32.41,Default,,0000,0000,0000,,cognitively processes sensory information
Dialogue: 0,0:05:32.41,0:05:34.30,Default,,0000,0000,0000,,arising from the moving leg
Dialogue: 0,0:05:34.30,0:05:37.100,Default,,0000,0000,0000,,and makes decisions as to how to activate the muscle
Dialogue: 0,0:05:37.100,0:05:41.39,Default,,0000,0000,0000,,in order to stand, to walk, to run,
Dialogue: 0,0:05:41.39,0:05:43.50,Default,,0000,0000,0000,,and even here, while sprinting,
Dialogue: 0,0:05:43.50,0:05:45.80,Default,,0000,0000,0000,,instantly stand
Dialogue: 0,0:05:45.80,0:05:48.26,Default,,0000,0000,0000,,if the treadmill stops moving.
Dialogue: 0,0:05:48.26,0:05:49.60,Default,,0000,0000,0000,,This was amazing.
Dialogue: 0,0:05:49.60,0:05:52.98,Default,,0000,0000,0000,,I was completely fascinated by this locomotion
Dialogue: 0,0:05:52.98,0:05:55.48,Default,,0000,0000,0000,,without the brain,
Dialogue: 0,0:05:55.48,0:05:59.13,Default,,0000,0000,0000,,but at the same time so frustrated.
Dialogue: 0,0:05:59.13,0:06:01.52,Default,,0000,0000,0000,,This locomotion was completely involuntary.
Dialogue: 0,0:06:01.52,0:06:04.89,Default,,0000,0000,0000,,The animal had virtually no control over the legs.
Dialogue: 0,0:06:04.89,0:06:09.01,Default,,0000,0000,0000,,Clearly, the steering system was missing.
Dialogue: 0,0:06:09.01,0:06:10.90,Default,,0000,0000,0000,,And it then became obvious from me
Dialogue: 0,0:06:10.90,0:06:12.25,Default,,0000,0000,0000,,that we had to move away
Dialogue: 0,0:06:12.25,0:06:15.62,Default,,0000,0000,0000,,from the classical rehabilitation paradigm,
Dialogue: 0,0:06:15.62,0:06:17.34,Default,,0000,0000,0000,,stepping on a treadmill,
Dialogue: 0,0:06:17.34,0:06:20.56,Default,,0000,0000,0000,,and develop conditions that would encourage
Dialogue: 0,0:06:20.56,0:06:25.80,Default,,0000,0000,0000,,the brain to begin voluntary control over the leg.
Dialogue: 0,0:06:25.80,0:06:29.18,Default,,0000,0000,0000,,With this in mind, we developed a completely new
Dialogue: 0,0:06:29.18,0:06:32.41,Default,,0000,0000,0000,,robotic system to support the rat
Dialogue: 0,0:06:32.41,0:06:34.94,Default,,0000,0000,0000,,in any direction of space.
Dialogue: 0,0:06:34.94,0:06:37.11,Default,,0000,0000,0000,,Imagine, this is really cool.
Dialogue: 0,0:06:37.11,0:06:40.94,Default,,0000,0000,0000,,So imagine the little 200-gram rat
Dialogue: 0,0:06:40.94,0:06:44.64,Default,,0000,0000,0000,,attached at the extremity of this 200-kilo robot,
Dialogue: 0,0:06:44.64,0:06:47.22,Default,,0000,0000,0000,,but the rat does not feel the robot.
Dialogue: 0,0:06:47.22,0:06:49.29,Default,,0000,0000,0000,,The robot is transparent,
Dialogue: 0,0:06:49.29,0:06:51.65,Default,,0000,0000,0000,,just like you would hold a young child
Dialogue: 0,0:06:51.65,0:06:54.02,Default,,0000,0000,0000,,during the first insecure steps.
Dialogue: 0,0:06:54.02,0:06:57.57,Default,,0000,0000,0000,,Let me summarize: The rat received
Dialogue: 0,0:06:57.57,0:07:00.01,Default,,0000,0000,0000,,a paralyzing lesion of the spinal cord.
Dialogue: 0,0:07:00.01,0:07:02.60,Default,,0000,0000,0000,,The electrochemical neuroprosthesis enabled
Dialogue: 0,0:07:02.60,0:07:06.81,Default,,0000,0000,0000,,a highly functional state of the spinal locomotor networks.
Dialogue: 0,0:07:06.81,0:07:10.58,Default,,0000,0000,0000,,The robot provided the safe environment
Dialogue: 0,0:07:10.58,0:07:12.54,Default,,0000,0000,0000,,to allow the rat to attempt anything
Dialogue: 0,0:07:12.54,0:07:15.22,Default,,0000,0000,0000,,to engage the paralyzed legs.
Dialogue: 0,0:07:15.22,0:07:18.05,Default,,0000,0000,0000,,And for motivation, we used what I think
Dialogue: 0,0:07:18.05,0:07:21.88,Default,,0000,0000,0000,,is the most powerful pharmacology of Switzerland:
Dialogue: 0,0:07:21.88,0:07:24.19,Default,,0000,0000,0000,,fine Swiss chocolate.
Dialogue: 0,0:07:24.19,0:07:27.11,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:07:27.11,0:07:31.67,Default,,0000,0000,0000,,Actually, the first results were very, very,
Dialogue: 0,0:07:31.67,0:07:34.31,Default,,0000,0000,0000,,very disappointing.
Dialogue: 0,0:07:34.31,0:07:37.61,Default,,0000,0000,0000,,Here is my best physical therapist
Dialogue: 0,0:07:44.79,0:07:47.38,Default,,0000,0000,0000,,completely failing to encourage the rat
Dialogue: 0,0:07:47.38,0:07:49.44,Default,,0000,0000,0000,,to take a single step,
Dialogue: 0,0:07:49.44,0:07:52.29,Default,,0000,0000,0000,,whereas the same rat, five minutes earlier,
Dialogue: 0,0:07:52.29,0:07:54.60,Default,,0000,0000,0000,,walked beautifully on the treadmill.
Dialogue: 0,0:07:54.60,0:07:56.75,Default,,0000,0000,0000,,We were so frustrated.
Dialogue: 0,0:07:56.75,0:07:59.65,Default,,0000,0000,0000,,But you know, one of the most essential qualities
Dialogue: 0,0:07:59.65,0:08:02.13,Default,,0000,0000,0000,,of a scientist is perseverance.
Dialogue: 0,0:08:02.13,0:08:05.54,Default,,0000,0000,0000,,We insisted. We refined our paradigm,
Dialogue: 0,0:08:05.54,0:08:07.81,Default,,0000,0000,0000,,and after several months of training,
Dialogue: 0,0:08:07.81,0:08:11.61,Default,,0000,0000,0000,,the otherwise paralyzed rat could stand,
Dialogue: 0,0:08:11.61,0:08:13.43,Default,,0000,0000,0000,,and whenever she decided,
Dialogue: 0,0:08:13.43,0:08:15.76,Default,,0000,0000,0000,,initiated full weight-bearing locomotion
Dialogue: 0,0:08:15.76,0:08:19.01,Default,,0000,0000,0000,,to sprint towards the rewards.
Dialogue: 0,0:08:19.01,0:08:22.41,Default,,0000,0000,0000,,This is the first recovery ever observed
Dialogue: 0,0:08:22.41,0:08:24.31,Default,,0000,0000,0000,,of voluntary leg movement
Dialogue: 0,0:08:24.31,0:08:26.76,Default,,0000,0000,0000,,after an experimental lesion of the spinal cord
Dialogue: 0,0:08:26.76,0:08:30.22,Default,,0000,0000,0000,,leading to complete and permanent paralysis.
Dialogue: 0,0:08:30.22,0:08:32.21,Default,,0000,0000,0000,,In fact --
Dialogue: 0,0:08:32.21,0:08:33.93,Default,,0000,0000,0000,,(Applause)
Dialogue: 0,0:08:33.93,0:08:38.31,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:08:38.31,0:08:41.40,Default,,0000,0000,0000,,In fact, not only could the rat initiate
Dialogue: 0,0:08:41.40,0:08:44.08,Default,,0000,0000,0000,,and sustain locomotion on the ground,
Dialogue: 0,0:08:44.08,0:08:46.36,Default,,0000,0000,0000,,they could even adjust leg movement,
Dialogue: 0,0:08:46.36,0:08:48.72,Default,,0000,0000,0000,,for example, to resist gravity
Dialogue: 0,0:08:48.72,0:08:51.34,Default,,0000,0000,0000,,in order to climb a staircase.
Dialogue: 0,0:08:51.34,0:08:53.29,Default,,0000,0000,0000,,I can promise you this was
Dialogue: 0,0:08:53.29,0:08:56.40,Default,,0000,0000,0000,,such an emotional moment in my laboratory.
Dialogue: 0,0:08:56.40,0:08:59.14,Default,,0000,0000,0000,,It took us 10 years of hard work
Dialogue: 0,0:08:59.14,0:09:01.59,Default,,0000,0000,0000,,to reach this goal.
Dialogue: 0,0:09:01.59,0:09:04.14,Default,,0000,0000,0000,,But the remaining question was, how?
Dialogue: 0,0:09:04.14,0:09:05.84,Default,,0000,0000,0000,,I mean, how is it possible?
Dialogue: 0,0:09:05.84,0:09:07.51,Default,,0000,0000,0000,,And here, what we found
Dialogue: 0,0:09:07.51,0:09:11.19,Default,,0000,0000,0000,,was completely unexpected.
Dialogue: 0,0:09:11.19,0:09:15.35,Default,,0000,0000,0000,,This novel training paradigm
Dialogue: 0,0:09:15.35,0:09:19.02,Default,,0000,0000,0000,,encouraged the brain to create new connections,
Dialogue: 0,0:09:19.02,0:09:21.92,Default,,0000,0000,0000,,some relay circuits
Dialogue: 0,0:09:21.92,0:09:24.97,Default,,0000,0000,0000,,that relay information from the brain
Dialogue: 0,0:09:24.97,0:09:28.12,Default,,0000,0000,0000,,past the injury and restore cortical control
Dialogue: 0,0:09:28.12,0:09:31.57,Default,,0000,0000,0000,,over the locomotor networks below the injury.
Dialogue: 0,0:09:31.57,0:09:34.49,Default,,0000,0000,0000,,And here, you can see one such example,
Dialogue: 0,0:09:34.49,0:09:37.85,Default,,0000,0000,0000,,where we label the fibers coming from the brain in red.
Dialogue: 0,0:09:37.85,0:09:41.27,Default,,0000,0000,0000,,This blue neuron is connected with the locomotor center,
Dialogue: 0,0:09:41.27,0:09:43.63,Default,,0000,0000,0000,,and what this constellation
Dialogue: 0,0:09:43.63,0:09:45.98,Default,,0000,0000,0000,,of synaptic contacts means
Dialogue: 0,0:09:45.98,0:09:49.78,Default,,0000,0000,0000,,is that the brain is reconnected with the locomotor center
Dialogue: 0,0:09:49.78,0:09:53.78,Default,,0000,0000,0000,,with only one relay neuron.
Dialogue: 0,0:09:53.78,0:09:55.71,Default,,0000,0000,0000,,But the remodeling was not restricted
Dialogue: 0,0:09:55.71,0:09:56.80,Default,,0000,0000,0000,,to the lesion area.
Dialogue: 0,0:09:56.80,0:10:00.09,Default,,0000,0000,0000,,It occurred throughout the central nervous system,
Dialogue: 0,0:10:00.09,0:10:02.41,Default,,0000,0000,0000,,including in the brain stem,
Dialogue: 0,0:10:02.41,0:10:05.67,Default,,0000,0000,0000,,where we observed up to 300-percent increase
Dialogue: 0,0:10:05.67,0:10:09.43,Default,,0000,0000,0000,,in the density of fibers coming from the brain.
Dialogue: 0,0:10:09.43,0:10:12.96,Default,,0000,0000,0000,,We did not aim to repair the spinal cord,
Dialogue: 0,0:10:12.96,0:10:15.55,Default,,0000,0000,0000,,yet we were able to promote
Dialogue: 0,0:10:15.55,0:10:17.71,Default,,0000,0000,0000,,one of the more extensive remodeling
Dialogue: 0,0:10:17.71,0:10:20.18,Default,,0000,0000,0000,,of axonal projections ever observed
Dialogue: 0,0:10:20.18,0:10:22.44,Default,,0000,0000,0000,,in the central nervous system of adult mammal
Dialogue: 0,0:10:22.44,0:10:24.98,Default,,0000,0000,0000,,after an injury.
Dialogue: 0,0:10:24.98,0:10:30.05,Default,,0000,0000,0000,,And there is a very important message
Dialogue: 0,0:10:30.05,0:10:34.50,Default,,0000,0000,0000,,hidden behind this discovery.
Dialogue: 0,0:10:34.50,0:10:37.72,Default,,0000,0000,0000,,They are the result of a young team
Dialogue: 0,0:10:37.72,0:10:40.11,Default,,0000,0000,0000,,of very talented people:
Dialogue: 0,0:10:40.11,0:10:44.57,Default,,0000,0000,0000,,physical therapists, neurobiologists, neurosurgeons,
Dialogue: 0,0:10:44.57,0:10:46.77,Default,,0000,0000,0000,,engineers of all kinds,
Dialogue: 0,0:10:46.77,0:10:48.56,Default,,0000,0000,0000,,who have achieved together
Dialogue: 0,0:10:48.56,0:10:52.20,Default,,0000,0000,0000,,what would have been impossible by single individuals.
Dialogue: 0,0:10:52.20,0:10:55.28,Default,,0000,0000,0000,,This is truly a trans-disciplinary team.
Dialogue: 0,0:10:55.28,0:10:57.47,Default,,0000,0000,0000,,They are working so close to each other
Dialogue: 0,0:10:57.47,0:11:00.66,Default,,0000,0000,0000,,that there is horizontal transfer of DNA.
Dialogue: 0,0:11:00.66,0:11:02.29,Default,,0000,0000,0000,,We are creating the next generation
Dialogue: 0,0:11:02.29,0:11:04.53,Default,,0000,0000,0000,,of M.D.'s and engineers
Dialogue: 0,0:11:04.53,0:11:06.97,Default,,0000,0000,0000,,capable of translating discoveries all the way
Dialogue: 0,0:11:06.97,0:11:09.64,Default,,0000,0000,0000,,from bench to bedside.
Dialogue: 0,0:11:09.64,0:11:11.65,Default,,0000,0000,0000,,And me?
Dialogue: 0,0:11:11.65,0:11:16.20,Default,,0000,0000,0000,,I am only the maestro who orchestrated this beautiful symphony.
Dialogue: 0,0:11:16.20,0:11:22.100,Default,,0000,0000,0000,,Now, I am sure you are all wondering, aren't you,
Dialogue: 0,0:11:22.100,0:11:26.76,Default,,0000,0000,0000,,will this help injured people?
Dialogue: 0,0:11:26.76,0:11:30.66,Default,,0000,0000,0000,,Me too, every day.
Dialogue: 0,0:11:30.66,0:11:34.07,Default,,0000,0000,0000,,The truth is that we don't know enough yet.
Dialogue: 0,0:11:34.07,0:11:38.29,Default,,0000,0000,0000,,This is certainly not a cure for spinal cord injury,
Dialogue: 0,0:11:38.29,0:11:41.03,Default,,0000,0000,0000,,but I begin to believe that this may lead
Dialogue: 0,0:11:41.03,0:11:43.59,Default,,0000,0000,0000,,to an intervention to improve recovery
Dialogue: 0,0:11:43.59,0:11:46.78,Default,,0000,0000,0000,,and people's quality of life.
Dialogue: 0,0:11:46.78,0:11:49.27,Default,,0000,0000,0000,,I would like you all
Dialogue: 0,0:11:49.27,0:11:52.90,Default,,0000,0000,0000,,to take a moment and dream with me.
Dialogue: 0,0:11:52.90,0:11:58.79,Default,,0000,0000,0000,,Imagine a person just suffered a spinal cord injury.
Dialogue: 0,0:11:58.79,0:12:01.95,Default,,0000,0000,0000,,After a few weeks of recovery,
Dialogue: 0,0:12:01.95,0:12:04.31,Default,,0000,0000,0000,,we will implant a programmable pump
Dialogue: 0,0:12:04.31,0:12:07.34,Default,,0000,0000,0000,,to deliver a personalized pharmacological cocktail
Dialogue: 0,0:12:07.34,0:12:09.78,Default,,0000,0000,0000,,directly to the spinal cord.
Dialogue: 0,0:12:09.78,0:12:13.04,Default,,0000,0000,0000,,At the same time, we will implant an electrode array,
Dialogue: 0,0:12:13.04,0:12:15.15,Default,,0000,0000,0000,,a sort of second skin
Dialogue: 0,0:12:15.15,0:12:18.71,Default,,0000,0000,0000,,covering the area of the spinal cord controlling leg movement,
Dialogue: 0,0:12:18.71,0:12:21.98,Default,,0000,0000,0000,,and this array is attached to an electrical pulse generator
Dialogue: 0,0:12:21.98,0:12:24.44,Default,,0000,0000,0000,,that delivers stimulations that are tailored
Dialogue: 0,0:12:24.44,0:12:26.62,Default,,0000,0000,0000,,to the person's needs.
Dialogue: 0,0:12:26.62,0:12:31.48,Default,,0000,0000,0000,,This defines a personalized electrochemical neuroprosthesis
Dialogue: 0,0:12:31.48,0:12:34.23,Default,,0000,0000,0000,,that will enable locomotion
Dialogue: 0,0:12:34.23,0:12:38.28,Default,,0000,0000,0000,,during training with a newly designed supporting system.
Dialogue: 0,0:12:38.28,0:12:41.56,Default,,0000,0000,0000,,And my hope is that after several months of training,
Dialogue: 0,0:12:41.56,0:12:43.73,Default,,0000,0000,0000,,there may be enough remodeling of residual connection
Dialogue: 0,0:12:43.73,0:12:47.40,Default,,0000,0000,0000,,to allow locomotion without the robot,
Dialogue: 0,0:12:47.40,0:12:51.17,Default,,0000,0000,0000,,maybe even without pharmacology or stimulation.
Dialogue: 0,0:12:51.17,0:12:53.71,Default,,0000,0000,0000,,My hope here is to be able to create
Dialogue: 0,0:12:53.71,0:12:55.97,Default,,0000,0000,0000,,the personalized condition
Dialogue: 0,0:12:55.97,0:12:58.64,Default,,0000,0000,0000,,to boost the plasticity of the brain
Dialogue: 0,0:12:58.64,0:13:00.17,Default,,0000,0000,0000,,and the spinal cord.
Dialogue: 0,0:13:00.17,0:13:02.91,Default,,0000,0000,0000,,And this is a radically new concept
Dialogue: 0,0:13:02.91,0:13:06.20,Default,,0000,0000,0000,,that may apply to other neurological disorders,
Dialogue: 0,0:13:06.20,0:13:10.74,Default,,0000,0000,0000,,what I termed "personalized neuroprosthetics,"
Dialogue: 0,0:13:10.74,0:13:13.76,Default,,0000,0000,0000,,where by sensing and stimulating neural interfaces,
Dialogue: 0,0:13:13.76,0:13:17.48,Default,,0000,0000,0000,,I implanted throughout the nervous system,
Dialogue: 0,0:13:17.48,0:13:20.82,Default,,0000,0000,0000,,in the brain, in the spinal cord,
Dialogue: 0,0:13:20.82,0:13:23.57,Default,,0000,0000,0000,,even in peripheral nerves,
Dialogue: 0,0:13:23.57,0:13:26.74,Default,,0000,0000,0000,,based on patient-specific impairments.
Dialogue: 0,0:13:26.74,0:13:31.35,Default,,0000,0000,0000,,But not to replace the lost function, no --
Dialogue: 0,0:13:31.35,0:13:34.54,Default,,0000,0000,0000,,to help the brain help itself.
Dialogue: 0,0:13:34.54,0:13:37.18,Default,,0000,0000,0000,,And I hope this enticed your imagination,
Dialogue: 0,0:13:37.18,0:13:39.07,Default,,0000,0000,0000,,because I can promise to you
Dialogue: 0,0:13:39.07,0:13:42.32,Default,,0000,0000,0000,,this is not a matter of whether this revolution will occur,
Dialogue: 0,0:13:42.32,0:13:44.11,Default,,0000,0000,0000,,but when.
Dialogue: 0,0:13:44.11,0:13:46.34,Default,,0000,0000,0000,,And remember, we are only as great
Dialogue: 0,0:13:46.36,0:13:49.94,Default,,0000,0000,0000,,as our imagination, as big as our dream.
Dialogue: 0,0:13:49.94,0:13:51.93,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:13:51.93,0:13:55.93,Default,,0000,0000,0000,,(Applause)