Restoring Ability: Project NEUWalk

neuwalkIn the past few years, medical science has produced some pretty impressive breakthroughs for those suffering from partial paralysis, but comparatively little for those who are fully paralyzed. However, in recent years, nerve-stimulation that bypasses damaged or severed nerves has been proposed as a potential solution. This is the concept behind the NEUWalk, a project pioneered by the École Polytechnique Fédérale de Lausanne (EPFL) in Switzerland.

Here, researchers have figured out a way to reactivate the severed spinal cords of fully paralyzed rats, allowing them to walk again via remote control. And, the researchers say, their system is just about ready for human trials. The project operates on the notion that the human body requires electricity to function. The brain moves the body by sending electrical signals down the spinal cord and into the nervous system.

spinal-cord 2When the spinal cord is severed, the signals can no longer reach that part of the spine, paralysing that part of the body. The higher the cut, the greater the paralysis. But an electrical signal sent directly through the spinal cord below a cut via electrodes can take the place of the brain signal, as the team at EPFL, led by neuroscientist Grégoire Courtine, has discovered.

Previous studies have had some success in using epidural electrical stimulation (EES) to improve motor control where spinal cord injuries are concerned. However, electrically stimulating neurons to allow for natural walking is no easy task, and it requires extremely quick and precise stimulation. And until recently, the process of controlling the pulse width, amplitude and frequency in EES treatment was done manually.

brainwavesThis simply isn’t practical, and for two reasons: For starters, it is very difficult for a person to manually adjust the level of electrostimulation they require to move their legs as they are trying to walk. Second, the brain does not send electrical signals in an indiscriminate stream to the nerves. Rather, the frequency of the electrical stimulation varies based on the desired movement and neurological command.

To get around this, the team carefully studied all aspects of how electrical stimulation affects a rat’s leg movements – such as its gait – and was therefore able to figure out how to stimulate the rat’s spine for a smooth, even movement, and even take into account obstacles such as stairs. To do this, the researchers put paralyzed rats onto a treadmill and supported them with a robotic harness.

NEUWalk_ratsAfter several weeks of testing, the researchers had mapped out how to stimulate the rats’ nervous systems precisely enough to get them to put one paw in front of the other. They then developed a robust algorithm that could monitor a host of factors like muscle action and ground reaction force in real-time. By feeding this information into the algorithm, EES impulses could be precisely controlled, extremely quickly.

The next step involved severing the spinal cords of several rats in the middle-back, completely paralyzing the rats’ lower limbs, and implanted flexible electrodes into the spinal cord at the point where the spine was severed to allow them to send electrical signals down to the severed portion of the spine. Combined with the precise stimulation governed by their algorithm, the researcher team created a closed-loop system that can make paralyzed subjects mobile.

walkingrat.gifAs Grégoire Courtine said of the experiment:

We have complete control of the rat’s hind legs. The rat has no voluntary control of its limbs, but the severed spinal cord can be reactivated and stimulated to perform natural walking. We can control in real-time how the rat moves forward and how high it lifts its legs.

Clinical trials on humans may start as early as June 2015. The team plans to start testing on patients with incomplete spinal cord injuries using a research laboratory called the Gait Platform, housed in the EPFL. It consists of a custom treadmill and overground support system, as well as 14 infrared cameras that read reflective markers on the patient’s body and two video cameras for recording the patient’s movement.

WorldCup_610x343Silvestro Micera, a neuroengineer and co-author of the study, expressed hope that this study will help lead the way towards a day when paralysis is no longer permanent. As he put it:

Simple scientific discoveries about how the nervous system works can be exploited to develop more effective neuroprosthetic technologies. We believe that this technology could one day significantly improve the quality of life of people confronted with neurological disorders.

Without a doubt, restoring ambulatory ability to people who have lost limbs or suffered from spinal cord injuries is one of the many amazing possibilities being offered by cutting-edge medical research. Combined with bionic prosthetics, gene therapies, stem cell research and life-extension therapies, we could be looking at an age where no injury is permanent, and life expectancy is far greater.

And in the meantime, be sure to watch this video from the EPFL showing the NEUWalk technology in action:


Sources:
cnet.com, motherboard.com
, actu.epfl.ch

Biomedical Breakthroughs: “Biological” Pacemakers

biologicalpacemakersSince they were first developed some forty years ago, pacemakers have served an invaluable medical function. By stimulating the heart with electrical stimulation, they ensure that the recipients heart continues to beat at a steady rate. However, the implantation process calls for a major medical procedure, and the presence of the machine inside the body can lead to complications – i.e. infections.

Little wonder then why researchers are looking to create a better design to replace it with. However, up until now, proposed upgrades have focused on eliminating batteries (that require additional surgery to be replaced) with perpetual motion or piezeoelectric-powered devices. But this most recent proposal, which comes from the Cedars-Sinai Heart Institute in Los Angeles, looks to use the heart’s own cells to regulate it and keep it in working order.

piezoelectric-pacemakerIn an effort that was apparently the result of “dozens of years” worth of research, Dr. Eduardo Marbán and his research team used genes injected into the defective hearts of pigs to convert unspecialized heart cells into “biological pacemakers”. The pigs, all of which suffered from complete heart blocks, had the gene TBX18 injected into their hearts via what is described as a minimally invasive catheter procedure.

This caused some of the existing unspecialized cardiac cells to transform into sinuatrial node cells, which consist of tissue that initiates the electrical impulses that set the rhythm of the heart. The day after the procedure, the recipient pigs’ hearts were already beating faster than those of a control group and lasted for the duration of the 14-day study – indicating that the treatment could be a longer-term solution than previously thought.

biomedicineInitially, Marbán and his colleagues conceived of it more as a temporary fix for patients who were having problems with their man-made pacemakers. Now, they’re considering the possibility that it could be a long-term biological treatment. It could also be used on infants still in the womb, who can’t currently receive mechanical pacemakers. And while the research has so far been confined to pigs, human clinical studies could begin in as soon as three years.

In keeping with a trends in modern medicine, this gene therapy offers a potential third alternative to medical machiners and biomimetics. The one seeks to enhance the workings of our biological bodies through the addition of machinery while the other seeks to create machinery that mimics the bodies natural functions. But by simply programming the body to perform the role of machinery, we can cut out the middle man.

Sources: gizmag.com, cedars-sinai.edu

The Future of Medicine: Gene Therapy and Treatments

DNA-1Imagine a world where all known diseases were curable, where health problems could be treated in a non-invasive manner, and life could be extended significantly? Thanks to ongoing research into the human genome, and treatments arising out of it, that day may be coming soon. That’s the idea behind gene therapy and pharmacoperones – two treatment procedures that may make disease obsolete in the near future.

The first comes to us from the Utah School of Medicine, where researcher Amit Patel recently developed a non-invasive, naked DNA approach to deal with treating heart problems. His process was recently tested o Ernie Lively, an actor suffering from heart damage, who made a full recovered afterwards without ever having to go under the knife.

gene_therapyIn short, Patel’s method relies on a catheter, which he used to access the main cardiac vein (or coronary sinus), where a balloon is inflated to halt the flow of blood and isolate the area. A high dose of naked DNA, which codes for a protein called SDF-1, is then delivered. SDF-1, which stands for stromal cell-derived factor, is a potent attractant both for stem cells circulating in the bloodstream, and for those developing in the bone marrow.

Stromal cells, which manufacture SDF-1, are the creative force which knit together our fibrous connective tissues. The problem is they do not make enough of this SDF-1 under normal conditions, nor do specifically deliver it in just the right places for repair of a mature heart. By introducing a dose of these cells directly into the heart, Patel was able to give Lively what his heart needed, where it needed it.

gene_therapy1Compared to other gene therapies, the introduction of SDF-1 into cells was done without the assistance of a virus. These “viral vector” method have had trouble in the past due to the fact that after the virus helps target specific cells for treatment, the remnant viral components can draw unwanted attention from the immune system, leading to complications.

But of course, there is still much to be learned about the SDF-1 treatment and others like it before it can be considered a viable replacement for things like open-heart surgery. For one, the yield – the number or percentage of cells that take up the DNA – remains unknown. Neither are the precise mechanisms of uptake and integration within the cell known here.

Fortunately, a great deal of research is being done, particularly by neuroscientists who are looking to control brain cells through the use of raw DNA as well. Given time, additional research, and several clinical trials, a refined version of this process could be the cure for heart-related diseases, Alzheimer’s, and other disorders that are currently thought to be incurable, or require surgery.

pharmacoperones-protein-foldingAnother breakthrough treatment that is expected to revolutionize medicine comes in the form of pharmacoperones (aka. “protein chaperones”). a new field of drugs that have the ability to enter cells and fix misfolded proteins. These kind of mutations usually result in proteins becoming inactive; but in some cases, can lead to toxic functionality or even diseases.

Basically, proteins adopt their functional 3-D structure by folding linear chains of amino acids, and gene mutation can cause this folding process to go awry, resulting in “misfolding”. Up until recently, scientists believed these proteins were simply non-functional. But thanks to ongoing research, it is now known their inactivity is due to the cell’s quality control system misrouting them within the cell.

protein1Although this process has been observed under a microscope in recent years, a team led by Doctor P. Michael Conn while at Oregon Health & Science University (OHSU) was the first to demonstrate it in a living laboratory animal. The team was able to cure mice of a disease that makes the males unable to father offspring, and believe the technique will also work on human beings.

The team says neurodegenerative diseases, such as Alzheimer’s, Parkinson’s and Huntington’s, as well as certain types of diabetes, inherited cataracts and cystic fibrosis are just a few of the diseases that could potentially be cured using the new approach. Now working at the Texas Tech University Health Sciences Center (TTUHSC), Conn and his team are looking to conduct human trials.

DNA-molecule2One of the hallmarks of the coming age of science, technology and medicine is the idea that people will be living in post-mortality age, where all diseases and conditions are curable and life can be extended almost indefinitely. Might still sound like science fiction, but all of this research is indicative of the burgeoning trend where things that were once thought to be “treatable but not curable” is a thing of the past.

It’s an exciting time to be living in, almost as exciting as the world our children will be inhabiting – assuming things go according to plan. And in the meantime, check out this video of the SDF-1 gene therapy in action, courtesy of the University of Utah School of Medicine:


Sources: extremetech.com, gizmag.com

The Future of Medicine: Engineered Viruses, Nanoparticles and Bio-Absorbable Circuits

medtechThe future that is fast approaching us is one filled with possibilities, many of which were once thought to be the province of science fiction. Between tricorders and other new devices that can detect cancer sooner and at a fraction of the cost, HIV vaccines and cures, health monitoring tattoos and bionic limbs, we could be moving into an age where all known diseases are curable and physical handicaps will be non-existent.

And in the past few months, more stories have emerged with provide hope for millions of people living with diseases, injuries and disabilities. The first came just over three weeks ago from University of California, Berkley, where researchers have been working with an engineered virus which they claim could help cure blindness. As part of a gene therapy program, this treatment has been shown to effectively correct a rare form of inherited blindness.

virus-sight1For the past six years, medical science has been using adeno-associated viruses (AAV) as part of a gene therapy treatment to correct inherited retinal degenerative disease. However, the process has always been seen as invasive, since it involves injected the AAVs directly into a person’s retina with a needle. What’s more, the rpocess has shown itself to be limited, in that the injected virus does not reach all the retinal cells that need repair.

But as Professor David Schaffer, the lead researcher on the project, stated in an interview with Science Translational Medicine:

[D]octors have no choice because none of the gene delivery viruses can travel all the way through the back of the eye to reach the photoreceptors – the light sensitive cells that need the therapeutic gene.

Building on this and many more years of research, Prof David Schaffer and his colleagues developed a new process where they generated around 100 million variants of AAV and then selected five that were effective in penetrating the retina. They then used the best of these, a strain known as 7m8, to transport genes to cure two types of hereditary blindness on a group of mice.

virus-sightIn each case, the engineered virus delivered the corrective gene to all areas of the retina and restored retinal cells nearly to normal. But more importantly, the virus’ ability to penetrate the retina on its own makes the process far less invasive, and will likely be far more cost-effective when adapted to humans. And the process is apparently very convenient:

[W]e have now created a virus that you just inject into the liquid vitreous humor inside the eye and it delivers genes to a very difficult-to-reach population of delicate cells in a way that is surgically non-invasive and safe. It’s a 15-minute procedure, and you can likely go home that day.

Naturally, clinical trials are still needed, but the results are encouraging and Professor Schaffer indicated that his team are busy at work, now collaborating with physicians to identify the patients most likely to benefit from this gene-delivery technique.

nanoparticles_miceNext up, there was the announcement back at the end of May that researchers from North Carolina State and University of North Carolina Chapel Hill had found yet another medical use for nanoparticles. In there case, this consisted of combating a major health concern, especially amongst young people today: diabetes.

In a study that was published in the Journal of Agricultural and Food Chemistry, the collaborating teams indicated that their solution of nanoparticles was able to monitor blood sugar levels in a group of mice and released insulin when their sugar levels got too high. Based on the results, the researchers claim that their method will also work for human beings with type 1 diabetes.

image descriptionEach of the nanoparticles have a core of insulin that is contained with a degradable shell. When glucose levels in the blood reach high concentrations spike, the shell dissolves, releasing insulin and lowering the subject’s blood sugar. The degradable nano-network was shown to work in mice where a single injection kept blood glucose levels normal for a minimum of 10 days.

While the exact cause of this kind of diabetes is unknown, the effects certainly are. Patients living with this genetically-acquired form of the disease require several shots of insulin a day to keep their blood sugar levels under control. And even then, blindness, depression and even death can still result. What’s more, if the insulin shots are specifically calculated for the individual in question, side-effects can occur.

???????????????????????????????Hence the genius behind this new method. Not only would it relieve people who have type 1 diabetes from constantly injecting themselves, it would also remove the need to monitor their own blood sugar levels since the nanoparticles would be controlling them automatically.

In a study published recently in the Journal of Agricultural and Food Chemistry, Zhen Gu, lead author of the study claimed that the technology functions essentially the same as a pancreas. Hence another benefit of the new method, in that it could make pancreatic transplants – which are often necessary for patients with diabetes – unnecessary.

biocircuitsAnd last, but certainly not least, comes from the University of Illinois where John Rogers are developing a series of bio-absorbable electronic circuits that could help us win the war on drug-resistant bacteria. As part of a growing trend of biodegradable, flexible electronic circuits that operate wirelessly, fighting “superbugs” is just one application for this technology, but a very valuable one.

For some time now, bacteria that is resistant to antibiotics has been spreading, threatening to put the clock back 100 years to the time when routine, minor surgery was life-threatening. Some medical experts are warning that otherwise straightforward operations could soon become deadly unless new ways to fend off these infections are found. And though bacteria can evolve ways of evading chemical assaults, they are still vulnerable to direct assault.

electronics_dissolvingThis is how the new bio-absorbable circuits work: by heating up the virus. Each circuit is essentially a miniature electric heater that can be implanted into wounds and powered wirelessly to fry bacteria during healing before dissolving harmlessly into body fluids once their job is done. While this might sound dangerous, keep in mind that it takes only a relatively mild warming to kill bugs without causing discomfort or harm to surrounding tissues.

To fashion the circuits, Rogers and his colleagues used layers of utra-thin wafers and silk, material so thin that they disintegrate in water or body fluids or (in the case of silk) are known to dissolve anyway. For the metal parts, they used extra-thin films of magnesium, which is not only harmless but in fact an essential nutrient. For semiconductors, they used silicon membranes 300 nanometres thick, which also dissolve in water.

In addition to deterring bacteria, Rogers says that implantable, bio-absorbable RF electronics could be used to stimulate nerves for pain relief, and to stimulate bone re-growth, a process long proven to work when electrodes are placed on the skin or directly on the bone. Conceivably they could also be used to precisely control drug release from implanted reservoirs.

In other words, this is just the beginning. When it comes to the future of medicine, just about any barrier that was once considered impassable are suddenly looking quite porous…

Sources: sci-news.com, stm.sciencemag.org, singularityhub.com, bbc.com/future

Envisioning The Future of Health Technology

My thanks, yet again, to Futurist Foresight for providing the link to this fascinating infographic, which is the work of the good people at Envisioning Technology. People may remember this website from their work on “Envisioning Emerging Technology”, an infographic from a previous article which addressed the likelihood of interrelated technological developments in the coming decades. As a trend forecasting studio, compiling information and predictions into reports and tables in pretty much what these guys do. What a cool job!

In any case, here we have a table representing the future of health technology, as predicted by ET. Diving their findings into the fields of Augmentation, Biogerontology, Diagnostics, Telemedicine, Treatments, and Regeneration respectively, they attempt to show how small advancement in the near future will branch outwards to more radical ones in the not-too-distant future. The rough dates correspond to their previous graphic, starting with modern day research and culminating in 2040.

And of course, the infographic also shows how developments in all these fields over time will be interrelated, corresponding to different sub fields and becoming part of the ever-expanding field of advanced medicine. These sub fields include:

  • 3D Printing
  • Big Data
  • Cryonics
  • Life Extension
  • mHealth (health services supported by mobile devices)
  • Remote Virtual Presence
  • Neuroprosthetics
  • Sensors
  • Sensory Augmentation
  • Synthetic and Artificial Organs

Some inventions that are predicted include the Tricorder, 3D printed organs, artificial limbs, artificial eyes, cryogenic freezing, gene therapy, AI therapists, robotic nurses, robot surgery, implanted sensors, and exoskeletons. Wow, tricorders, really? In truth, I am often alarmed at what will be possible in the near future, but knowing that advancements are around the corner that could make life a lot healthier and happier for so many people gives me hope. Until next time!