Aug 3, 2026 · 1 hr 28 min · 12 segments
Doris D. Wang is an associate professor of neurological surgery at the University of California, San Francisco, a functional neurosurgeon specializing in movement disorders, and a systems…
Doris WangGuest
Andreas HornHost
What does the nervous system actually have to coordinate for us to take one normal step? Um, y- we probably don't know, right? That's probably the, the honest answer.
What even happens in the brain or, you know, how, how does it work? What, what has to happen to make a step?
So when we're normally walking, like once you start walking, to maintain the rhythmic, just like while you're, um, going for a stroll in the park, for instance, actually requires very little higher cognitive, probably cortical function.
Um, you know, it's just the basal ganglia scaling these if there's, you know, you have to change your step length, um, change direction.
You know, it just becomes automated, the cyclical event that drives your, you know, muscle activation between the two legs while maintaining balance.
But it's when there are, you know, changes to that just direct rhythmic continuous walking, then that requires more cognitive higher order function.
So things like, you know, initiating walking, going from static to movement, that probably requires some type of cortical demand coming from, you know, um, premotor, like the intention to move, to motor cortex to initiate that drive.
And then also more complex gait, right? Like if you're walking in the forest, going hiking, where you have to avoid tree roots, step over rocks, um, that requires a lot more attention.
Again, the normal brain, I think a lot of these, uh, circuits, even involving, like, the visual s- uh, visual circuits, sensory processing, um, we don't have to devote a lot of, like, attention to it.
Like, they can walk sometimes when they devote a lot of attention, but then these, the automated walking process, gait process, that breaks down.
And then you, you did mention, you know, when you started your own lab, um, to essentially there was the, the technology was right with the Percept, uh, sorry, the, um, Activa PC+S and then I think the Summit later that was used in the-
What does the nervous system actually have to coordinate for us to take one normal step? Um, y- we probably don't know, right? That's probably the, the honest answer.
What even happens in the brain or, you know, how, how does it work? What, what has to happen to make a step?
So when we're normally walking, like once you start walking, to maintain the rhythmic, just like while you're, um, going for a stroll in the park, for instance, actually requires very little higher cognitive, probably cortical function.
Um, you know, it's just the basal ganglia scaling these if there's, you know, you have to change your step length, um, change direction.
You know, it just becomes automated, the cyclical event that drives your, you know, muscle activation between the two legs while maintaining balance.
But it's when there are, you know, changes to that just direct rhythmic continuous walking, then that requires more cognitive higher order function.
So things like, you know, initiating walking, going from static to movement, that probably requires some type of cortical demand coming from, you know, um, premotor, like the intention to move, to motor cortex to initiate that drive.
And then also more complex gait, right? Like if you're walking in the forest, going hiking, where you have to avoid tree roots, step over rocks, um, that requires a lot more attention.
Again, the normal brain, I think a lot of these, uh, circuits, even involving, like, the visual s- uh, visual circuits, sensory processing, um, we don't have to devote a lot of, like, attention to it.
Like, they can walk sometimes when they devote a lot of attention, but then these, the automated walking process, gait process, that breaks down.
And then you, you did mention, you know, when you started your own lab, um, to essentially there was the, the technology was right with the Percept, uh, sorry, the, um, Activa PC+S and then I think the Summit later that was used in the-
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3 of 6
Walking-Synced Brain Stimulation Breakthrough
Here’s how the implant reacts instantly
Patients Choose Adaptive Mode
What happened when people took it home
Why Gait Still Fails
The question that changed her research
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