“And the paralyzed will walk again”

With this promising statement of Michio Kaku ends a video cut that I made from a TV documentary entitled "2057 The Body" and which I use inside a presentation on wearable and implantable medical devices. The documentary predicts that in the year 2057 we will be able to inject tiny wireless sensors and actuators inside the body thereby restoring the connectivity of the peripheral nervous system and be able to use our senses and control our muscles again.

Last week, still 46 years away from the year 2057, it was reported in the Lancet that [from the UCLA Newsroom] "a team of scientists at the University of Louisville, UCLA and the
California Institute of Technology has achieved a significant breakthrough in
its initial work with a paralyzed male volunteer at Louisville’s Frazier Rehab
Institute — the result of 30 years of research to find potential clinical
therapies for paralysis.

The man, Rob Summers, 25, was completely paralyzed below the chest after
being struck by a vehicle in a hit-and-run accident in July 2006. Today, he is
able to reach a standing position, supplying the muscular push himself. He can
remain standing, and bearing weight, for up to four minutes at a time (up to an
hour with periodic assistance when he weakens). Aided by a harness support and
some therapist assistance, he can make repeated stepping motions on a treadmill.
He can also voluntarily move his toes, ankles, knees and hips on command.
 
These unprecedented results were achieved through continual direct
"epidural electrical stimulation" of the subject’s lower spinal cord, mimicking
signals the brain normally transmits to initiate movement. Once that signal is
given, the research shows, the spinal cord’s own neural network, combined with
the sensory input derived from the legs to the spinal cord, is able to direct
the muscle and joint movements required to stand and step with assistance on a
treadmill.
 
The other crucial component of the research was an extensive regime of
locomotor training while the spinal cord was being stimulated and the man
suspended over the treadmill. Assisted by rehabilitation specialists, the man’s
spinal cord neural networks were retrained to produce the muscle movements
necessary to stand and to take assisted steps.

[…]

Relief from secondary complications of complete spinal cord injury —
including impairment or loss of bladder control, sphincter control and sexual
response — could prove to be even more significant.
 
"The spinal cord is smart," said Edgerton, distinguished professor of
integrative biology and physiology and of neurobiology at UCLA. "The neural
networks in the lumbosacral spinal cord are capable of initiating full
weight-bearing and relatively coordinated stepping without any input from the
brain. This is possible, in part, due to information that is sent back from the
legs directly to the spinal cord."
 
This sensory feedback from the feet and legs to the spinal cord facilitates
the individual’s potential to balance and step over a range of speeds,
directions and levels of weight-bearing. The spinal cord can independently
interpret these data and send movement instructions back to the legs — all
without cortical involvement.

[…]

More than 5 million Americans live with some form of paralysis, defined as
a central nervous system disorder resulting in difficulty or inability to move
the upper or lower extremities. Roughly 1.3 million are spinal cord injured, and
of those, many are completely paralyzed in the lower extremities.
 
Epidural stimulation, in the context of paralysis of the lower extremities,
is the application of continuous electrical current, at varying frequencies and
intensities, to specific locations on the lumbosacral spinal cord corresponding
to the dense neural bundles that largely control movement of the hips, knees,
ankles and toes. The electrodes required for this stimulation were implanted at
University of Louisville Hospital by Dr. Jonathan Hodes, chairman of the
department of neurosurgery at the University of Louisville.

[…]
 
For a more in-depth discussion of the research behind the breakthrough,
watch this interview with
Edgerton
." 

Running for brains!

On June 2 (Hemelvaartdag) we go with seven people (you are right, one is missing on the picture) of TU Delft (BHV members and Gerard Meijer) to the Golden Ten Loop in Delft to run 10 kilometers for “De hersenstichting”, a charity foundation stimulating brain research and educating the public about it.
As three of us had problems with our brain (one had a stroke, one had another brain problem and I had a complete brain check-up for my undefined kind of hyperventilation) it was a brainwave to run for this good cause.
De hersenstichting” takes care of a lot of research in all kind of brain damages, so therefore we ask you to be a sponsor of our running event. You can give cash money to Marion or send it to bank account 3532534 t.n.v. N.J.M. van Zon and mention "Golden Ten Loop – hersenstichting".  In both cases you will sponsor the whole group.
The orange shirts are from the hersenstichting and the health coach of the TU Delft sponsored the printing of the shirts with a TU Delft logo. Please be so kind to donate a small amount for this running event and maybe you can also be a supporter on June 2 at the start and finish place on the Burgwal in Delft. It will be a nice afternoon with a lot of people and a lot of music.
Marion 
 

STW project ReaSONS approved!

Today I received some good news by means of a phone call of Wouter Segeth, program officer with STW, the Dutch Technology Foundation. Our ReaSONS project (Realtime Sensing of Neural Signals), a collaboration between Delft University of Technology and Leiden University Medical Center has been approved.

The project aims at the realtime recording of the evoked compound action potential (ECAP) generated by the haircells in the cochlea while fitting a cochlear implant. Also it is considered to be one step towards the creation of realtime online closed-loop neurostimulators.

This is of course good news for Cees-Jeroen, upcoming PhD student in the BME group, who supposedly will start his duties in September this year. 

Wouter

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(W)out

Brain and ears…

Usually this blog reports on fancy inventions or breakthroughs related to the biomedical field. We have discussed many technical advances that will ultimately improve the quality of people who suffer from a wide range of pathologies.

Sometimes though medical knowledge and engineering can come together in a funny way, too. The company ‘neurowear’ is doing exactly this as stated on their website: "to develop fashion items and gadgets using brain waves and other biosensors". Their first product is called ‘Necomimi’ and instead of spending a lot of words explaining what it exactly does, this movie might be self-explaining:

http://www.youtube.com/watch?v=w06zvM2x_lw

Enjoy!

Marijn

Unexpected Meet and Greet with Hero in Circuit Theory

Georg Simon OhmLast week, I was in Köln, Koeln, Keulen or Cologne (depending on from which country you are) with my family and while on our way to the Dom, Cologne’s well-known cathedral, I bumped into one of the greatest heroes of electric circuit theory: Georg Simon Ohm. The sign says that "George Simon Ohm discovered, in this house, being a teacher at the Old Gymnasium in Cologne, in 1826, the foundation of electric current."

Though one of the most important discoveries indeed, I think it is not so much the discovery of the foundation of electric current, but rather the relation between voltage and current that holds for linear resistances (and impedances, in the harmonic regime), later known as "Ohm’s Law" that caused his name to be remembered forever.

For those that have both an interest in technology and law, I cordially recommend Ohm’s Law and Kirchhoff’s Laws as basic study material.

Wouter

First clinical tests!

 

Last friday a milestone was reached in the Biomedical Electronics Group: the first clinical experiments were conducted with the neurostimulator ‘uStim’ designed within the group! This neurostimulator allows the use of arbritrary waveforms for neural stimulation while still assuring safe stimulation by charge cancellation. After extensive electrical characterization of the device in the last couple of months the moment was finally there to test it in real life!

Two subjects were implanted with percutaneous leads. These leads were connected to the stimulator while the EEG activity of the subjects was closely monitored. The subjects were first stimulated using a commercially available stimulator (ANS – St. Jude Medical) and after that using the uStim. 

The first prelimenary results are promising. Both subjects showed clear responses in the EEG as a result of the stimulation pulses generated by our stimulator. The data will need further analysis in order to compare it to the commercially available stimulators, but at least it is possible to conclude that the stimulator is able to generate arbritrary stimulation pulses in a safe manner.

It was a great moment for the researchers to see their work in real action! We are looking forward to working on the next version of uStim!

Marijn

 

Preparing the electronics: 

 

 

Connecting the leads!!

 

 

EEG monitoring showing the response to the stimulator: 

 

All activity is closely monitored. 

 

 

Can I ask a question?

There was a very interesting lecture from dr. Firat Yazicioglu yesterday. This lecture, entitled Analog Signal Processing for Bio-Medical Applications, was at IMEC Belgium in Leuven. However, Biomedical Group members attended the lecture online, using streaming technology. The lecture was real-time projected in the Davidsezaal at the 18th floor of our building at Delft University of Technology (TU Delft). As I really enjoyed the lecture, I would like to share a few main points with you.

Dr. Yazicioglu introduced the lecture by explaining what main drivers are behind emerging biomedical electronics. One of the most important drivers is that healthcare costs can be reduced by remote monitoring of the patients. Other important drivers are the need for tools for emerging therapies, need for smart (closed-loop) devices that can adapt their therapy to the patient’s condition, understanding of biology and brain communications and Brain Computer Interfaces (BCI) for, i.e., the gaming industry.   

The speaker continued the lecture with topics about instrumentation amplifiers, impedance measurements and biomedical signal processing.  

One of the main messages of instrumentation amplifiers part is that implantable and wearable biomedical devices tighten the specifications of traditional instrumentations amplifiers where an optimum between noise and power consumption has to be found. In the biomedical electronics field, instrumentation amplifier specifications are much tougher and an optimum among noise, supply voltage, # of extern components, CMRR, input impedance and DC filtering range needs to be found.

Other types of electronic circuits treated by the speaker were circuits for impedance measurements. Such measurements can be useful in electrode quality check, motion artifact monitoring, medical imaging, respiration monitoring and impedance cardiography. 

Last part of the lecture was about biomedical signal processing. In biomedical signal processing, very often, there is a need for high count channel measurements. Employing traditional signal processing schemes it is impossible to keep biomedical devices power efficient. However, by combining Analog Signal Processing (ASP) and Digital Signal Processing (DSP), more power efficient medical devices can be developed. Important massage here was that in the case of careful design the total power consumption of the system can be less than the sum of the power consumptions of all separate blocks,
Psystem << Panalog+Pdigital+Pradio.
I would like to end this post by thanking dr. Firat Yazicioglu for a very interesting and useful lecture.

Making music keeps the brain fitter

On http://esthenews.org/tag/brenda-hanna-pladdy/ we can read the following:

"The Tiger Mothers were right all along: Music lessons as a kid may make you a sharper grown-up.

A new study finds that older adults with musical experience perform better on some cognitive tests than those who had never studied music. With only 70 participants, the study was small, but the results match those from other studies of challenging tasks, including findings that learning a second language protects against dementia.

no music no life"Musical activity throughout life may serve as a challenging cognitive exercise, making your brain fitter and more capable of accommodating the challenges of aging," study researcher Brenda Hanna-Pladdy, a neurologist at the Emory University School of Medicine, said in a statement. "Since studying an instrument requires years of practice and learning, it may create alternate connections in the brain that could compensate for cognitive declines as we get older."

[…]

"Whether the participant continued to play music into old age didn’t matter, the researchers found. Instead, long-term study in youth seemed to confer benefits far down the road."

The entire scientific article can be found at: http://www.apa.org/pubs/journals/releases/neu-25-3-378.pdf.

This is, of course, good news for those involved in the ELCA Music Festival, all of them who speak a second language (often English) and took up making music in their childhood, or, like Senad, inspired by the ELCA Festival, are currently taking up music lessons. Gradually I start looking out for the next edition…

Wouter

Programmable Implants

This article originally appeared in Delta, April 13, 2011. By Thomas van Dijk

For his PhD research, Dr Christos Strydis rethought the architecture for processors in biomedical implants.

In future implants might be recharged by the brain. (Photo: Ana Laura Santos)

Saying that they are committed to their research into neurostimulation is an understatement. In their quest to develop a treatment for patients with tinnitus, a syndrome where people hear phantom noises, Professor Dirk De Ridder, a neurosurgeon and neuroscientist at  University Hospital Antwerp, and assistant professor Eddy van der Velden, a medical researcher at Antwerp’s Monica hospital, are about to be operated on themselves. During an experiment to be held at the end of this month, the professors will have wires sticking out of the back of their heads, through which electrical pulses will travel to their brains. 

“They are really crazy,” says computer engineer, Dr Christos Strydis, laughing. In his office, Dr Strydis shows an application on his smart phone. With this app he will command the device – which is the size of a packet of cigarettes – that is attached to the guinea pig professors and generates the pulses. Depending on the frequency of the pulses, the test subjects might feel energetic, euphoric or sleepy, to name but a few of the possible states. 

Strydis is part of a large team of researchers from the faculties of Electrical Engineering, Mathematics and Computer Science, and Applied Sciences, who over the years have been working with the Belgian medics on biomedical implants. The team’s goal is to develop tiny, low-energy consuming implants that can be controlled by software, rather than being based solely on hardwired circuits. 

Strydis has been focusing on the type of processor needed for such devices. Last month he defended his PhD thesis, titled ‘Universal processor architecture for biomedical implants.’

Strydis believes that it’s time for a paradigm shift in the field of biomedical implants: “One big problem is that the electrical signals created by implants no longer aid patients with neurological diseases after a certain period of time, because the body simply gets used to the signals and ignores them. So the device should be smarter and more flexible. You should be able to programme it. What’s more, every patient is different, so standard implants with standard signals do not work optimally for everyone.”

It will take at least another five years before the device built by the Delft researchers will be miniaturised enough to be placed directly under the skull of patients, Strydis surmises. Neuroscientist Prof. van der Velden hopes that the battery inside the implant, which ultimately must work at a voltage of no more than half a millivolt, will be recharged by the brain.