Cortical Brain Implants Are Paving the Way for Visual Restorative Medicine

This podcast is about big ideas on how technology is making life better for people with vision loss.

Today’s big idea highlights how innovations don’t happen in a vacuum, but rather a long chain of science and research and developments that build on each other. Dr. Shelley Fried’s work exemplifies this process. It took him a career’s worth of experiments and adjustments to enable his cortical brain implants to bypass the eye and restore the patient’s ability to perceive light. He had a lot of obstacles to overcome, everything from circumventing the brain’s natural inflammatory response to getting the research published. One thing is clear, breakthroughs take time and you cannot give up in the process. Your work often becomes an iteration of an iteration. Dr. Fried took inspiration from the artificial retina, which was prototyped from a cochlear implant. Dr. Fried’s revolutionary technology is another step towards a world in which no person is limited by their visual capacity.

 

The Big Takeaways:

• A cochlear implant is a neuroprosthetic device surgically implanted in the cochlea, the inner part of the ear that is responsible for the transmission of nerve impulses in to the auditory cortex of the brain. Originally developed in 1950, the modern form was honed in the 1970s with help from NASA engineer.
• Dr. Mark Humanyan took design cues from the cochlear when he was developing the Argus II retinal implant.  What is a retinal prosthesis and how does it work? The simplest way to explain it is that it’s an array of electrodes that stimulates the retina and it helps restore vision loss. They work for some blindness cases but not all. For example, this treatment is not recommended for people with advanced glaucoma.
• Dr. Fried took inspiration from retinal prostheses to build upon the cortical brain implant. The implants are revolutionary because it means they go directly to the source (the brain).
• The cortical brain implant works by gathering information externally and it converts that data to stimulate the brain so the patient can perceive it. However, vision science doesn’t end there! Vision science keeps building on itself. In this case, the cortical implant technology was inspired by artificial retinas, which took their inspiration from the cochlear implant.
• How do you target a single neuron? Dr. Fried’s innovative solution was the use of coils, which are smaller than a human hair, to help specify which neurons need activation. When you go directly to the brain, there are some complications that occur. The brain sees the implant as a threat and creates an inflammatory response, which blocks the electrodes from communicating with one another. By using these coils, it bypasses the body’s natural inflammatory response and keeps the lines of communication open.
• This innovation in technology did not happen overnight. It took over a year and a half to get the coil experiments to work alone, and that doesn’t include all the other methods Dr. Fried experimented with that didn’t succeed. Science is about building upon prior research, and it takes time and a lot of experimentation before a solution will work.

 

Tweetables:

“Cochlear implants had taught us that if you even put some of a rudimentary signal in the ear, that the brain can start to use it….. So we want of reconfigured a cochlear implant and used it to stimulate the retina”.  — Dr. Mark Humayun

“In its simplest form, a retina prosthesis is an array of electrodes. The common one is 6x10 electrodes and each electrode is designed to stimulate a small portion of the retina.” — Dr. Shelley Fried

“We run into additional problems when we go into the brain that don’t exist in the retina. One of them is the brain has a huge inflammatory response to the implant.” — Dr. Shelley Fried

 

“Coils are not only more stable over time, but they’re more selective.  They’re able to create a smaller region of activation. And so we think we can get much higher acuity with coils than we can with conventional electrodes.” – Dr. Shelley Fried

“Our advance was that we showed that we could really shrink down coils to the sub millimeter size and that they would still be effective, that they can still induce neural activation. – Dr. Shelley Fried

“I was fortunate that I certainly was not one of the pioneers in terms of being one of the first people to be implanted. [B]eing able to rely on other people’s experiences and being able to trust the process was really helpful.” – Rebecca Alexander, cochlear implant recipient

 

Contact Us:

Contact us at [email protected] with your innovative new technology ideas for people with vision loss.

 

Pertinent Links:

Lighthouse Guild

Rebalexander.com

Dr. Shelley Fried

 

Guest Bios:

Dr. Shelley Fried

Shelley I. Fried, PhD, is an Associate Professor of Neurosurgery, Harvard Medical School and an Associate Professor for Massachusetts General Hospital, Department of Neurosurgery. He is the developer of cortical brain implants. Dr. Fried was inspired to do this work after reading a New York Times article on the in-depth work that went behind trying to restore vision to returning blind Vietnam vets.

 

Dr. Mark Humayun

Mark S. Humayun, MD, PhD, is Director, USC Ginsburg Institute for Biomedical Therapeutics and Co-Director, USC Roski Eye Institute. Dr. Humayun has devoted much of his career to clinical and scientific research in ophthalmology and bioengineering, becoming both a biomedical engineer and professor of ophthalmology. You can hear more about him and his work in Episode 4 — The Development of Artificial Vision.

 

Rebecca Alexander

Rebecca Alexander is an author, psychotherapist, group fitness instructor, advocate, and extreme athlete who is almost completely blind and deaf. Born and raised in the San Francisco Bay Area, she currently lives in New York City.

 

Host Bio:

Dr. Calvin W. Roberts

Calvin W. Roberts, MD, is President and Chief Executive Officer of Lighthouse Guild, the leading organization dedicated to providing exceptional services that inspire people who are visually impaired to attain their goals. Dr. Roberts has a unique blend of academic, clinical, business, and hands-on product development experience. Dr. Roberts is a Clinical Professor of Ophthalmology at Weill Cornell Medical College. He was formerly Senior Vice President and Chief Medical Officer, Eye Care, at Bausch Health Companies where he coordinated global development and research efforts across their vision care, pharmaceutical, and surgical business units. As a practicing ophthalmologist from 1982 to 2008, he performed more than 10,000 cataract surgeries as well as 5,000 refractive and other corneal surgeries. He is credited with developing surgical therapies, over-the-counter products for vision care, prescription ocular therapeutics, and innovative treatment regimens. He also holds patents on the wide-field specular microscope and has done extensive research on ophthalmic non-steroidals and postoperative cystoid macular edema. Dr. Roberts has co-founded a specialty pharmaceutical company and is a frequent industry lecturer and author. He currently serves as an Independent Director on multiple corporate boards and has served as a consultant to Allergan, Johnson & Johnson, and Novartis. A graduate of Princeton University and the College of Physicians and Surgeons of Columbia University, Dr. Roberts completed his internship and ophthalmology residency at New York-Presbyterian Hospital/Columbia University Medical Center in New York. He also completed cornea fellowships at Massachusetts Eye and Ear Infirmary and the Schepens Eye Research Institute in Boston.