Human Neural Prosthetics Program
The Human Neural Prosthetics Program is the result of a multidisciplinary effort to explore the utilization of brain computer interfaces for improving the lives of patients with motor disabilities. In 2007, a collaborative group was established—representing expertise in engineering, neuroscience and rehabilitation—to promote clinical trials using brain computer interfaces to control neural prosthetic devices.
Elizabeth Tyler-Kabara, MD, PhD, and Wei Wang, MD, PhD (Department of Physical Medicine & Rehabilitation) obtained an initial grant to evaluate micro-ECoG grids in patients in the Epilepsy Monitoring Unit. Data from this study demonstrated that patients could utilize a brain computer interface to control a computer cursor. This grant served as the kick-start for two clinical trials.
In the first, quadriplegic patients are implanted with a custom-designed ECoG grid for up to 30 days. The first subject was able to obtain consistent three-dimensional cursor control using a 3D visual environment. He was also able to successfully control a robotic arm. Additional subjects have also successfully achieved cursor control in a 3D virtual environment and control of a robotic arm. The intial work was funded by the Cortical Control of a Dextrous Prosthetic Hand study funded by National Institute of Neurological Disorders and Stroke (NINDS) and Andrew B. Schwartz, PhD (Department of Neurobiology) was the principle investigator.
A second study utilizes microelectrode arrays that penetrate the surface of the brain. This study is funded by the Defense Advanced Research Projects Agency (DARPA) and is part of the Revolutionizing Prosthetics Program, Phase 3 study for which Michael L. Boninger, MD, chairman of the Department of Physical Medicine & Rehabilitation, is the principle investigator. In the study, two 96-channel electrode arrays were implanted into the brain of a quadriplegic patient. This patient was able to obtain control of up to 10 degrees of freedom. Using seven degrees of freedom, she has been able to utilize the robotic arm to perform standardized rehabilitation tasks, such as placing objects on a shelf. Once FDA approval was obtained, she was able to interact personally with the robotic arm and was able to grasp a food item and feed herself. As part of the Revolutionizing Prosthetics Program, Phase 3 study, investigators also obtained FDA approval to place stimulating arrays in conjunction with recording arrays in anticipation of adding sensory feedback to the control of the robotic arm. A second subject has been implanted with two recording arrays in motor cortex and two stimulating arrays in sensory cortex.
Future studies are currently under development. Researchers are working on FDA approval for chronic ECoG implantation. Investigators hope to begin up to one-year studies soon. Development of a wireless system is also under development and it hoped that the pre-IDE studies will begin in the next year. It is anticipated that over the next year that the Department of Neurological Surgery will assume the leadership role for the ECoG based studies as Dr. Tyler-Kabara assumes the PI role for the ongoing studies and future studies.