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Wayfinding : RFID. Telemedical Retinal Imaging of : Diabetic Retinopathy, Glaucoma, Macular Degeneration. Hearing and Tinnitus. Developing new devices to expand diagnostic opportunities Development of Tinnitus Management Program From inception through implementation.
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Telemedical Retinal Imaging of : Diabetic Retinopathy, Glaucoma, Macular Degeneration
Hearing and Tinnitus Developing new devices to expand diagnostic opportunities Development of Tinnitus Management Program From inception through implementation
Spinal Cord Injury Translational Collaborative Consortium forRegenerative Research • Goal : Develop and translate novel therapies bench to bedside • Focus: Restoration of upper limb function with 2 research teams • Discover genes responsible for axon growth and inhibition of growth in the adult spinal cord • Testing of combination therapies in non-human primate (NHP) models • (cells, growth factors and drugs) • Long-term, chronic effects cell-based therapies on functional recovery in NHP models • Determining best approach overcome formation of glial scar • (body’s attempt repair injured cord) • Use cells and biologics already used for other clinical indications • Speed up regulatory process towards “investigational new drug” indication by FDA • Built-in replication criterion :Teams must reproduce results • Use rodent & NHP contusion & hemisection models for scale-up, • feasibility of therapy • Must overcome obstacle translating animal to human
West Haven: Human Oligodendrocyte Precursor for Myelination of Axons • Testing safety and ability of GERON cells used in clinical trials to form myelin around injured axons after lesion in NHP spinal cord • Cells are safe: survival studies up to 3 years post-transplantation with no tumor formation or adverse side effects • GERON cells form myelin and are superior to “self-repair” Self – repair 1 year after lesion Geron OPC 7 wks after lesion
San Diego: Human Neural Progenitor Cells (NeuralStem™) Form Functional Axon Bridges with Host Spinal Cord • Identified genetic signaling molecules involved in promoting and retarding growth of axons post-SCI • Studies blocking genetic signals that retard axon growth demonstrate increase in growth post-injury in rodents. Removing inhibition results in growth • Transplantation of NeuralStem™result in clinically relevant growth – up to 20 segments in rats, equivalent to inches in humans • Now being tested in NHP
Neural Prostheses:Functional Electrical Stimulation (FES) Don Crago, U.S. Army Veteran injured while on active duty Fort Carson, CO Result of car accident he is paralyzed from chest down uses FES system for exercise and limited walking at home
Traumatic Brain Injury (TBI):Intensive Multimodal Rehabilitation Advanced Rehab Devices Physical Therapy Recreation Therapy Assistive Devices
Rehabilitation Robotics: Physical Therapy Clinical Trial of Robot-Assisted Physical Therapy http//www.nejm.org/doi/full/10.1056/NEJMoa0911341
DEKA arm: Research Plan Past and Future • Congressional Hearing 2004 • DARPA’s “Revolutionizing Prosthetics 2007/2009” Programs began 2005 • VA Prosthetic Arm Optimization Study 2008-2012 (3 VA, 1 DoD site) • “Take-Home” Study to begin 2012 • Transition to Additional Applications • Collaborations with other agencies (DoD/DARPA)
Artificial Limbs:Ankle-Foot Prosthesis Powered Electronic Ankle-Foot Prosthesis May Improve Mobility of Veteran Amputees to Walk Dr. Hugh Herr
Osseointegration • Biohybridlimb combining living tissue with external prosthetic device consisting of a titanium rod • Device is of the leg stump fused into bone • Problem has been infection • Salt Lake City VA made progress by using porous disc placed under the skin – animal studies • 1-year infection free without antibiotics • Recently received FDA approval for human trial • Photo from work in Europe
Brain-Computer Interface http://www.nature.com/nature/journal/v485/n7398/full/nature11076.html
Journal of Rehabilitation Research & Development: JRRD http://www.rehab.research.va.gov/jour/jourindx.html • JRRD sponsored by RR&D • Scientific peer reviewed journal • Fully accessible online: sign up today!
ORD/RR&D Supported Research:Available to the Public • Search on NIH RePORTER website • Merit, Pilot, Career Development (recent addition) • Other award types to follow as forms are generated for use in eRA • Search on Clinical Trials website