The Brain and Body Connection

Dr. Cesar Marquez-Chin explores remarkable technology to help rehab patients

When you hear a term like “brain-computer interface,” your mind might conjure an image of a mad scientist, donned with goggles, white lab coat, and spiky hair, whiling away in a laboratory on a dark and stormy night.

If this is the case, don't worry. Dr. Cesar Marquez-Chin, a scientist at the KITE Research Institute, University Health Network, doesn't mind such connotations. When asked how he feels about being heralded as KITE's resident “mad scientist,” he basks in the title: “I love it!” He takes pride in thinking of outside-the-box solutions to address rehabilitation problems. One of those solutions could revolutionize the field of rehabilitation therapy. And if it sounds like science fiction, he's very aware of that.

There is a skeptical ethos in the academic research community that promotes the idea, “if it sounds like science fiction then it probably is.”

Twenty or so years ago, this was the label appended to brain-computer-interfacing (BCI). BCI is a computer-based system that acquires brain signals, analyzes, and translates them into commands that are relayed to carry out a desired action.

The fanciful-seeming nature of these ideas stopped BCI research in its tracks. However, as a young biomedical engineer out of Mexico working towards his PhD, Dr. Marquez-Chin and like-minded pioneers saw BCI as a way to revolutionise rehabilitative care. Sure, it's one thing to turn lights off and on with your brain as if one were Professor X of Marvel's X-Men. However, Dr. Marquez-Chin saw a use for the technology that could serve a different purpose. Dr. Marquez-Chin's work seeks to explore BCIs as a new frontier to help paralyzed patients with serious rehabilitative needs regain the ability to move.

In his research, Dr. Marquez-Chin uses BCI technology to help scan qualifying patients' brain signalling, while the patient attempts to move immobile body parts. The team then uses BCI technology to identify the areas the patient was trying to move, and the corresponding patterns and brain indicators. Next, external devices designed to assist the person in moving helps them to perform the desired movement. In the case of Dr. Marquez-Chin's lab, functional electrical stimulation (FES) is used.

This technique applies electrical discharges to selected muscles to create functional movements. Not only can patients regain sensation, but as a result of muscle contraction, they can perform functional tasks like grabbing a water bottle. Dr. Marquez-Chin is wholly aware of electroshock therapy's dark history, but he wants to redeem electrical therapy, and associate it with recapacitating, not incapacitating.

When asked about the future of the field, Dr. Marquez-Chin believes that in the next ten to fifteen years, a new generation of researchers will push towards a greater evolution between BCIs and possible rehabilitation. Another exciting area of BCI's potential is in its relationship to the brain.

My passion is to help people. Science, tech, engineering are just the vehicles I have chosen to do that. – Dr. Marquez-Chin

Since BCI replicates brain signalling in real time, Dr. Marquez-Chin and his colleagues believe that there may be potential to allow for greater understanding into how the brain works. If we can now fulfil functions of the brain, then might that give us a clue into what's going on up there?

Yet, most of all, Dr. Marquez-Chin values his role as a mentor to a new generation of scientists beginning their journey at KITE.

Much like the rest of the working world, Dr. Marquez-Chin's work was disrupted in March of 2020 with the onset of the COVID-19 pandemic. When the initial batch of stay-at-home orders were mandated, he had two students working with him that were almost done with their studies. Fortunately, since they were so close to completion, the students had collected enough data that they could continue their analyses from home. Unfortunately for Dr. Marquez-Chin, this meant having to devise a way to help students with their studies – often requiring complex electrical engineering without the guaranteed ability to be on-site.

During the summer of 2021, Dr. Marquez-Chin had an undergraduate student assisting him with electrical circuit programming. The catch: it was all done over Zoom. This was the first time he had to guide such precise technical work in a remote setting. Luckily, he was able to find humour and excitement in such a challenging situation. “We were laughing at how geeky this was,” says Dr. Marquez-Chin, “because it felt like we were astronauts.” He played the role of ground control, communicating with his pupil, lost in space, trying to guide their malfunctioning ship home. Currently, he has one student working under him on the BMI project, who due to recent developments, is once again floating in space. But the research goes on.

These students are not the only remote collaborators on Dr. Marquez-Chin's project team. One group of researchers is based in Japan. After much hard work, the Japanese researchers were able to recreate the model Dr. Marquez-Chin had developed and got it to work. It was at that moment where he thought to himself, “Maybe this thing works after all!” As inspiring a moment as that was, he knows that more work needs to be done: more testing, more tweaks, to craft a sufficient and robust final product.

However, Dr. Marquez-Chin's journey has not been without its challenges; and those challenges are ongoing. To continue his research, more funding needs to come his way. “Funding is especially hard in the time of COVID,” he says. “We have to park things for right now while we apply for more.” Once more funding is forthcoming, Dr. Marquez-Chin says the next steps involve really understanding what happens in the human body when the stimulation occurs. They know the what and how FES works, they just need to get to the why.

For Dr. Marquez-Chin, the answers to these questions matter; it will mean more people who have suffered significant injuries will get to live a fuller life. “My passion is to help people,” he says, “science, tech, engineering are just the vehicles I have chosen to do that.” The results he has seen thus far with patients have been highly encouraging. The patients he took on were those who are traditionally considered difficult cases, as all of them had tried other forms of therapy without any success.

Ultimately though, it's not about the technology itself. “If a rubber band around a pencil works [for some],” Dr. Marquez-Chin says, “then that's fine!” It's a “whatever works” approach. And he's betting that his research could be the thing that works for millions of people. When asked about what this means to him, he replies, “The privilege of seeing your work fulfilling that function is extraordinary. I am very, very lucky to be in this position.”

KITE continues partnership with Centennial College

KITEworks Magazine is an annual collaborative project between Centennial College's Professional Writing-Communications and Photography programs and KITE. The stories, experiences and photographs shared in this year's edition of the magazine give an unfiltered look into how KITE has evolved to become a world leader in rehabilitation science. Come and explore how KITE works!