NEURAL PROSTHESIS 2000

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NEURAL PROSTHESIS 2000

• Michael Weinrich, MD
• National Center for Medical Rehabilitation
  Research, NICHD, NIH

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Incidence per 100,000--U.K.
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Prevalence per 1,000--U.K.
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TBI

• Incidence 100-300 per 100,000
• Severe 10-30/100,000
• 80,000 per year in U.S. with disability
• 5.3 million living today in U.S. with disability
• Bimodal age distribution
• Direct annual U.S. costs 4.5 billion
• Total annual U.S. costs 37.8 billion

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SCI

• Incidence 4-6 /100,000 developed countries
• U.S.--11,000 per year
• 250,000 living SCI survivors in U.S.
• 55 paraplegia, 45 quadriplegia
• 60.5 between ages 16 to 30
• U.S. lifetime costs 600,000
• Total U.S. annual costs exceed 10 billion

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Disabilities--U.S.

• 14.7 limited in activity --chronic condition
• 10.1 limited in major activities
• 1.6 million in wheelchairs
• 32.5/1000 with visual limitation
• 85.8/1000 with hearing impairments

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Stroke

• Incidence 250/100,000 ingt25 Denmark
• Incidence declining--Prevalence constant
• 550,000 annually in U.S.
• 1/3 severely impaired
• 3 million living in U.S. disabled by stroke
• deficits include paralysis, sensory loss,
  cognitive deficits, aphasia, apraxia

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World Distribution--Mortality

• Stroke 9.5
• Alzheimers 0.4
• Parkinsons 0.1
• Injuries 10.7 (6.2 in high-income)
• Multiple sclerosis 0.04
• Infectious diseases 30.5

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Sensory Loss--Prevalence

• Childhood deafness 133/100,000(UK)
• Childhood deafness 120/100,000 Finland
• Blindness 11.6/100,000 Germany
• 10 of population in developed countries could
  benefit from hearing aids
• 25,000 cochlear implants worldwide

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Impairments

• Cognition--memory, executive, attention...
• Language--aphasia, dysarthria, dyslexia
• Motor--paraplegia, quadriplegia, hemiparesis,
  sphincter control, focal or diffuse weakness
• Sensory--vision, hearing, position sense,
  tactile, pain, somatic
• Coordination and balance disorders

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Consequences

• Mobility
• ADLs
• IADLs
• Employment
• Living Situation
• Socialization

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Social Trends

• Demographic bulge
• Increasing life expectancy
• Decreasing disability
• Cost containment pressures
• Disability rights
• Consumer safety e.g. airbags

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Scientific Trends

• Moores Law
• Tissue engineering
• Identification of genetic diseases
• Genetic therapies
• Nanotechnologies

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Neural ProsthesesGoals Challenges--Time Frame

• Goals
• Improve function through electrical neural
  prostheses
• Shape circuitry in newly engineered tissue and
  integrate into body

• Challenges
• Interface between nervous system and prostheses
• Development of complex tissues integration

Future
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Nanotechnology
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Tissue Engineering