Two new IEEE.tv programs feature panel discussions with IEEE members about the newest techniques being applied to rehabilitate patients suffering from neurological disorders. Brain-imaging techniques, applications of virtual reality, and wearable sensors are some of the topics covered by the panelists, experts in neuroengineering and neurorehabilitation. The two roundtable discussions were filmed during the IEEE Engineering in Medicine and Biology Society’s annual international conference, held in September in Minneapolis. IEEE Spectrum’s editor-in-chief Susan Hassler moderated both sessions.
In the session on “Technology’s Role in Understanding and Treating Conditions of the Brain,” experts discussed the application of MRI and brain stimulation. Other panelists discussed applications for brain imaging, the brain-machine interface, and implantable devices.
Biomedical imaging—particularly the use of MRIs as a neurofeedback mechanism for dealing with human pain—is making tremendous strides, according to IEEE Member Gary Glover. He is director of radiological sciences at Stanford University’s School of Medicine. Neurofeedback presents real-time physiological signals from MRIs in a visual or auditory form to provide information about brain activity. These signals are used to train the patient to alter neural activity in a desired direction.
“Traditionally, feedback using EEGs or other mechanisms has not focused on the brain because the resolution is not good enough on the networks involved with pain,” Glover says. “By using an MRI, we can focus on networks involved with a particular process, such as perception and registration of pain. We’ve been able to reduce a person’s perception of pain from the training we’ve given them.”
Another panelist, IEEE Senior Member Dominique Durand, director of Case Western University’s Neuroengineering Center in Cleveland, talked about advances in using deep brain stimulation to prevent epileptic seizures. Epilepsy is the abnormal firing of neurons in the brain. Deep brain stimulation involves implanting a device that sends electrical impulses to specific parts of the brain.
“We are using deep brain stimulation based on its success in treating Parkinson’s disease, but epilepsy is like cancer in that there is no one type, and there’s not a one-bullet solution to curing it,” Durand says.
“Some applications involve a closed-loop system that starts where the seizure starts, and we try to stimulate that to prevent seizures,” he continues. “There’s some hope, but the targets are varied. We are making progress but are still a long way away.”
For his part, IEEE Member Andrew Schwartz, a professor of neurobiology at the University of Pittsburgh, discussed how neural activity drives behavior. In his lab, Schwartz has implanted a tiny grid of 100 sensors in the brains of monkeys. Each sensor listens to a different brain cell, or neuron. Schwartz then decodes the brain “language” by watching the monkeys’ movements and recording the corresponding signals in their brains.
“Because we are recording activities of a network of individual neurons, which are the meat of how the brain works, we’ll be able to watch a patient to see how the neurons interact and generate a learning process,” Schwartz says. “As we learn how neurons talk to each other, we can begin to understand how higher-order learning processes, such as cognition and perception, take place. These are things we ascribe to higher functions of the brain, but we really have no idea of the mechanisms that take place.”
In addition, three other panelists spoke about their work. IEEE Fellow Bin He, director of the Center of Neuroengineering at the University of Minnesota in Minneapolis talked about the latest functional brain imaging techniques. He is also the 2009 president of the IEEE Engineering in Medicine and Biology Society.
Jose Principe, also an IEEE Fellow, talked about his work with brain-machine interfaces. He’s a distinguished professor of electrical engineering and biomedical engineering at the University of Florida.
IEEE Fellow Nitish Thakor discussed his research on implantable devices. Thakor is the director of the Laboratory for Neuroengineering at Johns Hopkins University in Baltimore.
In the second panel, on “Advances in Neurorehabilitation," four panelists each discussed their work. Virtual-reality applications for rehabilitating patients suffering from stroke and other neurological disorders was the topic of Member James Patton, an associate director of the Center for Rehabilitation Robotics at the Rehabilitation Institute of Chicago. His center has developed robots that operate in three dimensions within a large work space and a visual interface. The visual display superimposes images that replicate real-life situations to help patients practice how to perform activities of daily living.
“If stroke victims, for example, want to get better at functioning in the real world, they have to practice things like reaching for a can of soup in a cupboard, turning a doorknob, or taking a teakettle off the stove,” Patton says. His patients do this, for example, by moving a handle connected to a computer-controlled robot and perform tasks in a virtual reality system similar to a video game.
Paolo Bonato, an IEEE senior member and director of the Motion Analysis Laboratory at Balding Rehabilitation Hospital in Boston, discussed his work on wearable sensors used to monitor people in their homes who have Parkinson’s disease.
Bonato recently completed a study in which miniature sensors, embedded in items such as wristwatches or clothing, were used to collect physiological data in order to assess the severity of symptoms of patients with late-stage Parkinson’s.
“By recording the performance of their daily activities, we can track changes in the severity of a tremor; dyskinesia, or excessive movement; or when they suffer from bradykinesia and move very slowly,” Bonato says. “Sensors are becoming smaller and less obtrusive. This area is expanding significantly.”
Senior Member Richard Jones, director of the Christchurch Neurotechnology Research Program, in New Zealand, talked about his research in detecting, predicting, and preventing attention lapses and “microsleeps”: little-known episodes of sleep that can last anywhere from a fraction of a second to half a minute. Preventing microsleeps is especially important for workers in transportation, such as truck drivers, pilots, and air traffic controllers.
“Most of us have microsleeps, and we don’t even have to be sleep-deprived,” Jones says. “The focus of our work is to prevent microsleeps by warning the person, which could include a way to wake them up or to possibly predict a microsleep by using an EKG.”
Jones reported on a study he conducted recently of 20 young adults asked to perform a long list of tasks over a period of 50 minutes. The subjects were monitored with a functional MRI. Of the group, 16 were found to have microsleeps, some of as long as 3 seconds, and were completely nonresponsive during that time.
A fourth panelist, IEEE Member Zev Rymer discussed virtual reality applications as a rehabilitative tool for stroke victims and patients with spinal cord injuries. Rymer is director of sensory motor performance programs at the Rehabilitation Institute of Chicago.