Relying on Progress

The hardware problems with deep brain stimulation electrodes reported by Andres Lozano and his colleagues at the University of Toronto represent a temporary setback for the neurostimulation industry. The problems they encountered, though widespread, in no way diminish the promise and the value of DBS therapy for Parkinson’s Disease and other movement disorders. Indeed, as we discuss in our article, identification of the specific failures presents an opportunity for other neural engineering firms to build more reliable devices and devise new methods of interfacing electrical components with excitable tissue.

Still, this experience should make us ponder at least two lessons we can learn from this. First, as we design and manufacture implantable devices for long-term patient use, we must do everything we can to ensure that the devices will be stable, reliable, and well integrated with the cellular environment in which they will reside.

Research conducted at the University of Michigan and other institutions regarding new materials and new strategies for strengthening the mechanical and electrical properties of the electrode-tissue interface offers a good deal of promise toward that end. It’s also important to consider carefully the means used for delivering electrical energy from source to destination. Components and subassemblies like connectors, ribbon cables, and pulse generators must be as reliable and stable as the electrodes themselves.

The second lesson is that we must be always mindful that the state of technology that exists at the moment a device is implanted may not remain the same during the life of the implanted device. At first blush, this may seem like a challenge; it could greatly complicate a stimulation product’s design and manufacture if the device must be surgically removed and replaced every time new technology avails itself.

But in reality, the steady progress of electronics and software technology represents a major selling point for manufacturers of neurotechnology devices compared to other forms of therapy. Our society has come to take for granted the fact that microelectronic devices—whether for consumer, industrial, or medical applications—will grow progressively smaller, while consuming less power and exhibiting more features and flexibility.

Moore’s law, which describes the rate at which processing power progresses, is a powerful ally for neurotechnology that is not necessarily available to researchers in neurobiology, pharmacology, or genomics. And of course implanted devices that rely on software control will realize even greater benefits from code revisions, increased available memory, and advances in software engineering.

These advantages may not entirely erase the technical and marketing challenges that neurotechnology firms encounter when trying to gain funding, acceptance, approval, and reimbursement for new devices. But in a market that is increasingly driven by public perceptions, clinician inertia, and investor ROI calculations, neurotechnology executives would be wise to point out these advantages every opportunity they can.

James Cavuoto
Editor and Publisher