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Miniature Smart Chip to Fight Chronic Pain

Print Email Updated May 8, 2011 1300 How you can beat chronic pain with the smallest smart chip DESLEY BLANCH : Atiny pain management device is being developed byAustralian scientists that promises to have a big impact on treating chronic pain. The new Implantable Neuro Sensing and Stimulation device (INS2) is not a new product in practice but it's its scale that has everybody taking notice. The miniature smart chip is slightly smaller than a match-head with a power source about the size of a mobile phone sim card. To put it into perspective, conventional technology is match-box sized. The Sydney researchers are preparing for first human trials by implanting it near the spinal cord. Dr John Parker is chief technology officer at NICTA, Australia's ICT Research Centre of Excellence and is the project's leader. Their device is much smaller and much smarter than current technologies, so what will their device do which current technologies can't? DR JOHN PARKER : Well firstly, the size is really very important, because it means the device can be placed almost anywhere in the body. The second thing that is really important is that we can achieve a level of fine control over what the device does, because it has many more channels than existing devices. DESLEY BLANCH : Well, the device as you said is fully implantable and it's designed to treat chronic pain. Now, lower back pain comes to mind as an obvious site of pain but are there other parts of the body which would suit this device? DR JOHN PARKER : Well, the pain can come from almost anywhere, so from lower limbs, from the arms. These sorts of devices are currently even being used to treat things like migraine and heart pain or angina as well. DESLEY BLANCH : So there is not a place in the body that it really can't be positioned? DR JOHN PARKER : No, not really, that's the whole aim. DESLEY BLANCH : OK, for your human trials, you plan to implant it near the spinal cord. Is the performance of the device enhanced because of its size and where it's placed? DR JOHN PARKER : Yes, very much so, because one of the big problems with existing devices is that because they're large, you need a lot of cabling to connect the electrode which is next to the nerve to the device that generates the stimulus. And because there's a lot of cabling, you can imagine you can't really put a whole bunch of wires in that cabling because it gets stiff. Every wire that you add makes it quite stiff and the stiffer it becomes, the more prone to breakage and so on. With our concepts, we don't have any of those problems because the leads themselves can be very short, which means they can have a large number of wires in them and that gives us all of the fine control and ability to really target the tissue in very nice ways. DESLEY BLANCH : Just tell us how the device works, what do you do? DR JOHN PARKER : So the way the device works is you pass a tiny current between two electrodes that are placed near the nerve that you're trying to stimulate. In the case of pain, what you're trying to do is stimulate a group of fibres that actually inhibit the transmission of the pain signals from wherever they're originating in the body up through the spinal cord to the brain, so you don't feel them. DESLEY BLANCH : So how does the Smart Chip disrupt the pain signals so that the patient feels less pain? DR JOHN PARKER : Well, it disrupts it because there's one group of fibres that are in the spinal cord: one type of nerve that actually switches off the transmission of signals from the pain fibres. There's a famous theory of how this works, which is called the Gate Theory Control of Pain -- it's like a little gate; you turn on one group of fibres and it gates - it switches off the conduction of the information from another group of fibres. Now it's a little bit more complicated than that, but in principle that's how it works. DESLEY BLANCH : And does the chip emit some voltage electric pulses into the nerves, is that part of how it works? DR JOHN PARKER : Yes, that's right, so you pass a tiny current you need to generate 10 volts or more across two or three or four electrodes depending on how you set the thing up and that causes the axons that are in the nerve directly underneath it, to depolarise and generate propagating action potential which is how the nerves conduct in the first place. DESLEY BLANCH : You said before that you can manage different levels of pain. So how does the device give you the ability to fine tune it to what degree? You mentioned there are a lot of wires there. DR JOHN PARKER : It's all about the level of control, so one of the things you can do with lots and

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lots of electrodes is that you can adjust very precisely where the stimulus occurs. You can imagine that trying to put something inside the body in the case of the spinal cord, the electrodes are placed in the epidural space and that's the same area where anaesethetics are applied for epidural block during child birth, that's the procedure that's used there. So in terms of safety, it's a very safe procedure. It's something that's simple and safe to do. But in order to get really fine control it's very difficult to place something very accurately in that place, but what you want to do is be able to control the place of stimulation electrically just by adjusting where the locus of stimulation comes from and that means lots of electrodes and do that in a very precise way. DESLEY BLANCH : And it also has a tiny computer processor powered by a miniature battery, so how's the battery charged? DR JOHN PARKER : Well, it's charged exactly the same way that you charge your cordless toothbrush. There's a coil inside the implant itself and then there's a coil that's on the outside to be placed against the skin and it inductively charges it. DESLEY BLANCH : No need for any wires to come out of the body or exit the body? DR JOHN PARKER : Oh, certainly not. DESLEY BLANCH : That's a relief. Well there are applications far beyond treating chronic lower back pain, so what do you see as the future for this device? DR JOHN PARKER : Oh, neuromodulations are an enormously expanding field and there are applications for neuromodulation for things like Parkinson's Disease for essential tremor. There are some applications for things like Tourette Syndrome, Obsessive Compulsive Disorder. People have looked at using neuromodulation for weight control, epileptic seizures. Every month I go and have a look and there's even more applications for this type of technology. DESLEY BLANCH : So are you still on track for human trials to begin this year? DR JOHN PARKER : Ah yeah, we'll start testing some of the components of the system this year. We'll do that with some volunteer subjects that we have, yep. DESLEY BLANCH : And the device has been two years in development which is when you arrived at NICTAfrom Cochlear. They are the developers of another tiny device the Cochlear Implant for the deaf and your work with the bionic ear was recognised last year with Australia's most prestigious scientific award, a Clunies Ross Award. So I sincerely congratulate you on that. DR JOHN PARKER : Thanks so much. DESLEY BLANCH : And is this pain management miniature smart chip the first of the new generation of medical devices that you've come to NICTAto develop? DR JOHN PARKER : I hope so, yes. DESLEY BLANCH : Because you would have been miniaturising things back with the ear program. So what have you got in the pipeline? DR JOHN PARKER : Well, I'm really attracted to things that are broad based and big problems and so I don't know what solutions actually lie ahead, but I'm interested in things like blood pressure and vascular disease and chronic wound healing and things like that. I think there are applications, at least there have been some studies that show that neuromodulation might be able to help in some of those things and some of these diseases -they're not glamorous, but they are significant issues for a large number of people and particularly when they get to an advanced stage. They're very difficult things to deal with and so it'd be nice to have advanced treatments for those as well. DESLEY BLANCH : Will these treatments be along the same line that you have with the pain management system? DR JOHN PARKER : Well, I don't know yet. We'll see how we go. (laughs) DESLEY BLANCH : Wait til you invent them, hah! DESLEY BLANCH : So how will the pain management system be brought to market? DR JOHN PARKER : We're in the middle of preparing everything for a spin out company. The company will be called Saluda Medical and we're actively trying to raise money right now in order to support the commercial development of the technology. DESLEY BLANCH : So is there a guesstimate that you might have on its arrival in the marketplace? DR JOHN PARKER : Yeah well that depends on how successful we are at raising money. It's a big project. These sorts of devices are difficult and time consuming to develop and it's a 40 or a 50 million dollar exercise and as soon as we can attract the sufficient funding, then we can get started and after we get started, it should be a sort of a four to five year kind of project before it's available in the market place. DESLEY BLANCH : Are people coming forward, are they excited about the project, saying hey, here we are, here's our money? DR JOHN PARKER : Ah, we have a lot of interest from potential investors from overseas and there are a few things going on, but it would be nice to keep this as a home grown activity. DESLEY BLANCH : Dr John Parker is chief technology officer at NICTA, Australia's ICT Research Centre of Excellence and he was talking about their world-first miniature smart chip for treating chronic pain. Contact: Dr John Parker, Chief Technology Officer National ICT Australia (NICTA) Address: Implant Technologies

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Locked Bag 9013, Alexandria, NSW 1435 Email: john.parker@nicta.com.au Website: http://www.nicta.com.au

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