Neural Engineers Convene in Cleveland for Neural Interfaces Conference

by James Cavuoto, editor

More than 500 neural engineering professionals, clinicians, and students attended the 2008 Neural Interfaces Conference in Cleveland, OH earlier this month. The conference is a spinoff of the NIH Neural Prosthesis Workshop, which in later years was combined with the DBS Consortium meeting. After skipping a year in 2007, the meeting moved away from Bethesda, MD for the first time, and future meetings will be held in other locations and organized by a committee of researchers involved with the field, though several NIH institutes continue to provide funding for the event.

This year’s event was hosted by Case Western Reserve University and the Cleveland Functional Electrical Stimulation Center. FES Center Director Hunter Peckham chaired the conference and Barbara Snyder, the new president of Case, made some opening comments.
The technical conference opened with a session examining whether DBS can have a curative effect on neurodegenerative disorders. A session on neuronal excitability explored the anatomical and therapeutic implications of sub-threshold stimulation protocols, including safety, toxicity, and specificity. Brian Litt from University of Pennsylvania spoke on the topic of localizing and tracking epileptic seizures, zeroing in on high-frequency epileptic oscillations. Imad Najm from the Cleveland Clinic described work on STN DBS for treatment of epilepsy. Results from the Medtronic-sponsored SANTE trial are expected later this year.

Elias Greenbaum from Oak Ridge National Laboratory described a novel “metabolic” prosthesis that would oxygenate ischemic tissue in conditions such as diabetic retinopathy. The stimulation device operates on the principle of selective electrolysis of physiological saline in a precisely timed and pulsed process that would deliver oxygen molecules and remove chlorine ions.

Warren Grill from Duke University described his work with FES to treat urinary retention, a condition that afflicts a sizeable population including elderly, and some individuals with diabetes, prostrate surgery, and related conditions. Grill’s team has looked at the augmenting reflex, a feedback loop that helps activate bladder muscles and inhibit the sphincter. The Duke researchers have constructed a stimulating catheter that has been used in early trials, though it is too early to assess the effectiveness of the potential therapy.

Andrew Fuglevand from the University of Arizona presented his lab’s work on probabilistic control of FES, in which he tries to estimate the paths of neuromuscular activity associated with various patterns of kinematic and joint states. The Arizona team has found that the stochastic patterns of EMG/kinematic relationships can hold true from one individual to another.

Florian Solzbacher from the University of Utah described his lab’s work with a wireless cortical microelectrode array. The 100-element array may take the place of the original tethered Utah electrode array in many applications, including brain-computer interfaces. Arto Nurmikko from Brown and Martin Bak from Micro Probe Inc. also made presentations related to wireless electrode arrays.

There were several presentations related to visual systems and retinal prostheses at this year’s event. James Weiland from University of Southern California gave attendees an update on commercial work in retinal implants, including the 60-electrode Argus II device from Second Sight Medical Products. According to Weiland, passive implant manufacturer Optobionics Inc. has left the market, presumably because of failed trials. There are also two new European manufacturers, including Retina Implant AG, which is developing a subretinal device being tested in seven patients, and Epi Retinal GmbH, which has six subjects testing its intraocular coil with a single current driver that is switchable among 25 electrodes. Robert Matc, a professor of opthalmology at University of Utah, gave a presentation on neural remodeling in retinal degeneration.

A lunchtime breakout session on the second day devoted to commercialization of neurotechnology featured presentations from Geoff Thrope, president of NDI Medical, Ben Pless, formerly of NeuroPace Inc., and founder of Autonomic Technologies Inc., and Pete Lando from St. Jude Medical. Lando gave attendees advice on partnering with larger firms. He advised inventors and entrepreneurs to have a realistic idea of the relative value of their innovation to the overall system value. Thrope recounted some of his personal experiences in the neurotechnology commercialization process, including his company’s recent sale of intellectual property for treating urinary disorders to Medtronic for $42 million. Pless spoke briefly of some of the legal and licensing issues confronting neurotech entrepreneurs, noting that the bulk of life science licensing deals involve royalty rates of only 1 or 2 to 4 or 5 percent.

As with previous Neural Interfaces Workshops, this year’s conference featured several representatives from the user community. An individual with Parkinson’s disease spoke positively of his experiences with DBS therapy, though he advised implanters to be more cognizant of patient issues during the implantation process, in particular, sounds, conversations, and vibrations that the patient is sensitive to.

A panel of users with spinal cord injury spoke of their experiences with the disorder and with early FES devices they encountered. Kim Anderson from the Reeve-Irvine Research Center at University of California, Irvine, described some of her research assessing needs and desires of individuals with SCI. Secondary functions such as bowel and bladder control and sexual function factor high in surveys of both paraplegic and tetraplegic users. She advised the industry to target their research programs to the priorities of consumers.

According to her research, users by a margin of 2 to 1 would be willing to undergo surgery for a 30 percent increase in elbow extension strength, and by a margin of 4 to 1, tetraplegics would accept two to three months of hospitalization and recovery for restoration of hand function from tendon transfer surgery. Unfortunately, more than 50 percent of tetraplegics reported that they were never told of this option by their clinicians.

For the first time, this year’s conference featured several commercial sponsors, in addition to the NIH institutes funding the event. Neurotech firms exhibiting at the event included ANS/St. Jude, Medtronic, Synapse Biomedical, Cleveland Medical, NDI Medical, Intelect Medical, and NeuroNexus Technologies.