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Motor Control Team

Motor Control Team. Michael Keith MD representative. Disclaimer:.

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Motor Control Team

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  1. Motor Control Team Michael Keith MD representative

  2. Disclaimer: • All participants seemed to have an expressed conflict of interest representing their own area of expertise- all were confident and enthusiastic regarding the ability and importance of their contribution to the mission. We moved ahead in spite of this…

  3. Motor Control Program Development • Objectives: • Bring Neuroprosthetic Principles, Technologies and Experience to the Military Solutions for limb salvage and Neurotrauma. • Transfer technologies for current neuroprostheses and anticipate and accelerate deployment of cutting edge devices and surgical procedures. • Prove efficacy and safety, and establish benchmarks for prosthetic performance. • Develop strategies for next generation wireless and implantable networks, communication methods and information systems. • Provide basis for target population Needs Assessment, Expectations and Outcomes Measurements for these technologies.

  4. High Priorities for development • Control Signals for Motor Control • Require Fidelity of Sensor Output Properties. • Stability for Lifetime, consistency of recording • Perform chronic animal models, electrode and cell survival demonstration. • Assure capacity for multiple independent sources. • Assure Biocompatibility of electrode designs.

  5. Implantable Technology • RF, wireless, telemetry systems required • bidirectional communications from multiple simultaneous control sources • All progressive systems are invasive, implanted, biocompatible, have neural tissue interfaces.

  6. Sensory Feedback • a critical component of future prostheses. • Afferent Signal model, • sensory-motor integration at machine level • Electrode: neural interfaces- • need assurance there is not damage by insertion chronic implantation leads.

  7. Electronic Progress • Develop Adaptive Electronics • Promote Low Power Electronics

  8. Cortical Re-organization • Understand Cortical Re-organization and Plasticity. • where to implant control electrodes uncertain given cellular and functional MRI adjustment to injury. • Question assumption that pre-injury geometry persists. Are there alternative control sites that could be mapped? • Rehabilitation, training • early intervention for plasticity/ training needed.

  9. Alternative Priorities • Pain Relief • Skin, Pressure sores, Wound Healing • Vascular insufficiency • Limb Volume • Tissue Engineering • Preserve Limb integrity

  10. Pain Management • A High priority from the user and medical perspective and to be investigated in the course of neural interface deployment. • Not an assured NP outcome due to multi-factorial causation. • More likely with amputee intervention. • Needs integration with drug and cognitive therapies.

  11. Low then High Priority • Ethics: discussion of risk • Needed Peer Support, technology adopters, leaders • Long term Cost/benefit studies to support • Eventual Regulatory/FDA compliance • Standards will emerge with success • Ergonomics a major consideration when deployed.

  12. Surgical Techniques • Definitions of Invasiveness from the user community needs clarification. • all technological progress has come with initially invasive implants. • Surgical development of minimally invasive technique.-Low then high priority

  13. Neurotrauma- SCI, TBI • Disorders of CNS with hyper-reflexive muscle currently have well modeled treatment with Neuroprostheses. (FES) • Converging on • simplification, • proximal intervention, • wireless sensors and stimulation, • higher density, interface stability.

  14. Neurotrauma • Next development requires incremental progress in early intervention with rescue models for denervated muscle- • artificial ganglion with cellular plus neural interface. • Neurotization • Alternate muscle stimulation protocols. • Processing electronics on interface.

  15. Conclusions • Confidence is high that Neuroprosthesis Technology will contribute to limb salvage or replacement, and neurotrauma recovery in injured soldiers. • We see motor control recovery with progress in neural interfaces, electronic implants for control signal sources and sensory signal stimulation.

  16. Conclusions We are honored to be of service to our volunteer military colleagues serving and protecting our national research interest. -author’s message

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