Doctors know that deep brain stimulation works as a therapy for Parkinson’s disease. But they’re still trying to figure out why and how. A new study sheds some light on the mechanism of action, suggesting that DBS disrupts a pattern of excessively synchronized activity in the brain.

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Illustration: Alfred Pasieka/Science Photo Library/Corbis

In DBS, an implanted device sends tiny jolts of electricity through neurons, acting somewhat like a brain pacemaker. The technique is widely accepted as a treatment for Parkinson’s and other movement disorders; more than 100,000 patients have received implants that help control their tremors, rigidity, and other kinetic symptoms.

The research on Parkinson’s won’t just add to our stockpile of knowledge about the brain’s workings, it may also lead directly to the next generation of DBS devices. Experts in many neurological disorders (including epilepsy and chronic pain) are working on closed-loop systems, where an implanted device records signals from the body, and modulates its stimulation according to the patient’s need.

De Hemptinne explains that this phase-amplitude coupling, or PAC, is a normal feature of a healthy brain; it’s the excessive degree of synchronicity that poses a problem in the Parkinson’s brain. “In a healthy brain, the PAC is present when you’re not moving; then when you want to initiate a movement that PAC is strongly decreased,” she says. The neurons have to fall out of lockstep so some of them can engage in a new task. “But in Parkinson’s patients,” she says, “the neurons that are supposed to engage in the new task cannot, because they are still synchronized. So you have the difficulty with movement, the slowness, the rigidity.”

The surgery is most commonly performed as an asleep-awake-asleep procedure. The patient is asleep and anesthetized at the start of the procedure and awakened after the brain is exposed so he or she can respond to verbal commands with feedback that assists the surgical team in optimal placement of the electrodes. Afterward, the patient is put to sleep again as the final stage of the operation is completed. Since there are no pain receptors within the brain, patients experience no discomfort while awake during the operation.

References:

https://spectrum.ieee.org/the-human-os/biomedical/devices/how-brain-pacemakers-treat-parkinsons-disease

https://www.uclahealth.org/vitalsigns/brain-pacemaker-has-proven-benefits-for-patients-with-some-movement-disorders

https://www.theinsightpartners.com/reports/brain-pacemakers-market

Different kinds of seizures are common to each category of epilepsy, according to the CDC. Generalized seizures vary in severity: Absence seizures may cause a person to stare off into space or blink rapidly, while tonic-clonic seizures cause muscle jerks and loss of consciousness. Focal seizures, on the other hand, might cause a person to experience a strange taste or smell, or act dazed and unable to respond to questions.

The Centers for Disease Control and Prevention (CDC) estimates that 3.4 million people in the United States have active epilepsy. While symptoms of epilepsy may vary among cases, the disorder always causes seizures, which are periods of sudden irregular electrical activity in the brain that can affect a person's behavior.

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Image Credit: Focal epilepsy is a result of electrical instability in one area of the brain while generalized epilepsy involves electrical instabilities in many areas of the brain. (Image credit: Shutterstock)

According to healthline, each year 150,000 Americans are identified with central nervous system disorder and every 1 in 26 U.S. people are diagnosed with this disease. After migraine, stroke and Alzheimer, Epilepsy is the fourth most common neurological disease.

Healthy people may have seizures under certain circumstances. If the seizures have a known cause, the condition is referred to as secondary or symptomatic epilepsy. Some of the more common causes include the following:

• Tumor
• Chemical imbalance such as low blood sugar or sodium
• Head injuries
• Certain toxic chemicals or drugs of abuse
• Alcohol withdrawal
• Birth injuries
• Abnormal blood vessels in the brain
• Other illness that damages or destroys brain tissue

Market Dynamic Epilepsy –

The high susceptibility rate of attaining epilepsy among the elderly is projected to drive market demand. As per the 2018 study in the Neuroepidemiology Journal, the prevalence rate of epilepsy among individuals older than 60 was 7.7 per 1000. Moreover, brain injuries which can trigger post-traumatic epilepsy (PTE) and post-traumatic seizure (PTS) can fuel the demand in the epilepsy market.

Developing economies in Africa offer a prime opportunity for investment in the market. According to a report by the World Health Organization (WHO) in 2017, nearly 80% of the patient population with epilepsy live in middle- and low-income countries. Manufacturers of epileptic drugs can capitalize on the opportunity to invest and establish facilities to cater to the growing demand.

APAC epilepsy market is set to touch a valuation of USD 2,046.57 million by 2023 due to high incidence of the disorder registered in the region. In addition, countries of India, South Korea, and China emerging as viable destinations for testing and development of novel drugs can spur market demand over the forecast period.

Europe is expected to exhibit 8.31% CAGR over the forecast period. Increased investment in research and development of effective drugs to treat epilepsy coupled with high incidence of the disorder are factors projected to drive regional market growth exponentially.

References:

https://www.livescience.com/34723-epilepsy-symptoms-and-treatment.html

https://www.emedicinehealth.com/epilepsy/article_em.htm

https://www.theinsightpartners.com/reports/epilepsy-market/

In theory, organ-on-a-chip devices are aptly named. The engineered silicone modules contain small “organs,” represented by specific types of human cells. Fluid courses through thin channels — like veins, but only a fraction of the size — which interconnect the various cells, and expose them to drug treatments carefully administered by lab scientists. They may look like gadgets from the future, but these organ-on-a-chip devices have already garnered attention from scientists hoping to fix a broken drug discovery process.

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• Organ-on-a-chip and disease-on-a-chip platforms for modeling human physiology and pathophysiology. Reprinted with permission from Elsevier. Citation: Zhang YS, Zhang Y-N, Zhang W. Cancer-on-a-Chip Systems at the Frontier of Nanomedicine. Drug Discovery Today, 2017, 22, 1392-1399.

Within the last decade, scientists began designing organ-on-a-chip devices. The scientific ambition tethered to these devices has been lofty from the start. Scientists promise more realistic pre-clinical results compared to the existing gold standard in labs: traditional in vitro studies. But early iterations of this new technology have had their own limitations, and the way many researchers grow the “organs” may not be as realistic as promised. Recent work out of Harvard’s Wyss Institute addresses this concern. At Wyss, researchers have pioneered a method to develop what may be the most accurate representation of kidney function to-date.

Despite the great promise, creating an organ-on-a-chip system is not a simple process, with a number of obstacles to be overcome. “Challenges include reproducing the architectural complexity of the human tissues and organs in vitro in a miniaturised fashion, and how to link them in the right format (arrangement) that the interconnected systems also recapitulate the human tissue/organ interactions.

However, 3D cell cultures fail to reproduce features of living organs that are crucial for their functions, such as tissue-tissue interfaces (between epithelium and vascular epithelium for example), chemicals or oxygen gradients or the mechanical action of the microenvironment.

Adoption Of OOC Technology By Major Pharmaceutical Companies – OOCs are now being explored worldwide as tools for developing disease models and accurately predicting drug efficacies and toxicities. Many companies and universities have been continuously looking for new and better models for drug development. The advantages of OOCs over cell culture, animal models, and human clinical trials have captured the attention of the medical and pharmaceutical communities focusing on developing targeted therapies. In May 2018, AstraZeneca partnered with Emulate, Inc. to develop OCC models to demonstrate the utility of this technology as a more predictive alternative for efficacy and safety testing of new chemical entities .

Human organs-on-chips (OOCs) are miniaturized versions of lungs, livers, kidneys, heart, brain, intestines and other vital human organs embedded in a chip. With advances in OOC technology, drug regulatory bodies have started testing OOCs for their reliability and their use as an alternative to animal testing.

References:

https://thenewstack.io/organs-on-chips-emulates-human-organs-for-better-biomedical-testing/

https://massivesci.com/articles/futuristic-organ-on-a-chip-stem-cells-kidneys/

https://www.technologynetworks.com/drug-discovery/articles/organs-on-chips-applications-challenges-and-the-future-288031

https://www.theinsightpartners.com/reports/organs-on-chips-market

Parkinson’s disease is the second most common age-related neurodegenerative disorder after Alzheimer’s disease. For instance, according to the Parkinson's UK, in 2015, estimated number of people suffering with the Parkinson’s disease in Northern Ireland were 241, amongst which 157 were male and 85 were female

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Neuroscience is a study of that is concerned with the structure and function of the nervous system. The study covers the evolution, development, physiology, cellular & molecular biology, anatomy & pharmacology of the nervous system, and also behavioral, computational and cognitive neuroscience. Tools such as MRI scans and computerized 3-D models are used to perform tests for some common conditions including Down syndrome, Parkinson's disease, brain tumors, effects of stroke such as, language loss and many others.

Major market players are focused on adopting inorganic growth strategies such as mergers, collaborations, partnerships, and acquisitions which are expected to boost the market growth over the forecast period. For instance, in April 2019, Philips and Hong Duc General Hospital in Ho Chi Minh City in Vietnam entered into a seven-year partnership agreement, under which Philips will offer Hong Duc General Hospital with the latest medical imaging, patient monitoring, and healthcare IT solutions.

Moreover, in August 2017, Charles River Laboratories International, Inc. acquired Brains On-Line, a contract research organization (CRO), for expansion of Charles River’s portfolio of Central Nervous Systems (CNS) services.

For instance, in November 2018, GE Healthcare launched Revolution Apex, a new CT scanner in its Revolution product portfolio. This device features Quantix 160 X-Ray tube and deep learning imaging reconstruction, a system built on GE’s Edison, an artificial intelligent platform to produce high quality images in challenging cases.

Moreover, Europe is expected to hold the second largest market share over the forecast period, owing to product launches in the market. For instance, in January 2018, Philips launched a new line of AI-powered imaging devices in India named Access CT 32 Slice, Ingenia Prodiva 1.5T MRI, and Dura Diagnost F30 Digital X-ray.

Major players operating in the global Neuroscience market include Alpha Omega, Inc., GE Healthcare, Axion Biosystems, Inc., Siemens Healthineers, Scientifica Ltd., Blackrock Microsystems LLC, Femtonics Ltd., LaVision Biotec GmbH, Intan Technologies, NeuroNexus Technologies, Inc., Newport Corporation, Neuralynx Inc., Plexon Inc., Mediso Medical Imaging Systems, Noldus Information Technology, Sutter Instrument Corporation, Thomas Recording GmbH, and Trifoil Imaging Inc.

Source:

https://www.theinsightpartners.com/reports/neuroscience-market

Biomarkers—molecules that indicate the presence of a disease or dysfunction—are becoming increasingly instrumental for confirming diagnoses, choosing the best treatments, and monitoring disease progression. One exception is biomarkers for neurological conditions. Neurological biomarkers are present in cerebral spinal fluid (CSF), but rarely—or at undetectable levels—in blood. The brain is closely protected by its own private “security guard,” the blood–brain barrier, which shields it from harmful substances circulating in the bloodstream. Unfortunately for diagnostic purposes, this barrier has also made the brain’s chemistry inaccessible to a convenient blood test. Neurological biomarkers can be studied using CSF, but this requires an invasive and painful lumbar puncture procedure.

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Central Nervous System (CNS) biomarkers are used to check clinical utility and to help decisions regarding particular drug treatment, and if it is effective, it is most likely to receive reimbursement from the regulatory advisor. These biomarkers are valuable because they could be implemented as diagnostic screens for several diseases, as it would be less invasive for patients.

However, these elusive neurological biomarkers are now coming into view. Recent advances in detection, as well as the comprehensive power of clusters of biomarkers, or biomarker signatures, are making the brain more accessible and neurological diseases more treatable. Diagnosing and treating neurological disorders—such as chronic traumatic encephalopathy (CTE), Alzheimer’s disease, Parkinson’s disease, autism, and major depressive disorder—is likely to become easier with the recent advent of neurological biomarkers detected in blood.

The recent ability to detect neurological biomarkers in the blood is due in part to technological advances in detection. For example, Quanterix’s Simoa (single-molecule array) technology bumps up sensitivity by digitizing an ELISA (enzyme-linked immunosorbent assay), a highly effective method of determining binding between two molecules. Quanterix screens patient samples with 720,000 microscopic beads coated with capture antibody (for the biomarker of interest), incubates the beads with a capture antibody and mixes them with a fluorescent marker, then spreads the beads into 216,000 isolated microchambers. The resulting high signal-to-noise ratio makes for very responsive detection.

About half of Quanterix’s current applications are linked to neurology, and many researchers using their platform measure biomarker concentrations in both CSF and blood. “Typically, we see a concentration difference of about 1:100 or 1:500, so we think it’s a breakthrough to now be able to look at brain health noninvasively,” says Kevin Hrusovsky, CEO of Quanterix in Lexington, Massachusetts. “We can see a single femtogram per mL of a biomarker, which is sensitive enough to detect biomarkers in saliva and breath condensate as well.”

References:

https://www.theinsightpartners.com/reports/central-nervous-system-biomarkers-market

https://www.sciencemag.org/features/2017/12/biomarkers-brain-putting-biomarkers-together-better-understanding-nervous-system

Neurostimulation is an advanced treatment for reducing chronic pain and improve the quality of life of people who are paralyzed or suffer from severe losses to sense organs. Neurostimulation devices are often surgically implanted in the patient and function with the help of thin wires or leads. These devices function by initiating stimulation of nerve impulses or by inhibiting pain signals produced at target sites that include autonomic nervous system, deep nuclei of the brain, peripheral nervous system, and central nervous system.

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What are the neurostimulation devices?

Neurostimulation devices relieve pain by disrupting the signals of pain between the spinal cord and the brain. A neurostimulation device generates electrical impulses. Neurostimulation devices are surgically inserted in the patient and operate through thin wires or leads. They are effective treatments for pain caused by various medical conditions, such as diabetic neuropathy or failed back surgery. These not only soothe patients, but they also prevent the use of strong pain killers, including opiates.

Types of neurostimulation devices:

Spinal Cord Stimulators

Spinal cord stimulation devices are highly beneficial in the treatment of chronic pain. The implantable device provides a non-pharmacological solution to different pain conditions. Stimulators have been used to relieve both neuropathic and ischemic pain. Spinal cord stimulator implantation is typically reserved for those who have not had a range of conservative and pharmacological treatment options. A permanent stimulator is installed after a percutaneous test. Patients may experience long-lasting pain relief following the procedure.

Sacral Nerve Stimulators

Sacral nerve stimulation (SNS) system or sacral nerve neuromodulation is gradually being used for the diagnosis of overactive bladder, lack of dysfunction, and urge incontinence. The SNS implant is a minimally invasive surgical procedure and consists of an assessment period and the second stage of permanent stimulator implantation, providing the results of the test interval are clinically effective. The first stage, also known as the Percutaneous Nerve Evaluation (PNE), is most important to assess the efficacy of electrode implantation in the sacral foramina and to show therapeutic benefits worth exploring with permanent SNS.

Deep Brain Stimulators

Deep brain stimulation (DBS) is an effective treatment for common movement disorders and has been used to modulate neural activity by delivering electrical stimulation to key brain structures. The long-term efficacy of stimulation in the treatment of disorders such as Parkinson's disease and severe tremor has encouraged its application to a wide range of neurological and psychiatric conditions.

However, the adoption of DBS remains limited, even in Parkinson's disease. Advanced deep brain stimulation tools concentrate on interaction with disease circuits through additive, spatial, and temporally sensitive approaches. Spatial specificity is promoted by the use of segmented electrodes and field guides, and temporal specificity includes the delivery of pattern stimulation, mostly controlled with disease-related feedback.

References:

https://globalriskcommunity.com/profiles/blogs/neurostimulation-devices-and-their-applications-in-the-treatment

https://www.theinsightpartners.com/reports/neurostimulation-devices-market

A brain pacemaker is a medical device implanted into the brain to stimulate the nervous tissues with electric signals. These pacemakers are being used widely to provide treatment to the patients having neurological disorders such as Parkinson's disease, epilepsy, and others. Other than giving stimulation to the brain, pacemakers also play an essential role in stimulating the spinal cord. Brain pacemakers have been found to offer a safe and effective procedure that provides symptomatic relief to patients.

Deep brain stimulation (DBS) is the use of a pacemaker-like device implanted in the brain to treat the symptoms of diseases like Parkinson’s, or other maladies such as depression. For the first time in the US, surgeons at Johns Hopkins in Baltimore, Maryland have used this technique to attempt to slow memory loss in a patient suffering from the early stages of Alzheimer’s disease.

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Back in 2010, a safety study in Canada showed that patients with this device showed increased glucose metabolism over thirteen months while untreated patients suffered decreased glucose metabolism. While this new trial only has one patient so far, the second will be receiving the implant this month. The fornix, a vital part of the brain that brings data to the hippocampus, is being targeted with this device. Essentially, the fornix is the area of the brain that converts electrical activity into chemical activity. Holes are drilled into the skull, and wires are placed on both sides of the brain. Then, the stimulator device pumps in small and unnoticeable electrical impulses upwards of 130 times per second. Half of the patients will begin the electrical treatment two weeks post-surgery, but the other half won’t have their pacemakers turned on until a full year after the surgery to provide comparison data for the study.

While the researchers are hopeful that the deep brain stimulation will be an effective tool to treat Alzheimer’s disease directly, that isn’t the end-game. Even if these studies don’t work out as planned, it will provide better information for these researchers to develop better and less-invasive treatments going forward. It’s important to note that this is in no way meant to cure Alzheimer’s disease. However, stimulating the areas of the brain that aren’t damaged yet will hopefully drastically slow the loss of memory associated with the disease.

The fornix, a vital part of the brain that brings data to the hippocampus, is being targeted with this device. Essentially, the fornix is the area of the brain that converts electrical activity into chemical activity. Holes are drilled into the skull, and wires are placed on both sides of the brain. Then, the stimulator device pumps in small and unnoticeable electrical impulses upwards of 130 times per second. Half of the patients will begin the electrical treatment two weeks post-surgery, but the other half won’t have their pacemakers turned on until a full year after the surgery to provide comparison data for the study.

References: https://www.extremetech.com/extreme/142797-brain-pacemaker-helps-treat-alzheimers-disease

https://www.theinsightpartners.com/reports/brain-pacemakers-market/

What is a BCI?

Simply put, a brain-computer interface is a way to connect the brain to an external device in order to send and/or receive information directly from it. They’re nothing new as research started in the early 70’s, so why are they gaining so much attention lately?

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While Neuralink presents a technical milestone in permitting high-fidelity recording of an unusually large number of biological neurons, it is not unique in concept – recent years have seen a surge in the number of next-generation implantable BCI prototypes developed in both academic labs, and also in industry. Companies like Kernel, Mindmaze, Longeviti, Neuropace, Neurable, Medtronic, and CTRL-Labs (which Facebook has just announced the acquisition of), along with Neuralink, are developing BCIs for many research and medical uses. In fact, there are already several hundreds of individuals with FDA-approved implantable BCIs nationally.

The key players influencing the market are Integra LifeSciences Corporation., Mindmaze, CASMED, EMOTIV, Compumedics Limited, Advanced Brain Monitoring, Inc., Natus Medical Incorporated., OpenBCI, Cadwell Industries, Inc., and Cortech Solutions

Principled computer architecture techniques will be vital to unlock the full range of brain-computer interactions that BCIs offer. Modern BCIs are domain-specific (i.e., they generally treat a particular class of diseases in a particular brain region, or enable a particular technology), and there is a need to build more general-purpose BCI platforms.

The growing healthcare infrastructure in the developing economies such as India, is expected to provide huge opportunities for the growth of BCI technology in the region. As the healthcare infrastructure improves, innovative systems that improve the lives of the disabled are encouraged. Also, the government in such regions is expected to contribute funds for the welfare of the population that creates immense opportunities for the R&D of BCI technology. Moreover, as per a WHO report, around 82 million people will be affected by dementia by year 2030, which directs the potential demand for BCI in the upcoming years. Growing occurrence of neurodegenerative conditions such as Alzheimer’s, Parkinson’s disease and epilepsy are anticipated to fuel the demand for brain computer interface during the forecast period.

The technology whereby miniaturization of several electronic components is made possible on a single chip is referred to as flexible circuit technology. The flexible circuit technology eliminates the need to build a separate chip to support individual electronic components. In BCI technology, flexible electronics, due to their versatility, have enabled implementing pressure sensors in blood vessels and electrodes on the heart. They are also biocompatible with the brain as compared to silicon chips. The data is then transferred to external devices.

References: https://www.sigarch.org/computer-architecture-for-brain-computer-interfaces/

https://medium.com/advances-in-biological-science/the-future-of-perception-brain-computer-interfaces-part-2-4b69970d8ba9

https://www.theinsightpartners.com/reports/brain-computer-interface-bci-market

Autism spectrum disorder is typically diagnosed between 1 and 2 years of age, a time which has been noted to coincide with marked brain volume overgrowth. Now, additional and new evidence from magnetic resonance imaging (MRI) studies indicates that the changes in the brains of children with autism spectrum disorder leading to brain overgrowth can be detected by 6 to 12 months of age. However, from autopsy studies it appears that the dysregulation of the prefrontal and temporal lobes of the brains in children with autism spectrum disorder actually occurs much earlier and during pregnancy. Such prenatal changes are set in motion due to genetic and/or epigenetic alterations happening around the time of conception or shortly thereafter. Approximately 65 new genes have been identified in this role.

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An estimated 1% of the population (62.2 million globally) are on the autism spectrum as of 2015. In the United States it is estimated to affect more than 2% of children (about 1.5 million) as of 2016. Males are diagnosed four times more often than females. The autism rights movement promotes the concept of neurodiversity, which views autism as a natural variation of the brain rather than a disorder to be cured.

Growing pipeline for the autism spectrum disorder is one of the prime factors for the growth of the market. There is no current therapies for the treatment of autism spectrum disorders, which have increased number of untreated population. For instance, autism prevalence has increased by 15% in children, affecting 1 out of 59 children, the CDC. Moreover, increasing government efforts to increasing knowledge regarding autism is boosting the growth of the market. For instance, in August 2019, the Centers for Disease Control and Prevention announced to invest USD 27 million in the next five years to conduct the Study to Explore Early Development (SEED). This is one of the largest studies in the U.S., which will help in identifying risk factors in children for autism spectrum disorder (ASD).

A revision to autism spectrum disorder (ASD) was presented in the Diagnostic and Statistical Manual of Mental Disorders version 5 (DSM-5), released May 2013. The new diagnosis encompasses previous diagnoses of autistic disorder, Asperger syndrome, childhood disintegrative disorder, and PDD-NOS. Slightly different diagnostic definitions are used in other countries. Rather than categorizing these diagnoses, the DSM-5 has adopted a dimensional approach to diagnosing disorders that fall underneath the autism spectrum umbrella. Some have proposed that individuals on the autism spectrum may be better represented as a single diagnostic category. Within this category, the DSM-5 has proposed a framework of differentiating each individual by dimensions of severity, as well as associated features (i.e., known genetic disorders, and intellectual disability).

Source: The Insight Partners

Neuroprosthetics: The 21st century also known as the digital age is an era marked by rapid adoption of information technologies. Artificial intelligence (AI) has taken the world by storm and new advancements are on the rise in the field of robotics.

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Scientists could create neuroprosthetics for vision and hearing based on studies investigating how visual and auditory neurons functions Visual Neuroprosthetics or Retinal implants. In the case of auditory, sound waves pulsate the eardrum, which conveys the vibrations to a series of little bones inside the ear. Eventually, those mechanical vibrations are transformed into electrical signals by inward ear sensory cells called hair cells. Hair cells then convey these signals to the hearing nerve, which delivers the message from the inner ear to the brain. The procedure is similar to vision, despite the fact, photoreceptors cells located at the back of the eye in a tissue called the retina, create electrical signals when stimulated by light. They connect with the optic nerve to pass on visual info. A developed prosthetics can immensely negate the disabilities of individuals with ear, vision or limb disabilities. These can substitute the natural functions of the body and even can make them superior with the latest developments.

One incredible use of AI and robotics is through neuroprosthetics. Neuroprosthetics are devices that convert brain’s intentions into external actions as well as translate environmental stimuli input directly to the nervous system like the bionic ear and cochlear implant.

The merge between neuroengineering and robotics is paving the way to the future where prosthetics can restore functionality of a lost limb by shared control. Shared control is a system that not only has user control but also automation components.

One new improvement in shared control technology is the work done by Silvestro Micera and colleagues. They recently published in Nature Machine Intelligence their work on the development of a smart artificial hand that can aid amputees.

Signals from the amputee’s stump were detected by the sensors and learnt by the machine to distinguish between different finger movement patterns. Next they worked on engineering the algorithm for the grasping ability of the robotic hand on user’s action.

The algorithm enables the prosthetic hand to close its fingers and grasp an object when the surface sensors come in contact with an object. In order to test the algorithm the subject, an able-bodied individual, was assigned the task of moving a water bottle from one platform to another that was 30 cm away.