Matt’s back to introduce Michael Wolfson, who’s the Program Director in the Division of Discovery Science and Technology at the National Institute of Biomedical Imaging and Bioengineering.

Progression is advocates — state legislators — federal legislators — federal agency

Michael Wolfson doing an overview of NIH’s spending, which NIBIB is part of. 90% of NIH money goes to non-government places … NIBIB is one of the smallest of the 27 Institutes and Centers at NIH.

(Don’t care about most of this background, who gets what money … at least not as he’s describing it.)

Okay, NIBIB has a long list of program areas, but he’s here to talk about just one of them: rehab engineering. What informs funding at NIBIB, congress, the Dod, the NIH, obviously, but also US .. along with other agencies, academics, and clinicians.

Ah. got it.

He’s saying that because of how is research funded, we have to inform the people who ASK for money, too. They’re the ones who write the grants, so if they’re asking for money to do projects we don’t care about, the things we DO care about are less likely to make it through the funnel.

Neuromodulation is what he really wants to discuss. There are 3 main categories. One is brain control, which would work on every level of injury. It’s high risk, and so far there is only modest function return demonstrated. Another is to bridge the gap in the cord. It could work with MOST levels of injury, it has only a modest risk, but on the plus side it’s very mature. A challenge is that it’s hard to scale. The 3rd is to enhance residual capability. It has modest to low risk. It’s an immature technology, and there may be limits to how well it works.

Talking about a device being worked on at the University of Miami. It works by reconstructing motion from neural information. Then there’s 2nd generation FES … where there are now clinical trials underway, and we’re going to hear some more about this later in the program.

Bionic Enhancement Olympics! Hadn’t even heard of this, but it happened in Zurich right after the Paralympics … wow. Video of people having fun and competing. This ain’t a parlor trick, it’s a way to try this stuff out. Check it out. Cybathlon

Hoffmann Reflex can be retrained to improve walking capability in incomplete patients. Can complement  other rehab therapies. Has been in testing since 2013.

Epidural Stimulation, which enhances residual capability. Showing a guy wearing an exoskeleton and walking with transcutaneous stimulation. NIH has a whole set of programs focused on the brain … there’s also a whole set of efforts to take advantage of peripheral activity (SPARC).

Can I just say that I really hate these overview-ish presentations? You can’t take all this high-level information in nearly as quickly as it’s on the screen.

Back to this slide: Research — applied research — development — first in human — FDA approval — payer approval.

That’s the path from good idea to let’s go buy it. And it’s not a linear path. Sometimes things that worked thru the first three steps fail in humans, or have side effects that the animals didn’t experience or couldn’t tell us about.

Oof, he ends.

And it’s time for a break, good grief.