Medtech in plain language
Meet the people behind the technology. There is no glamour or showcase. This is simply the stories of real people living with neurological conditions who have found the use of neurotechnology to impact their lives.
These posts bring the technology to life and feature how this evolving technology can change the lives of average people.
Read our summaries of neurotech devices, therapies and treatments for specific conditions on Medium.
The word “embodiment” can conjure up an array of thoughts and images. For a patent, embodiment describes the use, production, expression, or practice of an invention. In the world of art, embodiment drives the meaning of the perception of emotion. Both are true in their own context. What do you imagine when you think of brain interface embodiment?
This takes me back two decades to my first Neural Interfaces meeting on the campus of the National Institutes of Health in Bethesda, Maryland. As part of a panel of neurotechnology users, I and other panelists were taking questions from an audience of scientific investigators. Dr. Joe Schulman of the Alfred E. Mann Foundation posed a question like this:
“If we cut open your skull, implanted an array into your motor cortex, wirelessly connected it to a prosthetic, and then you can move by thought, would you get it?”
My gut reaction took over and I blurted out this response:
Is it just hype or are brain interfaces here to stay? Are we at an inflection point? There has been an explosion of non-invasive modalities for the brain while at the same time a thrust to commercialize brain implant technology. At this point, it seems donning a ball-cap or helmet to read signals from the brain seems more accepting than a surgical implant. On another note, a brain implant to treat a chronic medical condition seems more acceptable while the idea of a brain implant to augment human performance leads to discussions toward fears of the unknown or potential unethical practices. Overall, are brian interfaces the right thing to do? Setting aside the technical and scientific jargon, our focus is to probe this area of neurotechnology. In this series, we will explore the origins of brain interfaces, embodiment options, the bionic pioneers of our time, and where we are headed in the future. If there is a specific area that you would like to see covered, post a comment and we will add it.
Human and machine interfaces have been evolving for several decades. The heart pacemaker has advanced tremendously since its first-in-human implant in 1958. Today, they seem to be commonplace with new bells and whistles like wireless communications, rechargeable batteries, and remote monitoring. Still, the heart pacemaker seems to be in a different class since it is an intervention for a muscular organ rather than the complex neural network of the brain.
Meet Richdeep, Sandra and Jon who participated in a panel discussion about their experiences as clinical trial participants using spinal cord stimulation for the treatment of spinal cord injuries. The discussion is moderated by Barry Munro with the Canadian Spinal Research Organization and John Chernesky with the Praxis Institute. Topics explored include participant expectations, benefits of involvement, and challenges to participate.
Learn more about neurotechnologies for spinal cord injury with our neurotech directory.
Stress from work and strained relationships took a toll on Danielle as her migraine headaches became more severe and more frequent. This physically active young woman who loves to cook, bake, and work out found herself struggling as her migraines started to disrupt every aspect of her life.
Migraine headaches tend to be a hereditary condition, but for Danielle, there are no known family members with the condition. Not an official causal diagnosis, Danielle started having migraine headaches after she was in a car accident at the age of 19. As she turned into her 20s, the condition became worse. Despite taking prescription and over-the-counter medications, she still endured days, even weeks with debilitating pain. By the time she was in her 30s, her migraine headaches were at a peak where she was having rebound headaches and became resistant to medications. She went to countless neurologists but consistently walked away feeling like they weren’t listening to her. “I couldn’t find a physician who would take the time to see my circumstances,” she says. “to really get to the bottom of it.”
Prior to the pandemic, she was working in a fast-paced healthcare environment as an occupational therapist and was pushing herself to succeed. That internal drive to succeed left her with severe migraine headaches landing her in the hospital. The standard treatment of prescription medications did not work for her and the side effects were not healthy. She tried other alternatives like physical therapy, injections or creams but none had a significant change to her migraines. Pushed to the point where she was no longer able to work, Danielle found herself bed bound from severe headaches and living on disability.
Once the COVID-19 pandemic took over the world headlines, her condition was uncontrollable and she decided to quit all the medications cold turkey. She was taking so many medications and the side effects were unbearable. That process was not easy. “It was the worst.” She remembers, “I never felt so much pain before.” It was a friend who recommended a doctor based in Cleveland, OH. She made an appointment and traveled there. During their visit, the doctor recognized that Danielle was desperately trying to find a solution. He was the first to recommend a new, non-invasive, drug-free remote electrical stimulation (REN) device. The REN device is worn on the arm. It delivers electrical stimulation to the C and Aδ fibers in the peripheral nerves activating a brainstem-mediated pain control pathway to block the pain signal. This “conditioned pain modulation” method is believed to “switch off” the catalyst of migraine attacks in the brain.
Interested in finding other solutions that would quell her migraine episodes, Danielle ordered the device. She was a little hesitant at first but after trying so many other failed therapies she was excited to try a potential solution. Upon her first attempt, she had mediocre results. During the second treatment session, she drastically increased the intensity with lackluster results. Turning to a Facebook group, there was one person who responded to her question about the REN therapy who had poor results as well.
A customer service agent from the company explained to Danielle that the highest intensity is not always the most effective setting. They recommended Danielle to turn down the intensity and then try the device again. At that point, she started feeling the benefits, so much so that Danielle was using the device multiple times per day. After using the REN therapy for one year, she uses the device only when she has a migraine attack. Today, Danielle now works part-time at a special needs school and she is taking classes to earn her Bachelor’s degree in Education.
Chronic pain conditions are seldom a one treatment fix. Many pain experts recommend a combination of methods and modalities to help people take control of their chronic pain. For Danielle, she now uses a combination of biofeedback, acetaminophen, and the REN therapy to control her migraine headache condition. She also found that using the REN therapy while in a dark, quiet room yields the best results for her. The advice she offers to others living with migraine headaches is to search every avenue for the right treatments. Pain management is an individualized endeavor. “Don’t get discouraged. There are always options.”
Watch this exclusive video interview.
Learn more about neurotechnologies for pain management with our neurotech directory.
This story is a combination of immediate impact and slow progression of Parkinson’s Disease, a degenerative brain disorder, and how one man changed his cards to gain a better quality of life.
As a cardiac anesthesiologist, Jon was living his dream. He had a great job, a wonderful wife and two beautiful daughters. Although there was stress related to his job and long hours, he truly enjoyed his work. A strange symptom surfaced that sparked Jon to seek medical assistance. He was pouring a Coke into a glass and observed his pinky finger quivering. That was it, a tremor. That tremor motivated Jon to seek the advice of a neurologist. Without any hesitation, the neurologist diagnosed Jon with Parkinson’s Disease. He was 38 years old. After receiving the news, there was a sense of relief. He was relieved to have a name associated with the strange symptoms he was experiencing. Now that he had a diagnosis, he educated himself about the disease and ways to manage the symptoms.
The initial symptoms of Parkinson’s Disease can be very subtle and often do not surface until the symptoms reach an escalated level. People can have Parkinson’s Disease all their lives but they do not receive a diagnosis until a larger amount of neurons in the brain begin to be impacted. At that point, the outward symptoms begin the surface.
Accepting his diagnosis, Jon began to educate himself about the disease and inventory his options. Being an anesthesiologist helped with his quest. One of his options for the treatment of Parkinson’s Disease is a medical device called Deep Brain Stimulation (DBS). Several times in the past, Jon had been the anesthesiologist during surgeries to implant deep brain stimulators. Even with this knowledge, Jon took the medical advice and began the typical pharmaceutical regime of taking a myriad of medications.
As Jon began to do his research about DBS, he watched video after video on the internet about success stories of people who received a DBS system. Not all of the videos were about success stories. Jon watched one video about a man for whom the DBS was not successful and he had the device removed. In his research, Jon educated himself about the system, how it works, the surgical procedure, the complication rates and spoke with other doctors regarding the DBS technology. He approached his neurologist with an inquiry as to whether he would be a candidate for the technology. Once Jon asked, his neurologist agreed that he would be good candidate.
As he became more resistant to the medications, his symptoms began to impact every aspect of his life. He was no longer able to work much less perform basic activities of daily living. For Jon, DBS was an option he couldn’t deny. “Once I get my wires, I’ll be able to function.”
The day that the system was activated was a vivid day for him. His appointment was for one o’clock in the afternoon. That morning, he could not take any of his medications and his body reacted to the lack of medications. His symptoms were severe as Jon’s body became stiffer and stiffer. To one point, he could hardly move. He went to the hospital early with the escort of his parents. His doctor came into the waiting room and said, ‘Come with me.’ It was time to activate the system; one side of the electrode at a time. His doctor activated one side and immediately the stiffness in Jon’s muscles melted away. The DBS system gave him new freedom of movement that was strangled by Parkinson’s Disease.
This short story is an adaptation of Jon’s full story featured in the book Bionic Pioneers.
There are many symptoms associated with Parkinson’s disease. There’s an array of options includes those of neurotechnologies like DBS, robotic therapy, peripheral nerve stimulation, and more. Learn about neurotechnologies for Parkinson’s disease with our neurotech directory
Kierstin was diagnosed with primary progressive multiple sclerosis a few years ago. Her physicians discovered lesions in her spine that indicated the disease. This is not the typical way to find MS. The most common way is the discovery of lesions in the brain. Getting to a diagnosis did not come easy for her, which is more common than you might think. Typically, a clear diagnosis is not found until the person has outward symptoms of the disease.
Multiple sclerosis is a complex neural degenerative condition. According to a study published in the journal Neurology, multiple sclerosis (MS) is the most common progressive neurologic disease of young adults worldwide. There are nearly 1 million people living with MS in the United States and an estimated 2.5 million worldwide. The condition is more prevalent in women and the average age of diagnosis is 32.
Multiple sclerosis is a progressive immune disease attacking the central nervous system, including the brain, spinal cord, and optic nerve. The disease impacts the myelin sheath that protects nerve fibers. Once any part is damaged, then nerve impulses are disrupted when traveling to and from the brain or along the spinal cord. This results in a variety of symptoms of the disease.
For Kierstin, she was a black belt with 4 children and married. She has a very active family. Gradually, she was not able to do even a classic karate move. Her doctors first told her that it was aging. When she started having other symptoms like back pain, drop foot, and problems urinating, she knew there was something wrong.
She found an Artificial Intelligence (AI) online tracking tool that will take brain MRI scans and cover them to easy to understand, visual images and allows for tracking of MRI images over time. Kierstin found this new online tool by clicking on a Facebook ad, which she admits she never does, but she is happy that she did.
This is not a tool to self-diagnosis. She says it gives her the tools she needs to have a better and more productive conversation with her doctors. “It let’s me say things to my doctor that I normally wouldn’t,” she admits and uses the tracking of her brain scans as evidence for what she is experiencing. As a mother of four, she is very leary of giving her personal information out. When signing up for this service, she was apprehensive and decided to call the company. To her surprise, when she contacted them, it was an actual human who answered her call.
She values this technology and asks for more. It is a way for her to track the progression of her multiple sclerosis with knowledge so she can be active in her future decisions.
Learn more about technologies for multiple sclerosis by visiting our directory.
There are so many options for treating chronic pain but finding the right solution and getting the right diagnosis is like trying to find a needle in a haystack. Jill is no exception. Living in rural Wisconsin, she lives a very active lifestyle with her husband and three children, enjoying the outdoors and being small business owners. But when her pain started to interfere with her lifestyle, something had to change.
Jill remembers always having aches and pains, even when she was young and raising her children. The chronic pain in her lower back transformed into becoming systemic and she could no longer have a direct cause for the pain such as lifting a child the wrong way or twisting too much while gardening. The pain was constant and she wanted to know why and how to fix it. While in her 30’s she was diagnosed with fibromyalgia, but she as not satisfied with that labeling of her pain.
Not having a clear treatment guideline, she began to try various options. First was pharmaceutical. She tried a few but did not like the way she felt and truly opposed taking medications over a long period of time. She then began to see a chiropractor, but that did not help either. She then tried an osteopathy and then physical therapy but neither was effective. Jill’s back pain persisted. She then opted for some cortisone injections into her back. It helped temporarily, but the nagging pain in her lower back would come back before she could schedule another injection. Not finding a solution in the medical field, Jill started to look elsewhere. She tried gadgets sold on-line and over broadcast television. She felt like she was “chasing rainbows” and spending a lot of money trying to find a treatment.
Jill was on the internet searching, hunting for a solution. She found the manufacturer of a percutaneous electrical nerve stimulation (PENS) device. While speaking to the company representative, she was cautious at first, even a little skeptical. She was familiar with transcutaneous electrical nerve stimulation (TENS) but not PENS. TENS units use pulsed low frequency electrical current delivered from a small unit through two electrodes placed on the surface of the skin. The electrodes are small pads with a sticky gel to help conduct the electrical activity from the unit through the surface of the skin. A PENS device sends alternating high frequency current signals from the unit through deep tissue electrodes also placed on the surface of the skin. The PENS electrodes are different from TENS electrodes because they have microscopic needle-like probes that penetrate the surface of the skin to deliver the current deep into the tissue. The deep tissue treatments tend to have a long lasting effect. Clinical trials have also demonstrated not only a reduction in pain, but improved range of motion and reduced muscle spasms.
Jill got a prescription for the device from her doctor and ordered the device for home delivery. Upon arrival, Jill set up the small, pre-programmed, portable device and placed the electrodes on her lower back. Trying the device for the first time, she could feel the electrical pulses on her skin but it was not uncomfortable like an electric shock. Instead, it felt more soothing like a massage. More importantly, the pain relief was almost immediate. There was no waiting for a medication or taking time to drive to an appointment. This small, handheld device was giving Jill relief from the pain that has been haunting her for years.
Over time, she has found her body to be flexible again and her movements more fluid. After playing volleyball with her son, her shoulder was bothering her the next day. She placed the electrodes on her shoulder area and with one treatment the shoulder pain extinguished. With consistent use, Jill has found the intensity of her daily lower back pain has decreased and confidence in her motions is back. “I just don’t hurt any more,” she declared.
Not all chronic pain is the same and that warrants the many options that people have for treating it. The key is to try the variety of options to find the right solution. Learn more about neurotechnologies for pain management with our neurotech directory.
It was an air trauma nurse who found Mike. She was driving to work late at night when she saw taillights coming from an irrigation canal off the side of a rural road in northern California. After working a long day as a general contractor, Mike was driving home in his work van when he had a seizure and drove off the road into the canal. Once in the ER, the doctor told Mike that he had a seizure, he was no longer able to drive, and they treated him for a possible heart condition.
From that point forward, Mike’s seizures became more frequent, having at least one every week. Those that he noticed were strong seizures resulting in physical injuries like dislocated joints or broken bones. He was prescribed a slew of medications but nothing seemed to work. The seizures kept coming. One of his general contracting clients suggested that he go to the Mayo Clinic in Rochester, MN. On the flight from Redding, CA to Rochester, MN he had a seizure and woke up in a Denver hospital. He then tried an Amtrak train and bus to get to Rochester but had a seizure while in transit too. Finally, he found a friend who would drive him to Rochester. There, he was diagnosed with epilepsy and began treatments at the Mayo Clinic.
Mike found himself jobless, broke, and divorced two years after diagnosis at the Mayo Clinic. His life now revolved around epilepsy. He moved to Phoenix to continue receiving care through the Mayo Clinic’s satellite location. Despite the treatments, Mike was still having grand mal seizures with loss of consciousness and violent muscle contractions. The seizure frequency was now every 3-6 days. He began to withdrawal from society. Mike was attempting a variety of treatments from vagus nerve stimulation to brain resection. Still, it was a roller coaster of promising treatments that only led to disappointment from poor results. “For years, the doctors did not believe me when I showed them my seizure diaries,” Mike says. “It was like I was doing something wrong to spark the seizures.” Living on disability assistance, Mike had to do something to change his life path, so he enrolled in a community college.
One of his doctors suggested that he participate in a clinical study of the NeuroPace RNS System for refractory focal epilepsy. The RNS neurostimulator is a device similar to a heart pacemaker but for the brain. Mike’s RNS System monitors his brain activity 24 hours a day, and recognizes & responds to his unique brain patterns to stop his seizures before they start. It also records Mike’s brain activity, which provided insights that enabled his doctors to optimize his epilepsy care. After the procedure and his recovery, Mike was back attending college classes.
As part of the RNS System clinical study, he was required to keep a seizure diary. Reviewing his diary entries with the research team, they would compare his documented seizures to the sensing activity from the RNS System. The data would match. “For years, I tried to explain all the seizures I was having. Now with this device, the data validated it,” he said. For Mike, that was his eureka moment when he felt the data gave him a voice. As they studied the seizure diaries with the sensing and stimulating data, they found triggers that would spark seizures like heat stress or a high carbohydrate intake. These were behavioral items that Mike could control, and did, by adapting life activities. He went from experiencing seizures every 3-6 days to having them every 2-3 months. Mike felt more in control, that he could get his life back. He started feeling “normal” again.
Still using the RNS System, Mike earned his Bachelor’s and Master’s degrees in social work. He graduated from both ASU & the Mayo Clinic School of Health Sciences. While working on his degrees, Mike started giving back by working as a Mayo Clinic Social Worker and visiting other people with epilepsy at the Mayo Clinic-Phoenix hospital. Eventually, the pages of Mike’s seizure diary were blank and he realized he had become seizure-free. He later moved to Portland, Oregon, found a job, and returned to being social. Putting his passion to work, Mike is now a Patient Educator for NeuroPace working with others living with epilepsy.
Learn more about the RNS device and Neuropace here: https://www.neuropace.com/the-rns-system/
Pioneers are not made; they are missioned. Conventional thinking points to scientists, engineers, and entrepreneurs as the sources of innovation. They definitely have a hand in the process, but we often forget the influence that the end-user, or consumer, has on the technology innovation process. Jim was one of those pioneers that shaped generations to come in neural prosthetics. Jim was an average guy, born and raised in Northeastern Ohio. He graduated from the University of Akron with a mechanical engineering degree and went to work for Firestone in Ohio. He had a loving family and married the love of his life. He had his beloved hobbies like playing pool, scuba diving and working on his green Chevy Camaro. The oldest of six, Jim spent much of his free time with his family and his younger siblings.
One summer afternoon, Jim dove into the lake to cool off on a hot summer day after helping to paint his sister’s house. He hit a shallow spot, compressing his head into his spine and paralyzed him immediately. Jim couldn’t move and couldn’t feel a thing. Being the first on the scene, his sister, Judy, pulled her brother to the surface in a panic to save him. “I can’t feel a thing,” Jim said. From that point on, Jim entered the world as a high quadriplegic, unable to move his four limbs, care for himself, or create the mechanical drawings that he loved to do. Life would be forever different. Jim later became one of the fire people to try an experimental implanted neural prosthesis to restore function in his arms and arms….this was back in the 1980s.
Remember: We are standing on the shoulders of pioneers like Jim.
Learn more about neurotech applications for spinal cord injury.
Read more of Jim’s story in the book, Bionic Pioneers. Proceeds go toward Neurotech Network.