In April, Rhode Island-based researchers David Borton and Dr. Jared Fridley presented their work on the Intelligent Spine Interface to members of Congress at the Defense Advanced Research Projects Agency’s 2023 Demo Day. They were only one of 10 teams given that honor.
Interface is a groundbreaking clinical trial aimed at restoring limb movement, sensation and bladder control through an implant in people who have suffered a spinal cord injury.
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Borton is an associate professor of engineering at Brown University, an associate professor of brain science at the Carney Institute for Brain Science at Brown, an associate professor of neurosurgery at Lifespan Corp. and a biomedical engineer at the Providence VA Health Center for Neurorestoration and Neurotechnology.
Fridley is an associate professor of neurosurgery at The Warren Alpert Medical School at Brown University and director of Spine Surgery Outcomes Research Laboratory.
PBN: Can you tell us about this clinical trial? What is the Intelligent Spine Interface and how does it work?
BORTON AND FRIDLEY: The Intelligent Spine Interface clinical study is our first step in building a communication link to the spinal cord to help those suffering from motor and sensory loss due to spinal cord injury.
Briefly, the system acts as a bridge across the injured area of the spinal cord, able to stimulate the spinal cord below the area of injury to provide muscle activation (e.g. trunk and leg muscles for standing and walking; bladder release, etc.), as well as above the injury site to provide sensory feedback (e.g. leg position, ground contact, bladder fullness, etc.). These two components are connected by an “intelligent” device able to adapt to the patient over time to optimize stimulation of the spinal cord.
Further, we aim to listen to the spinal cord circuits to develop approaches to sensory and motor signal decoding.
PBN: What are you hoping to achieve with this trial?
BORTON AND FRIDLEY: In this first phase, we are demonstrating the feasibility of the system to provide simultaneous leg muscle activation paired with sensory perceptions and to collect participant feedback on the use of this system for future functional restoration and rehabilitation efforts.
In addition, in the second phase, we will be piloting an advanced neurotechnology to greatly enhance the number of communication channels with the spinal cord.

PBN: How did this partnership between Lifespan, Brown, the Department of Veterans Affairs and DARPA start?
BORTON AND FRIDLEY: The close proximity of, and academic integration with, the Rhode Island Hospital’s Department of Neurosurgery, the Carney Institute for Brain Science, and Providence VA Healthcare Center for Neurorestoration and Neurotechnology made this collaboration possible.
When the call for applications came out from DARPA, our team was ready, building on foundational work from the principal investigator on both spinal cord stimulation and development of implantable technologies, as well as the extensive expertise of RIH in functional spine neurosurgery.
The Carney Institute makes for a fluid collaborative environment, which led to the critical integration of neural network experts … into the research program.
PBN: In April, you were invited to present your research to the U.S. Congress at the Defense Advanced Research Projects Agency’s 2023 Demo Day. What was the experience like?
BORTON AND FRIDLEY: It was wonderful to share our scientific and therapy-focused passion with the people in charge of setting financial and vision priorities of the country. Sen. [Jack] Reed and others who attended from Congress were incredibly supportive and really understand the critical nature of supporting neurotechnology and neuroengineering to help address neurological injury and disease.
PBN: When do you expect the trial to be completed? What are the next steps?
BORTON AND FRIDLEY: Phase I is expected to be completed this summer. Phase II is expected to be completed by summer 2024. We are currently seeking support to move this technology to the next phase, which is the creation of a system that can be taken home and used by the participants for years.
DAVID BORTON is a researcher who has been working on the Intelligent Spine Interface. / COURTESY BROWN UNIVERSITY