1. What are Neuromotor Prosthetics? A neuromotor prosthetic is a brain-machine interface that records neural activity from the brain and decodes cellular activity into a control signal, which can then be used to operate a device. NMP technology is relatively new and is currently being developed in labs around the world. NMP technology has not yet been approved for human use.

2. Primary Motor Cortex Arm ©John Donoghue 2001 Cortical Area for Voluntary Movement

3. Courtesy of Richard Normann U Utah Utah Array (Bionic Technologies): 10 x 10 array, 1.0 mm length; 400µm separation; 80µm base ~ KΩ impedance) ~ 100-350 KΩ impedance)

4. How NMPs Work

5. Patient Demographics Spinal Cord Injury: In the US alone, there are 11,000 new cases of spinal cord injury every year. Right now it is estimated that about 200,000 people in the US are living with spinal cord injury. Paralysis affects young people. The average age at injury is 32 years. 82% of all SCI cases are males. Since 1990, the leading cause of SCI has been motor vehicle accidents, but violence, falls, and sports can also cause the condition. Lou Gehrig’s Disease (ALS): About 20,000 People in the US currently suffer from ALS. There are 5,000 new cases of ALS that occur every year in the US. This fatal disease strikes in midlife and men are one and half times more likely to suffer from the condition than women.

6. John Donoghue, PhD “What we found, somewhat by chance, was that sometimes the monkey would just quit and sit there, and yet he’d still play the game. It’s tempting to say, the monkeys figured out that they could only use brain control, but you could never really know that. If we had people we could ask them ‘what are you thinking about,’ but not with monkeys.”

7. Gathering NM Data

8. Look Mom, No Hands!

9. Dr. Philip Kennedy

10. Miguel Nicolelis, et al Researchers have also recently used electrode array recordings and, through the use of complex algorithms, predicted 3-D movement of the arm in primates. This study controlled a robotic arm locally and across the internet.

11. Bionic Technologies array Brown/MIT arrayM&M array Electrode Arrays

12. Gerhard Friehs, MD “I would like one of those arrays.” Q. How do you ensure the electrode doesn’t move around one it’s implanted? A. Well I could tell you but I’d have to kill you. It’s a secret.

13. Implantation Electrode array placement is achieved stereotactically and through the use of MRI imaging done prior to surgery. Patients are told to “imagine” moving their arm which enables doctors to identify the motor cortex.

14. Estimated Costs Research costs to bring NMPs to human use are estimated at $35 million Device cost to patients are predicted to be around $35,000 for the device. Implantation costs would significantly increase this figure.

15. Obstacles

16. Future Allowing paralysis patients to regain use of their own limbs Fully implantable systems Military applications Augmentation of brain capacity “For now, the first handful of patients are going to be from this area. Once this works well… the world!” G.F.

17. On the Cutting Edge: