Global Neuroprosthetics: Introduction

Global Neuroprosthetics 

Neuroprosthetics is an interdisciplinary field that uses engineering principles to understand, repair, replace, enhance or augment neural systems and human function. With advancement in biomedical engineering, nanotechnology and material sciences, neuroprosthetics is revolutionizing the treatment of neurological disorders and injuries by restoring lost functions.

 

Cochlear Implants – A Major Success Story

Cochlear implants are the most successful neuroprosthetic devices developed to date. A cochlear implant is an electronic medical device that replaces the function of the damaged inner ear (cochlea) by directly stimulating the auditory nerve cells. Since the approval of the first multichannel cochlear implant by the U.S. Food and Drug Administration in 1984, over half a million people, including young children, have received cochlear implants worldwide and have regained their hearing. The technological advancement has enabled over 90% of implant recipients to achieve open-set speech recognition with these implants. Countries like the U.S., Australia, UK and several European nations have widespread public health coverage for cochlear implantation.

Retinal Implants to Restore Vision

Loss of vision due to retinal degenerative diseases like retinitis pigmentosa and age-related macular degeneration pose a major health challenge. Researchers are developing retinal prosthetic devices, commonly known as retinal implants, to restore vision in blind patients by bypassing the defective photoreceptors and directly stimulating the inner retinal neurons or optic nerve. Pacemakers for the retina that work similarly to cochlear implants are showing early promise. In 2021, researchers from the University of Southampton reported successful restoration of basic vision in five patients using the Argus II retinal prosthesis system. Several next-generation high-resolution retinal implant technologies are under clinical trails. If successful, they may enable visual prosthetic users to read, navigate, and carry out other visual tasks independently.

Brain-Computer Interfaces for Communication

Brain-computer interfaces (BCIs) are  Global Neuroprosthetics systems that establish a direct communication pathway between the brain and an external device, bypassing the brain's normal output pathways of peripheral nerves and muscles. Non-invasive BCIs using electroencephalography (EEG) and magnetoencephalography (MEG) are helping patients with severe motor disabilities operate computers, control prosthetic limbs or communicate through thought alone. In a breakthrough study published in 2019, researchers showed for the first time that a paralyzed person was able to communicate in full sentences using a BCI system. UC Berkeley researchers are also leading efforts to create a speech neuroprosthesis that decodes brain signals related to speech into words that can be spoken or text-to-speech. These communication BCIs have the potential to greatly improve quality of life for disabled individuals who have lost mobility or speech.

Regaining Motor Functions with Prosthetic Limbs

Loss of a limb due to accident, disease or war significantly impacts mobility and independence. Sophisticated neuromuscular interface systems are enabling amputees to operate thought-controlled multi-degree prosthetic arms and hands. The DEKA Arm developed by DARPA veteran Dean Kamen can perform numerous dexterous tasks like stacking blocks or using common tools. In 2016, DARPA implanted an experimental BrainGate BCI chip in Jered Chinnock, allowing him to move a mind-controlled robotic arm. Major advances are also being made to restore tactile feedback in prosthetic limbs using implanted nerve sensors. Researchers project that within a decade upper limb amputees may regain almost natural dexterity through direct brain-machine interfaces. Implanted interfaces are also helping quadriplegics perform basic tasks like sipping drinks by regulating their own muscle movements.

Challenges in Translating Lab Discoveries

While neuroprosthetic research has made notable progress, substantial challenges remain in translating discoveries from preclinical studies and early clinical trials into widespread clinical adoption and patient benefit. Problems like device reliability over long term use, interfacing variability across patients, data analysis complexity and high device costs hamper widespread commercialization. Ensuring device safety and efficacy as per international regulatory standards like FDA and CE marking also requires extensive validation testing. A major roadblock is the lack of reimbursement policies for new neuroprosthetic technologies in both government health programs and private insurances. Addressing these economic, technical and regulatory challenges would accelerate global development and access to life-changing neural prostheses

Government Funding Drives Innovation

Government funding especially through defence agencies has played a key catalytic role in advancing neuroprosthetic technologies. Over the past two decades, DARPA has invested over $150 million in BCI research programs to develop thought-controlled prosthetic limbs for injured soldiers. Similarly, European Union and UK funding bodies like EPSRC, Wellcome Trust and MRC have contributed significantly towards academic neuroprosthetic research. Increased government support for public-private partnerships is crucial to tackle the high commercialization costs. Countries like Germany, Canada, Australia and South Korea also offer tax incentives and early market access to medtech startups. To sustain progress, long term commitment of funding at national and international levels is essential for global neuroprosthetic research.

Neuroprosthetics is projected to grow into a multi-billion dollar industry by 2030 with the development of more sophisticated cochlear implants, retinal prostheses, brain stimulators and thought-controlled robotic systems. By 2050, full brain-computer interfaces may enable direct communication between healthy individuals and computers at high speed. It is also hoped that neuroprosthetic interfaces to treat paralysis, stop seizures or restore memory would greatly improve quality of life for millions globally. Though challenges remain, the future potential of this field to alleviate human suffering and augment ability nourishes hope. With continued coordinated public and private investments worldwide, neuroprosthetics research will certainly revolutionize medicine and transform humanity’s relationship with technology in the decades ahead.

 

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