Platform “BCI” Research Tools and Deployment Strategies to Accelerate Translational Discovery
Timothy Denison, PhD
Vice President, Research & Core Technology
Restorative Therapies Group
Neurological disease has a significant impact at the personal, economic, and societal levels. Brain disease alone affects well over 100M people globally and is a major contributor to the cost of healthcare; diseases such as Stroke, Brain Tumor, Parkinson’s disease, Epilepsy, Brain Injury, Alzheimer’s, and Depression rank among the leading causes of death and disability in the world. While promising in-roads for treatment have been made for some conditions, engineers can help play a key role in developing new therapy concepts and bringing them to the clinical market to address critical unmet needs.
Reflecting on the evolution of medical technology, there are many parallels between the current state of most neuromodulation therapies and early cardiac pacing devices. The first generation of cardiac pacemakers operated as “metronomes,” asynchronously delivering fixed-rate stimulation regardless of the intrinsic heart function. In a similar way, the first generation of neuromodulation systems used adapted circuits from cardiac pacers to provide tonic, fixed-rate stimulation to discrete neural circuits, leveraging electrode locations that were derived from established stereotactic neurosurgical targets for radiofrequency lesioning. Technological developments in cardiac systems have since evolved to include onboard diagnostics, programmability, and responsive pacing, which are all supported by a foundational understanding of the heart and its bioelectrical properties. As neuroengineers look to advance the treatment of neurological disease using similar technology concepts, the field needs to establish a similar physiological basis for how the nervous system operates, goes awry with disease, and how interventions might restore function.
For the many neurological diseases, the mechanism of action for therapy is still not yet completely clear, which confounds the optimization of the medical technology. To help bridge translation of devices across these unknowns, teams are creating investigational research tools that can be chronically implanted as part of existing care pathways. These new tools, including bi-directional brain-computer-interface technology, permit the active probing of diseased neural circuits by observing how they respond to both electrical and concomitant pharmaceutical interventions. The platforms are enabled by a system architecture that harnesses an existing neurostimulator’s capability to provide instrumentation with chronic access to the nervous system, while seamlessly maintaining the predicate therapy capability. Deployed with clinician-researcher collaborators, these instrumentation toolkits can bootstrap off existing clinical care pathways to facilitate exploration of novel therapeutic concepts and generate a pipeline of innovations.
This talk will provide a technical perspective on the state-of-the-art, promising areas for exploration, and challenges that remain.
Bio: Tim Denison is a Technical Fellow at Medtronic PLC and Vice President of Research & Core Technology for the Restorative Therapies Group, where he helps oversee the design of next generation neural interface and algorithm technologies for the treatment of chronic neurological disease. In 2012, he was awarded membership to the Bakken Society, Medtronic’s highest technical and scientific honor, and in 2014 he was awarded the Wallin leadership award. In 2015, he was elected to the College of Fellows for the American Institute of Medical and Biological Engineering (AIMBE). Tim received an A.B. in Physics from The University of Chicago, and an M.S. and Ph.D. in Electrical Engineering from MIT. He recently completed his MBA at Booth, The University of Chicago.