Dec 2017 Coherent News

Vercise

Boston Scientific, leading manufacturer of medical devices, use DBS for treatment of Parkinson’s disease, which is operated by stimulating a targeted region of the brain through implanted leads powered by a device called an implantable pulse generator (IPG). Around one million people in the U.S. and more than and 10 million worldwide are affected by Parkinson’s disease. The first commercial implant for manufacturing of DBS will be set up in the U.S. at the University of Minnesota Medical Center in Minneapolis by faculty physicians from the University. According to Deep Brain Stimulation Device Market report published by Coherent Market Insights, DBS device can be used on patient’s suffering from major complications of Parkinson’s disease for four years and more. Although there are other surgical options available such as thalamotomy and pallidotomy, deep brain stimulation is the most preferred option, as it does not involve tissue destruction and is a reversible surgical treatment.

The approval of the device was based on the Implantable Neurostimulator for the Treatment of Parkinson’s Disease (INTREPID) study. The study evaluated the safety and effectiveness of the system in 292 patients across 23 sites. The Vercise System is capable of controlling the amount of current delivered by each of the electrodes on the implanted leads. The System leads have eight contacts with a long total span of 15.5mm, tight spacing between each contact of .5mm, and multi-lumen construction. These system features are designed to work together to address common challenges in DBS therapy such as fluctuations in symptoms and the progressive nature of the condition by offering more adaptable delivery of stimulation.

“The Vercise DBS System changes the landscape of what physicians can do to help improve the quality of life for people living with Parkinson’s disease,” said Dr. Vitek, coordinating principal investigator for the INTREPID study. “This system provides an ability to sculpt the current field in the DBS target using novel technology that offers flexibility in programming. This flexibility allows us to target different regions of the subthalamic nucleus, which we believe will improve outcomes while reducing side effects.”

Dec 2017 IEEE The Institute

The Bionics Institute in East Melbourne, Australia, is a leader in hearing research, particularly cochlear implants, surgically implanted electronic devices that provide a sense of sound to people who are deaf or severely hard of hearing. The institute is using that same technology to improve vision and monitor brain activity.The institute’s CTO, IEEE Fellow Hugh McDermott, a pioneer in cochlear implants, mentions several of its latest projects.

A BETTER FIT
Each cochlear implant must be fitted to the individual and her comfort level of loudness, which can be difficult to gauge. Fitting patients who are as young as 6 months is especially complicated because babies cannot describe what they are hearing. The institute has developed a new type of brain imaging technique called functional near-infrared spectroscopy (fNIRS), a noninvasive way of seeing how the brain responds to sounds. With fNIRS, the patient wears a skullcap that’s similar to an electroencephalogram (EEG) cap, embedded with optodes. Optodes have light sources that operate in the infrared region and detectors that pick up light that is scattered back out of the brain. fNIRS measures the change in blood oxygen levels in each region of the brain, showing how active that part is. fNIRS imaging allows researchers to see how the brain is responding to the hearing device and tailor it to individual needs.  “If we could get an objective measurement of what’s actually happening in the brain when the cochlear implant recipient is hearing a sound, then we would know how to adjust the device and get the best possible fitting,” McDermott says. The institute is conducting proof-of-concept clinical trials.

VISUAL SENSATIONS
The Bionics Institute began developing a device in 2007 that used an electrode array to stimulate the retina of patients with retinitis pigmentosa, the most common cause of inherited blindness for which there is no effective treatment. For those who have the rare eye disorder, the light-sensitive cells of the retina—the photoreceptors—degenerate, but the retinal neurons that transmit information to the brain remain. The device electrically stimulated the receptor cells in the retina, and bypassed the receptors that were lost or damaged. By stimulating the cells, visual sensations in the brain can be created, McDermott says. The electrodes were placed near the retinal cells and connected to an electric stimulator, similar to the stimulator used in cochlear implants. Each electrode produces a spot or flash of light. During a clinical trial using the prototype device completed in 2014, patients reported “seeing” a type of connect-the-dots picture. “Patients’ normal vision isn’t restored by any means, but they do get information about things, like where the door is located or the placement of a table or chair,” McDermott says. “It helps them navigate.”
The institute has now developed a more advanced device with additional electrodes and a stimulator placed under the skin, similar to a cochlear implant. The system includes a small camera worn on eyeglasses and a video processor that can be carried in a pocket. The processor extracts information from the camera’s field of view and picks up obstacles in front of the person. Information about an obstacle is encoded into a pattern of dots and transmitted to the implant. The stimulation of the retina produces a dot-pattern image that helps the patient identify shapes, perceive movement, and navigate their way around without assistance, McDermott says. Three patients will receive the implant next year.

ADAPTING TO ABNORMAL MOVEMENTS
Deep brain stimulation treatments have been used for several years to manage Parkinson’s disease, a progressive disorder of the nervous system that affects movement. Electrodes are implanted into parts of the brain related to movement, and the electric stimulation continually pulses the area to remove or reduce symptoms such as tremors and rigidity. The treatments become less effective over time and although the symptoms constantly change,  the stimulation can’t be adjusted easily or quickly enough to maitain optimal therapy, McDermott says. 
The institute has developed a way to modify the stimulation in real time to adapt to the changes.

“The Holy Grail of our project was to find a signal that varies with symptoms, and we think we’ve found it,” McDermott says. “We can now measure the signal through the very same electrodes that are used to deliver the stimulation. This is a big step forward.” That same signal also could help surgeons implant the electrodes with more accuracy. The implant procedure is difficult because the surgeon is working with minimal information, according to McDermott. The electrodes have to be placed deep in the brain, and “it’s hard to visualise where with current imaging techniques,” he says. “What the surgeons need is to have a signal like a lighthouse that tells them where the target is, or to move the electrode closer. The same signal we think can control the stimulation could be used to help get the electrode to the right place.” Studies are being conducted with patients who have existing devices, he says, adding that clinical trials are still a few years off.

Nov 2017 Pensacola News Journal

Aaron HaleArmy Sgt. Aaron Hale rendered one improvised explosive device safe. He was returning to gather evidence from the first bomb on Dec. 8, 2011 in Afghanistan, when a second undetected device blew. The blast did not cause him to lose consciousness.   "I first thought my helmet was over my face. I started doing a systems check for my fingers and toes and then I tapped on my head and realised my helmet was gone," Hale said. "I knew something was really wrong with my eyes." 

But the veteran military bomb tech and explosive ordnance disposal team leader was more worried about the safety of those around him and whether more undetected pressure-plate IEDs could go off and hurt those trying to help. "I didn't want to put anyone else in danger because there could have been a tertiary device," he said. Just 14 minutes after the blast, he was en route to a Kandahar medical station. Within 24 hours he was at a U.S. military medical hospital in Landstuhl, Germany. A day later, he arrived at Walter Reed Army Medical Center in Bethesda, Maryland. The blast, which came from his right side, fused his eyelids together, perforated his eardrums and cracked his skull. Spinal fluid was leaking from his nose.  "I began to suspect that my eyesight was lost," Hale said. After multiple surgeries, his suspicions were confirmed. Hale's right eardrum never healed, but he was able to hear out of his left ear. He slowly began to adapt to a life without sight.
"It is not about what you don't have, it's about the tools you do have in your kit — my creativity, my senses, my patience," he said. 

 McKayla TracyMcKayla Tracy left, the wife of Aaron Hale, a former Explosive Ordnance Disposal team leader, describes the couple's journey since Arron lost his hearing from complications to injuries he sustained while serving in Afghanistan 

He eventually returned to Navy's Explosive Ordnance Disposal School at Eglin Air Force Base where he instructed others on how to rid war zones of deadly bombs. His presence at the school was a sobering reminder of the seriousness of the job.  "The first thing we tell (students) is all of the ways any device can hurt them and what can set it off. The first thing I told them about was how this IED got me. It's not something I wanted to be machismo about," he said. 

Hale started rebuilding his physical strength through running, climbing and kayaking. He ran marathons.  He reunited with a longtime family friend who later became his wife. The two started dating.  And then Hale became deathly ill.  He contracted bacterial meningitis likely related to his extensive facial and head injuries. It happened in 2015, four years after the blast that took his sight.  "Through the tons of antibiotics or the bacteria, my hearing was being erased," said Hale, who woke up in the hospital hearing only faint, muffled sounds.  He eventually lost 100 percent of his hearing. 

His then-girlfriend, McKayla, stayed at his side, communicating with him by writing on his palm with her finger.  She moved into his Destin-area home and helped him negotiate life without his hearing or sight.  Doctors thought Hale was a good candidate for a cochlear implant system to allow him to regain hearing.  But Hale had to wait for his body to heal before he could undergo the implant surgery.  "It was an extremely sad time. For six months he was deaf and blind," McKayla said.

Hale didn't start his military career as an EOD technician, he was a Navy chef. Cooking was a longtime passion and he was good at it. He cooked for admirals and for entire chow halls. 
He got interested in the EOD field while working as a Navy cook during his first deployment to Afghanistan after meeting EOD technicians at the chow hall. He asked the Navy to change career fields. "They said my cooking was too good and they wouldn't let me go," he said laughing.

He finished his contract with Navy and joined the Army where he entered the EOD program, one of the military's most challenging career fields with one of the highest washout rates.  Cooking and bomb disposal actually have a lot of similarities, he said. Both require attention to detail and a need to improvise. 

During the six months Hale was without his hearing and sight, he turned to cooking as therapy. But he couldn't use the tools he had used before he lost his hearing. He had a scan and bar-code system that helped him to identify items in the kitchen when he could hear.  Without his hearing, he turned to McKayla and their palm writing form of communication to help him move around the kitchen. It was during the holidays.  "I was sitting at the kitchen bar with literally nothing to do. I was in a wheelchair because I had lost my balance. I couldn't use my home gym. I was trapped in my own body," he said.  "I started thinking, when will I have paid my dues enough.” And then he started cooking.  "It was something I could still do. I started making fudge. I made so much fudge. It was something that gave me purpose, something I enjoyed doing," he said.

fudgeAaron Hale, a former Explosive Ordnance Disposal team leader, injured during the war in Afghanistan has turned his attention to the candy business with EOD (Extra Ordinary Delights) Fudge. Hale is selling his handmade confections online at WWW.eodfudge.com 

He made other holiday desserts, even the Thanksgiving turkey.  McKayla started giving the fudge and other candy to friends, family and people in the neighbourhood. They started a small home business selling the fudge.  It gave Aaron a purpose and distraction, McKayla said.  Through a small grant from a veteran's program, they built their business. Aaron came up with the candy recipes in his test kitchen and another company produced and packaged the candy and sold it online. 

In the meantime, doctors implanted the cochlear devices. Aaron waited for the devices to be turned on to find out if he would ever be able to hear again.  "I knew anything was better than being completely deaf and completely blind, I wanted to try it," he said.  The damage to his right ear was too extensive and the implant didn't work, but he regained some hearing in his left ear.  He uses a Bluetooth device that connects to a microphone to help him hear. The device also connects to his iPhone, which reads text messages and emails for him.  McKayla has her own microphone to communicate with her husband from anywhere in the house.  Aaron jokes that she is "the voice in my head.” "I can be anywhere and she will start talking to me, even in the bathroom," he laughed. 

Like anything in life, the key to learning the implant system was learning to adapt and make use of his available assets, he said. Despite the hurdles he has had to climb, Hale, who is now retired from the military, said he "has no regrets" about his decision to become a military bomb technician.  It is a dangerous but necessary job, he said.  "I hope one day we can get to a place where we don't have to be right on top of the devices, but right now there is nothing sophisticated enough. Right now, there is nothing compared to a well-trained EOD team leader," he said.

 

Nov 2017 Kent online

An 83-year-old woman who had gone deaf has been given the gift of hearing after successfully lobbying doctors for life-changing surgery. What began as a tale of frustration for Audrie Jackson at being told she was “too old” for the operation that could allow her to hear again became a story of incredible fighting spirit. Mrs Jackson, of Northfleet, was positively beaming as she told how her life had been turned around. “I started going deaf in 1991 and eventually it went completely, but no one seemed to want to know,” she said. “Actually I didn’t speak for six or seven years because I was so deaf I couldn’t even hear my own voice. I used to be in the choir at St Botolph’s Church but I had to give it up as well. But my mother lived until 96 and I thought, why should I go another 15 years or so in a world of silence?”

In order to have a chance of regaining her hearing, Mrs Jackson required a cochlear implant, but one doctor said her “age was against her”. Nevertheless, she was insistent that she should give it a shot and her persistence paid off, as she eventually found people willing to listen at Guy’s and St Thomas’ Hospitals. “You should have seen my face when they turned it on,” she recalled. “I cannot thank all of those staff enough, they are all wonderful. The doctors, the surgeons, the nurses, even the man who brought me tea. They have given me my life back and I can’t stop talking to people.
I can hear the toilet flush, I can hear the washing machine, I can hear the microwave, this morning I could hear the traffic.”

Mrs Jackson is still getting used to being able to hear again and so her ability to lip-read remains useful but her hearing is improving and seeing her excited about being able to hear her microwave and washing machine certainly puts things into perspective. The surgeon who performed Audrie Jackson’s cochlear implant says the devices should be available to everyone who needs one.