Neurotech Pioneers Interact with Public at National Academies BCI Workshop

by James Cavuoto, editor

September 2022 issue

Several neurotechnology researchers and entrepreneurs who were instrumental in the development of the industry participated in an intensive online workshop devoted to brain-computer interfaces and related technologies earlier this month. The two-day event, titled “Brain-Machine and Related Neural Interface Technologies: Scientific, Technical, Ethical, and Regulatory Issues,” was organized by the National Academies Policy and Global Affairs Division.

John Donoghue from Brown University and Nita Farahany from Duke University co-chaired the workshop planning committee. The workshop featured four sessions, each with several presentations and ample discussion between the presenters and the members of the planning committee.

The first session was devoted to exploring the current status and limitations of brain-machine and neural interface technologies. Cindy Chestek from the University of Michigan, Tim Denison from Oxford University, Ana Maiques from Neuroelectrics, Krishnan Thyagarajan from Palo Alto Research Center, and Sebasti√°n Alvarado from City University of New York each gave presentations.

Chestek was optimistic that there would be significant improvements in BCI technology over the next 10 to 20 years. But the field is not going to look anything like the science fiction representations any time soon, she said. “You’d never walk into a lab and mistake that for able-bodied control. We’re doing very simple tasks.”

Denison pointed out that economic considerations were often overlooked when planning new neurotechnology therapies. He mentioned workflow viability as an important factor that differentiates a clinical environment from a laboratory setting. He said that the effort to ameliorate side effects of implanted stimulation devices is driving where the field is now. For example, directional electrodes and adaptive stimulation paradigms emerged in response to off-target effects and fluctuations.

The second session was devoted to reading and writing the brain for movement, and featured presentations from neuroprosthetics pioneers Vivian Mushahwar from the University of Alberta, Doug Weber from Carnegie Mellon University, Jennifer Collinger from Pitt, Geoffrey Ling, the former program manager for DARPA’s Revolutionizing Prosthetics program, and Cristin Welle, a former regulatory scientist at the FDA and now a professor at the University of Colorado. The session also featured comments from Justin Lowery, a BrainGate clinical trial participant.

Mushahwar described her work with activation of spinal networks after spinal cord injury. She explained the four requirements of a neuroprosthetic system to restore walking: predicable, coordinated movements; weight bearing during the standing phase; propulsion, to allow forward progression; and fatigue resistance to allow long-distance walking. Her group has focused on lumbar activation for subjects with complete SCI vs. lumbar and cervical stimulation for those with incomplete injuries.

Collinger spoke of implanted bidirectional BCIs, which include sensor encoding from a robotic arm or muscle stimulation device in addition to electrode arrays in the brain. Challenges facing the field include longer longevity for recording and stimulation devices, improvements in wireless and portable hardware, and optimizing stimulation for naturalness and usefulness, she said.

Ling, who is now CEO of On Demand Pharmaceuticals, addressed the issue of funding efforts for BCI and neuroprosthetics research. He cited the new ARPA-H program as a good example of what’s needed, but a “moonshot” similar to JFK’s 1961 initiative, was still necessary. We need to add commercial value to our efforts in order to attract private capital.

The third session was devoted to reading and writing the brain for mood and affect and featured presentations from Andrew Krystal from UCSF, Talma Hendler from Tel Aviv University, Daniel Chao, founder of Halo Neuroscience and former NeuroPace executive, and Vivek Pinto, division director for neuromodulation and physical medicine devices at the CDRH/FDA. The session also featured observations from Brandy Ellis, a recipient of a DBS system for treating depression.

Krystal shared results from three patients with treatment-resistant depression using DBS therapy. His group at UCSF is exploring the use of therapy personalization to produce immediate effects of DBS in TRD patients. The team uses NeuroPace’s RNS device in an effort to optimize therapy based on closed-loop signals. Krystal said they were able to find biomarkers of a “high-depression state”—different in all three subjects—based on spectral power of brain electrical activity. Optimal target location was also different in all three patients; either VC/VS, orbitofrontal cortex, or subgenual cingulate.

The final session was devoted to thought, communication, and memory, and featured presentations from Michael Kahana from Penn, Rajesh Rao from University of Washington, Leigh Hochberg from Mass General, Andreas Forsland from Cognixion, Paul Larkin from the ALS Association, and Carlos Pena, former FDA Division head for neurological devices and now with the Jacobs Institute in Buffalo, NY.

Kahana, who is also a cofounder of Nia Therapeutics, spoke about closed-loop brain neuromodulation for treating memory disorders. His team has collected brain recordings from 600 patients in epilepsy monitoring units. He said that the connectivity of cortical networks demonstrating theta activity are an indication of a good memory state.

A concluding wrap-up session including discussion with workshop planning committee members, which included Edward Chang from UCSF, Helen Mayberg from Mount Sinai, Marcello Ienca from EPFL, Gaurav Sharma from Air Force Research Laboratory, Abidemi Bolu Ajiboye from Case Western Reserve University, Gina Poe from UCLA, and Kate Rosenbluth from Cala Health.


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