I am spending the first half of this week in Cleveland, Ohio at the 2008 Neural Interfaces conference.

The first day was spent mostly discussing neural stimulation as an interface paradigm. Judging from the presentations, deep brain stimulation (DBS) is the most popular in both the research and medical communities. There are about five devices on the market that are FDA approved for DBS so many clinicians are looking to use these stimulators in various off-label applications to stimulate many targets within the brain as well as the vagus nerve in the periphery. The primary success story for DBS is continuous stimulation in the sub-thalamic nucleus and globus pallidus to alleviate effects of Parkinson’s disease. The same techniques are being applied with marginal success as a treatment for epilepsy, depression and obsessive compulsive disorder. It is still tough to show significant improvement for some of these latter diseases. Furthermore, it is equally tough to prove that the turning on the stimulation has any beneficial effects for those diseases. In some cases, implanting the stimulating electrode is good enough.

The second day has had some excellent coverage of the state-of-the-art prosthetic devices. One of the novel mechanisms that I was not aware of is nerve re-direction in the case of amputation. For example, there are surgical techniques to re-route nerve bundles that control arm movement in the case of amputation near the shoulder. The muscle groups on the chest become the targets and in some cases, the amputee can control those muscles by attempting arm movement and feel arm sensations through mechanical stimulation of their chest. If this type of surgery is successful, there are examples of external prosthetic arms which are controlled by electrically tracking muscle contraction on the chest and provide basic tactile feedback through mechanical stimulation.

On a side note, there was a luncheon focusing on commercialization of neurological devices. Translating an implantable device from academia to “mass product” seems to be a process that will test the designer’s patience and humility. The general feeling on the commercial side is that the academic designer should already have a working design that is undergoing human clinical trials when they approach a company for commercialization. Even then, the commercialization company will evaluate their potential for revenue generation and may provide a 0.25-0.5% royalty for the academic designer to take over the mass production of their product. This is while keeping in mind that the path from specifications to clinical trials is at least ten years. This may be the reason that many researchers try to create start-up companies and commercialize their own products to see more fruits of their labors. This approach, however, is perilous and may end up being unrewarding. This is clearly seen with the bankruptcy of Cyber-Kinetics, the company that has been receiving media attention for years for allowing several paraplegics control of an on-screen cursor by thought alone. (Their website has not been updated recently to disclose this.)

 
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