Conversations on Bionics and Pain Dr. Max Ortiz Catalan

Episode on the article “Chronic Use of a Sensitized Bionic Hand Does Not Remap the Sense of Touch” (Ortiz-Catalan et al., Cell Reports, 2020). I discuss with Prof. Sliman Bensmaia at the University of Chicago, with whom we published this article, how the long-term used of a bionic hand that elicits tactile sensory feedback in a location distinct to that observed by the user, provided evidence to the inability of the brain to change enough as to generate an experience that solves the mismatch. In other words, we showed a hard constraint to brain plasticity in the somatosensory system.
Interview by Dr. Max Ortiz Catalan, Ph.D., Bionics Professor and Director of the Center for Bionics and Pain Research (Social media: FB, TW, IG, and LI).

Episode timestamps
(00:00) Coming up
(04:00) Introduction
(11:25) Introducing Prof. Sliman Bensmaia
(12:30) Betting on brain plasticity           
(13:48) How do we feel touch?
(14:54) Our experiment with neuromusculoskeletal prostheses
(17:53) Lack of selectivity of neural interface
(20:12) Why should percept location change?
(22:05) Evidence for perceptual updates
(28:19) Brain plasticity
(30:35) Somatosensory plasticity would have benefited designers of neural interfaces
(34:01) Single vs train of pulses
(39:58) Sex transfer procedures support the stability of somatosensory (phalloplasty)
(43:26) Stay open to possibilities, yet state your stand.
(46:36) Ideal restoration of sensory feedback

Prof. Todd Kuiken developed Targeted Muscle Reinnervation (TMR) – a surgical method to rewire the nervous system of people with amputations to better interface with prosthetic limbs. He is the Emeritus Director of the Regenstein Foundation Center for Bionic Medicine at the Sherly Ryan AbilityLab and an Emeritus Professor at Northwestern University. In addition to his contributions to the treatment of amputees, we talked about how great multidisciplinary medical and engineering teams can be created and the importance of having a clear direction. He also shared some insights on one of the hardest aspects of research - how to decide when to terminate projects and reject bad ideas, and we wrapped up with advices for students.

Interview by Dr. Max Ortiz Catalan, Ph.D., Bionics Professor and Director of the Center for Bionics and Pain Research (Social media: FB, TW, IG, and LI).

Episode timestamps
(00:00) Coming up…
(01:08) Introduction
(05:22) Career path
(07:02) Path leading to Targeted Muscle Reinnervation (TMR)
(09:16) The Center for Bionic Medicine (CBM) at RIC
(10:32) The Shirley Ryan Ability Lab
(11:56) Brining engineers and physicians together
(13:43) Working with different professions
(16:00) Targeted Muscle Innervation (TMR)
(19:00) Mathematical algorithms for decoding motor volition
(21:10) Route to TMR
(24:00) Dissemination of TMR
(24:39) TMR for Pain
(26:40) Regenerative Peripheral Nerve Interfaces (RPNIs)
(28:00) TMR to treat neuroma pain (Ann Surg)
(32:26) Neuroma Pain Vs Phantom Limb Pain
(34:37) TMR’s success rate
(36:00) Targeted Sensory Reinnervation (TSR)
(39:00) TMR as a standard of care
(40:35) Prof. Kuiken’s contribution to the field
(41:20) Further surgical modification for machine interfacing
(43:20) Osseointegration
(45:02) Myoelectric pattern recognition
(45:30) The relation between academy and industry
(48:40) Termination of "bad" ideas
(51:34) Using magnets to control wrist rotation
(43:40) Using magnets for dexterous control (Myokenetic)
(54:57) Neuromusculoskeletal prostheses
(56:20) Future of artificial limbs
(57:40) Wireless implantable electrodes
(59:23) Advice to students

Interview with the senior authors of the article “Design and clinical implementation of an open-source bionic leg” (Azocar et al., Nat Biomed Eng, 2020), Prof. Elliott Rouse, Ph.D., at the University of Michigan, and Prof. Levi Hargrove, Ph.D., at the Sherly Ryan AbilityLab and Northwestern University. We discuss their Open-Source Leg project in the context of the state-of-the-art in prosthetic legs, promising research directions, and how to identify “not so good” research or development ideas.
Interview by Max Ortiz Catalan, Ph.D., Assoc. Professor on Bionics and Director of the Center for Bionics and Pain Research (Social media: FB, TW, IG, and LI).

Episode timestamps
(00:00) Coming up
(01:23) Introduction
(02:51) Introducing A. Prof. Elliott Rouse
(04:32) Introducing A. Prof. Levi Hargrove
(06:10) Why the open-source leg (OSL)?
(10:30) The OSL: The Design and Development
(14:40) The OSL: The Purpose
(17:03) Translation to Industry
(20:40) Human testing
(24:05) Neural Integration
(27:48) Multiple degrees of freedom?
(30:13) The Limiter: Hardware or Control?
(36:55) Safety and Therapy as a Consideration
(38:04) Sensory feedback
(39:05) Setting research priorities: Are we satisfying patient’s needs?
(39:52) Interesting research topics and directions
(41:50) Critically appraising previous research
(45:00) Identifying bad ideas.
(51:55) OSL website and further information.

Interview with Dr. Gerald E. Loeb, Professor on Biomedical Engineering and Neurology at the University of Southern California in L.A., USA. He has written hundreds of scientific articles and holds over 70 patents on medical devices (google scholar). He has conducted pioneer work on motor, visual, and auditory neuroprostheses, from basic and translational research to entrepreneurship for making such technologies available to patients.
In this interview, we discuss his career path, contributions to different neuroprostheses, and the challenges faced during clinical implementation and commercialization. We also discuss the reasons to conduct a Ph.D. and subsequent career options. We finalize with a discussion on the human body as a machine (or not), and on descriptive and normative views of our jobs in society.

Interview by Dr. Max Ortiz Catalan, Assoc. Prof. on Bionics and Director of the Center for Bionics and Pain Research (Social media: FB, TW, IG, and LI).

Episode timestamps
(00:00) Coming up
(02:31) Intro to CBP
(03:40) Summary
(06:28) Career path
(10:41) Switch from NHS to Academia
(12:51) Motor neuroprosthesis – The Bionic Neuron (BION)
(17:40) Challenges to commercialize medical devices
(27:08) Explanting the device
(29:58) Hearing neuroprosthesis – Cochlear implants
(34:30) Visual neuroprosthesis – Cortical visual implants
(39:15) Motor neuroprosthesis – FreeHand System
(40:49) Sensing Touch and entrepreneurship – SynTouch's BioTac
(53:10) Commercializing research and intellectual property (patents)
(1:00:05) Provisional patents
(1:06:52) When to move on – changing to new fields
(1:10:00) Difference between Academia and Industry
(1:13:01) New technologies for neural interfacing
(1:15:30) Restoring touch in hand prostheses
(1:24:33) Why doing a Ph.D.? and then?
(1:28:45) Upcoming book
(1:31:30) The human body as a machine
(1:39:34) Solving problems or creating markets?

Introduction to the show and what to expect.