with a mixed background in physics and medicine.

我是一位神經科學家

My lab at the Swiss Federal Institute of Technology

有物理和醫學的背景

focuses on spinal cord injury,

在蘇黎世聯邦理工學院

which affects more than 50,000 people

我的實驗室專注在脊椎損傷

around the world every year,

每年全球有超過五萬人

with dramatic consequences for affected individuals,

深受其害

whose life literally shatters

每位受害者遇到的戲劇性後果

in a matter of a handful of seconds.

確實地粉碎了他們的生活

And for me, the Man of Steel,

一切都發生在短短幾秒的瞬間

Christopher Reeve,

對我來說, 鋼鐵英雄,

has best raised the awareness

克里斯多夫．李維

on the distress of spinal cord injured people.

喚起大數人們

And this is how I started my own personal journey

對脊椎損傷患者困境的認識

in this field of research,

這是我如何開始我個人的旅程

working with the Christopher and Dana Reeve Foundation.

在這研究領域中

I still remember this decisive moment.

和李維夫婦基金會一同共事

It was just at the end of a regular day of work

我仍記得這決定性的時刻

with the foundation.

那是一個在基金會的平常日子

Chris addressed us, the scientists and experts,

工作結束時

"You have to be more pragmatic.

克里斯多夫對我們這群科學家和專家說

When leaving your laboratory tomorrow,

"你們應該要更務實一點

I want you to stop by the rehabilitation center

明天你們離開實驗時

to watch injured people

我要你們到復健中心來一下

fighting to take a step,

看看這些傷患

struggling to maintain their trunk.

努力的跨出每一個步伐

And when you go home,

艱難的維持他們的身軀

think of what you are going to change in your research

然後當你們回家後

on the following day to make their lives better."

想想你們要如何改變你們的研究

These words, they stuck with me.

在將來可以讓他們的生活更好"

This was more than 10 years ago,

這段話震驚了我

but ever since, my laboratory has followed

這是十多年之前的事

the pragmatic approach to recovery

到今, 我實驗室一直都是

after spinal cord injury.

追求務實的方式

And my first step in this direction

使脊椎損傷患者復原

was to develop a new model of spinal cord injury

而我的第一步

that would more closely mimic some of the key features of human injury

是發展一個新的模型

while offering well-controlled experimental conditions.

使脊椎損傷能像其它種類的損傷

And for this purpose, we placed two hemisections

提供一個控制良好的實驗環境

on opposite sides of the body.

為了這個目的, 我們安置兩個半切的部位

They completely interrupt the communication

在身軀的兩側

between the brain and the spinal cord,

他們完全地阻礙

thus leading to complete and permanent paralysis

大腦和脊椎的溝通

of the leg.

造成腿部全面性及永久性的

But, as observed, after most injuries in humans,

癱瘓

there is this intervening gap of intact neural tissue

但觀察後發現, 大部分人體的損傷

through which recovery can occur.

在完好神經組織之間的存在著空隙

But how to make it happen?

讓復原的現象發生

Well, the classical approach

這是如何發生的呢?

consists of applying intervention

傳統的方法是

that would promote the growth of the severed fiber

施行手術

to the original target.

讓斷裂的神經纖維

And while this certainly remained the key for a cure,

生長到你的目標去

this seemed extraordinarily complicated to me.

這是目前治療的重要關鍵

To reach clinical fruition rapidly,

但對我來說是非常的複雜

it was obvious:

要即刻享受臨床的成果

I had to think about the problem differently.

很明顯地

It turned out that more than 100 years of research

我必須要用不同的方式思考問題

on spinal cord physiology,

脊椎神經生理學超過一百年的研究

starting with the Nobel Prize Sherrington,

脊椎神經生理學超過一百年的研究

had shown that

諾貝爾獎得主謝靈頓

the spinal cord, below most injuries,

曾指出

contained all the necessary and sufficient neural networks

脊椎神經在未達到重大損傷

to coordinate locomotion,

保有必要及足夠的神經網絡

but because input from the brain is interrupted,

來協調運動

they are in a nonfunctional state, like kind of dormant.

但因為從大腦來的訊號被阻礙

My idea: We awaken this network.

它們處於無作用狀態, 像是冬眠

And at the time, I was a post-doctoral fellow in Los Angeles,

我的想法是: 喚醒這神經網絡

after completing my Ph.D. in France,

當我在洛杉機做博士後研究時

where independent thinking

也是我在法國拿到博士學位之後

is not necessarily promoted.

獨立思考的能力

(Laughter)

還沒有必然地建立起來

I was afraid to talk to my new boss,

(笑聲)

but decided to muster up my courage.

我很擔心和我的新老闆對談

I knocked at the door of my wonderful advisor,

但我鼓起勇氣

Reggie Edgerton, to share my new idea.

敲了敲我那出色指導教授 Reggie Edgerton 的門

He listened to me carefully,

分享我新的想法

and responded with a grin.

他仔細地聆聽

"Why don't you try?"

不時露齒而笑

And I promise to you,

"你為何不去試試看呢?"

this was such an important moment in my career,

我可以向你保證

when I realized that the great leader

這是我生命中一個重要的時刻

believed in young people and new ideas.

一個出色的領導者

And this was the idea:

相信一位年輕人和新想法

I'm going to use a simplistic metaphor

我的新想法是:

to explain to you this complicated concept.

我要使用最簡單的比喻

Imagine that the locomotor system is a car.

向你們解釋這複雜的概念

The engine is the spinal cord.

想像一台汽車裡的引擎

The transmission is interrupted. The engine is turned off.

這引擎就是脊椎神經

How could we re-engage the engine?

當神經傳導被中斷, 引擎就熄火了

First, we have to provide the fuel;

我們要如何讓引擎再次起動呢?

second, press the accelerator pedal;

首先, 我們要提供燃油

third, steer the car.

其次, 踩下油門

It turned out that there are known neural pathways

最後, 發動汽車

coming from the brain that play this very function

有一個已知的從大腦出來的神經傳導路徑

during locomotion.

扮演著運動的關鍵功能

My idea: Replace this missing input

扮演著運動的關鍵功能

to provide the spinal cord

我的想法: 取代遺失的訊號

with the kind of intervention

提供脊椎神經

that the brain would deliver naturally in order to walk.

一種手術

For this, I leveraged 20 years of past research in neuroscience,

讓大腦可以自然地傳達走路的訊號

first to replace the missing fuel

我使用了過去二十幾年的神經科學研究成果

with pharmacological agents

先是用輔佐藥取代遺失的燃油

that prepare the neurons in the spinal cord to fire,

先是用輔佐藥取代遺失的燃油

and second, to mimic the accelerator pedal

讓脊椎中的神經元預備起動

with electrical stimulation.

然後用電極刺激模仿油門

So here imagine an electrode

然後用電極刺激模仿油門

implanted on the back of the spinal cord

想像一個電極

to deliver painless stimulation.

植入脊椎的後面

It took many years, but eventually we developed

以傳導無痛的刺激

an electrochemical neuroprosthesis

歷經許多年, 最終發展出

that transformed the neural network

電化學神經修補術

in the spinal cord from dormant to a highly functional state.

可以將脊椎的神經網絡

Immediately, the paralyzed rat can stand.

從休眠中喚醒成具高度功能性狀態

As soon as the treadmill belt starts moving,

緊接著, 癱瘓的老鼠就可以站立了

the animal shows coordinated movement of the leg,

步行機一旦開始移動

but without the brain.

老鼠腳部可以表現出相對應的動作

Here what I call "the spinal brain"

但不需要經過大腦

cognitively processes sensory information

我稱之為 "脊椎腦"

arising from the moving leg

它能處理從運動的腿部

and makes decisions as to how to activate the muscle

傳來的感覺訊息

in order to stand, to walk, to run,

然後決定如何去作動肌肉

and even here, while sprinting,

以便能站立, 行走, 或跑步

instantly stand

甚至在衝刺時

if the treadmill stops moving.

能在跑步機停止時

This was amazing.

馬上站立住

I was completely fascinated by this locomotion

這相當地神奇

without the brain,

我完全被這種

but at the same time so frustrated.

不需大腦的運動動作所震攝

This locomotion was completely involuntary.

但同時也很挫折

The animal had virtually no control over the legs.

這種運動是完全非自願性

Clearly, the steering system was missing.

動物幾乎是無法控制它的腿

And it then became obvious from me

很明顯地, 缺乏方向盤操控系統

that we had to move away

對我來說

from the classical rehabilitation paradigm,

我們必須改變方式

stepping on a treadmill,

從傳統復健的模式

and develop conditions that would encourage

踏上這一跑步機

the brain to begin voluntary control over the leg.

然後發展出一個機制

With this in mind, we developed a completely new

能喚起腦部自發性地控制大腿

robotic system to support the rat

在這思維下, 我們發展一個全新的機械系統

in any direction of space.

在任何方位來幫忙這隻老鼠

Imagine, this is really cool.

在任何方位來幫忙這隻老鼠

So imagine the little 200-gram rat

這很酷的

attached at the extremity of this 200-kilo robot,

想像一個200公克的小老鼠

but the rat does not feel the robot.

依在一個200公斤的機械上

The robot is transparent,

但它不會感覺到機械的存在

just like you would hold a young child

這機械是透明的

during the first insecure steps.

就像你扶著一個小孩

Let me summarize: The rat received

讓他踏出他的第一步

a paralyzing lesion of the spinal cord.

簡言之

The electrochemical neuroprosthesis enabled

這老鼠得了脊椎麻痺損傷

a highly functional state of the spinal locomotor networks.

電化學神經修補術

The robot provided the safe environment

能讓脊椎運動神經網絡再次作用起來

to allow the rat to attempt anything

這機械提供一個安全的環境

to engage the paralyzed legs.

讓老鼠能自主的觸發

And for motivation, we used what I think

作動起癱瘓的腿部

is the most powerful pharmacology of Switzerland:

就動機而言, 我們使用了

fine Swiss chocolate.

在瑞典最有影響力的藥理學:

(Laughter)

瑞士巧克力

Actually, the first results were very, very,

(笑聲)

very disappointing.

事實上, 第一的結果是非常非常

Here is my best physical therapist

非常的令人失望

completely failing to encourage the rat

這是我最好的物理治療師

to take a single step,

他完全地失敗

whereas the same rat, five minutes earlier,

無法讓老鼠踏出一步

walked beautifully on the treadmill.

這是五分鐘前的同一隻老鼠

We were so frustrated.

很優雅的在跑步機上行走

But you know, one of the most essential qualities

我們感到非常的挫折

of a scientist is perseverance.

但是你知道的, 科學家最重要特質之一

We insisted. We refined our paradigm,

就是堅持不懈

and after several months of training,

我們重新改善我們的模型

the otherwise paralyzed rat could stand,

經過數個月的訓練

and whenever she decided,

另外癱瘓的老鼠可以站立了

initiated full weight-bearing locomotion

無論何時它想要

to sprint towards the rewards.

可以激起帶動全身重量的運動

This is the first recovery ever observed

衝刺達向終點

of voluntary leg movement

這是第一次的大發現

after an experimental lesion of the spinal cord

自主性的腿部運動

leading to complete and permanent paralysis.

在造成永久癱瘓的脊椎損傷之後

In fact --

在造成永久癱瘓的脊椎損傷之後

(Applause)

事實上...

Thank you.

(掌聲)

In fact, not only could the rat initiate

謝謝

and sustain locomotion on the ground,

事實上, 這老鼠不單單地

they could even adjust leg movement,

激發並維持著運動

for example, to resist gravity

也能夠調整腿部的運動

in order to climb a staircase.

例如, 抵抗重力

I can promise you this was

以便能爬樓梯

such an emotional moment in my laboratory.

我可以向各位保證

It took us 10 years of hard work

這是我實驗室中多麼令人動容的時刻

to reach this goal.

十年的努力

But the remaining question was, how?

達到這樣的成果

I mean, how is it possible?

但我們仍要問, 這是如何辦到的?

And here, what we found

我是說, 為什麼可能?

was completely unexpected.

這裡我們所發現的

This novel training paradigm

是完全在意料之外的

encouraged the brain to create new connections,

這個全新的訓練模式

some relay circuits

讓腦部產生新的網絡聯結

that relay information from the brain

一些轉接的網絡

past the injury and restore cortical control

將來自大腦的訊息

over the locomotor networks below the injury.

繞過損傷, 恢復皮層的控制

And here, you can see one such example,

在損傷之下重建運動的網絡

where we label the fibers coming from the brain in red.

你可以看到一個例子

This blue neuron is connected with the locomotor center,

我們將來自大腦的神輕標成紅色

and what this constellation

藍色神經元連接到運動中樞

of synaptic contacts means

這些像星座的

is that the brain is reconnected with the locomotor center

神經突觸代表著

with only one relay neuron.

大腦重新連結到運動中樞

But the remodeling was not restricted

只經由一個轉接神經元

to the lesion area.

但這個重建現象不僅限於

It occurred throughout the central nervous system,

癱瘓的部位

including in the brain stem,

它也發生在中央神經系統

where we observed up to 300-percent increase

包含腦幹

in the density of fibers coming from the brain.

我們觀察到來自大腦的神經纖維密度

We did not aim to repair the spinal cord,

增加了三倍

yet we were able to promote

我們並沒有想要修復脊椎神經

one of the more extensive remodeling

但我們提供了一個

of axonal projections ever observed

針對神經突軸

in the central nervous system of adult mammal

非常廣泛的重建技術

after an injury.

應用在損傷的成年哺乳類動物的

And there is a very important message

中央神經統上

hidden behind this discovery.

在這個發現背後

They are the result of a young team

有個非常重要的訊息

of very talented people:

這些成果來自於

physical therapists, neurobiologists, neurosurgeons,

一個很有才氣的年經團隊:

engineers of all kinds,

包括物理治療師, 神經生物學家, 神經外科家

who have achieved together

各類的工程師

what would have been impossible by single individuals.

一同達成的成果

This is truly a trans-disciplinary team.

這對任何一個單獨的人都是不可能的任務

They are working so close to each other

這是一個真正的跨領域團隊

that there is horizontal transfer of DNA.

他們很密切的合作

We are creating the next generation

像是DNA的平行轉移

of M.D.'s and engineers

我們創造出下個世代的

capable of translating discoveries all the way

醫生和工程師

from bench to bedside.

有能力將基礎研究

And me?

轉到臨床實驗上

I am only the maestro who orchestrated this beautiful symphony.

那我呢?

Now, I am sure you are all wondering, aren't you,

我只是一個交響樂團的指揮家

will this help injured people?

現在, 你們一定都很好奇

Me too, every day.

這個真的能幫助受傷的人們嗎?

The truth is that we don't know enough yet.

我每天也問這個問題

This is certainly not a cure for spinal cord injury,

事實上我們還不知道

but I begin to believe that this may lead

這確實不算是脊椎損傷的治療

to an intervention to improve recovery

但我開始相信

and people's quality of life.

這很有可能是一個開端去改善

I would like you all

人們的復原和生活狀況

to take a moment and dream with me.

我希望各位

Imagine a person just suffered a spinal cord injury.

和我一起有著這個夢想

After a few weeks of recovery,

想像一個受到脊椎損傷的人

we will implant a programmable pump

在數週之後的復原

to deliver a personalized pharmacological cocktail

植入一個可程式化的泵

directly to the spinal cord.

把個人化的藥物

At the same time, we will implant an electrode array,

直接送到脊椎裡

a sort of second skin

同時, 也植入一個電極陣列

covering the area of the spinal cord controlling leg movement,

像是第二層的表皮

and this array is attached to an electrical pulse generator

覆蓋控制腿部運動的脊椎神經

that delivers stimulations that are tailored

這些電極陣列連結到一個電脈衝產生器

to the person's needs.

根據個人的需要

This defines a personalized electrochemical neuroprosthesis

傳導神經刺激