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Spinal Cord Community Warms to Neural Prostheses
by James Cavuoto, editor
After years of seeming neglect from funding and clinical communities, neurotechnology researchers developing neural prostheses as treatment for spinal cord injury are beginning to see signs that things may be changing. In an article on neural prostheses written by this editor in the April issue of IEEE’s Spectrum magazine, several prominent representatives of the spinal cord injury community voiced support for more funding of this technology.
One noteworthy source cited in the article is Susan Howley, the director of research at the Christopher Reeve Paralysis Foundation. Though in past years, the foundation has tended to favor pharmacological and biotechnology approaches to combating paralysis resulting from spinal cord injury, Howley says CRPF is now very open to funding neural prosthesis research, provided the project is “mission specific” and represents meritorious science.
Howley is particularly inclined to support neurotechnology research projects devoted to rehabilitation after spinal cord injury. “We now know that rehabilitation does more than preserve muscle and bone,” she says. She is also interested in neural prostheses addressing so-called concomitant functions like bowel function, sexual function, pain, and spasticity.
Howley acknowledged that in the past, research toward spinal cord regeneration and other efforts directed at a cure for paralysis received the lion’s share of the organization’s funding. But she said she did not recall seeing many grant applications for neural prosthesis applications. In the most recent funding cycle, CRPF funded a project involving cortical control of neural prostheses.
Another potential ally for neural prosthesis research comes from the medical specialty of physical medicine and rehabilitation, or physiatry. After the NeuroControl Freehand hand grasp stimulator was pulled off the market in 2002, some observers contended that one of the reasons the product failed was the lack of support from physiatrists.
Steven Kirshblum, director of the spinal cord injury program at Kessler Institute for Rehabilitation in West Orange, NJ, and a member of the American Academy of Physical Medicine and Rehabilitation, is a strong advocate of functional electrical stimulation and neural prostheses. He has previously provided patients with information about Freehand, and feels that it was taken off the market because of its ability to sell, rather than its ability to help users. “It’s been a rough road,” he says. “I can’t fault NeuroControl for their efforts, though.”
Kirshblum feels that physiatrists are becoming more aware of the capabilities of neural prostheses, though he concedes that more professionals from all fields of practice need to be more educated on the subject. He notes that most spinal cord injury patients follow with their local physician. “There’s no way they can all be up do date,” he says.
Like Howley, Kirshblum is a strong supporter of neural prostheses for bladder and bowel control. And he would also like to see more work done to develop a standing/ambulation prosthesis for paraplegics, though he notes that current systems need more sensory feedback control. Kirshblum also thinks that a leadless functional electrical system requiring less surgical intervention would do better in the market. |
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