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 Parkinsons 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
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. Its 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 products design and manufacture if the device
must be surgically removed and replaced every time new technology
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
deviceswhether for consumer, industrial, or medical applicationswill
grow progressively smaller, while consuming less power and exhibiting
more features and flexibility.
Moores 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
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