Prosthesis 2.0: Bridging the Brain-Prosthetic Gap

2-18-2013 8-45-08 PM

Research teams in the prosthetics field have announced some amazing technological advancements recently, including this week’s announcement from a Swiss research team which unveiled a new prosthetic hand that will be surgically connected to a recipient’s nervous system later this year.

Integrating the prosthetic with a patient’s nervous system will allow bi-directional communication between the device and the brain. This revolutionary step in prosthetics brings scientists much closer to replicating the natural state of an actual limb. The patient will be able to control the actions of the prosthetic with the brain and, at the same time, the prosthetic hand will be able to send tactile information about the environment through the patient’s nervous system back to the brain.

“We could be on the cusp of providing new and more effective clinical solutions to amputees in the next year.” – Silvestro Micera, MD, of the Ecole Polytechnique Federale de Lausanne

Doctors will attach the device to an Italian test patient for a month to gather critical performance data and test specific features and sensations. The hope is that with bi-directional information flow, the brain will fall into a natural synch with the prosthesis; telling the hand where to move and what to do and, in turn, processing the information coming in from the prosthetic hand.

Researchers are interested in measuring the patient’s ability to feel and identify sensation, such as the general pressure which will register as it squeezes a soda bottle, differentiated from the localized stabbing from a pin prick.

Researchers are also interested in seeing how the brain responds to constant inbound information from the hand. Will the brain learn to ignore sensory messages from the prosthetic hand, as it does for an actual hand, when the patient is trying to sleep? The device will be surgically attached to arm and nervous system, so it will be critical that the patient can tolerate wearing it at all times. If the study reveals that patients need a break from the device, the engineers will need to reconvene to address that problem.

Sensory feedback has been a major missing link in prosthetic capabilities until now. While many research teams have focused on controlling prosthetics through brain activity, this will be the first example of truly bi-directional communication and control of a prosthetic limb and, if successful, represents a promising future for the field.

 

In other astonishing prosthetic news, the FDA on Thursday approved an artificial retina prosthetic that restores partial vision to blind patients by capturing video, processing the image into signals that can be wirelessly transmitted to the implanted prosthetic, and then passing those signals through the prosthetic to the remaining healthy receptors in the eye – essentially bypassing the damaged retina.

The device has been tested on about 50 people both in the US and in Europe. The prosthetic has FDA clearance to treat severe retinitis pigmentosa, a degenerative disease that slowly destroys the retina. There are around 100,000 patients in the US living with retinitis pigmentosa. Researchers in Europe are optimistic that the prosthetic might be used to treat macular degeneration as well, which affects more than two million US adults.

The FDA worked with Second Sight to develop ways to measure risk vs. benefit, including tasks like walking on a sidewalk without stepping off; matching black, gray and white socks; and reading letters on a computer screen.

“The questions that this particular device raised for FDA were very new. It’s a big step forward for the whole ophthalmology field.” – Malvina Eydelman, MD, FDA director for the Division of Ophthalmic and Ear, Nose, and Throat Devices.

The prosthetic, dubbed Argus II, was developed by Mark Humayun, MD, an ophthalmologist and biomedical engineer at the University of Southern California.

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