By Sally Voth
Attendees at a medical symposium Friday watched as amputees and quadriplegics literally put mind over matter to use ground-breaking prostheses that could be available within months.
Valley Health's Neuroscience Center at Winchester Medical Center and the Winchester Medical Center Foundation presented the all-day neuroscience symposium at Lord Fairfax Community College.
Among the topics covered were the use of opioids for pain management, neurotrauma in children, epilepsy and transcranial magnetic stimulation for depression.
Dr. Geoffrey Ling was the keynote speaker, giving two presentations. In the afternoon, he discussed strides being made in prostheses.
Ling, the acting deputy director of the Defense Sciences Office of the Defense Advanced Research Projects Agency (DARPA), showed a video his Army unit took of trauma patients at the 86th Combat Support Hospital in Iraq.
The hospital had a 96 percent survival rate, according to the video, which showed harrowing images of soldiers with shredded and missing limbs, and injuries which turned body parts to pulp.
"If you ever want to know what war is like, that's war," Ling said at the end of the video.
According to his biography on DARPA's website, Ling retired from the U.S. Army Medical Corps last year at the rank of colonel, served in both Iraq and Afghanistan, and is a neuro critical care physician at Johns Hopkins Hospital.
After returning home, he decided there was a need for an advanced prosthetic research project. While there was a great deal of work being done on prosthetic legs, not as much was being done about arms, Ling said.
"Yes, it's a big organ, this leg, but it's a very simple one from a mechanical standpoint," he said. "That's very different from the arm. The hand is extremely complex."
The best device that had been available for missing hands was a hook, according to Ling. While cosmetic prostheses were available, they lacked function.
"The only way to get a better device than that, we felt, was to go out of myoelectrical control and go straight to neural control," Ling said.
Monkeys were fitted with electrodes as they moved cursors with a joystick, he said.
"As soon as the monkey thinks about moving, the arm moves," Ling said.
Those electrical signals in the monkeys' brains were decoded. The electrical impulses were then used to move the cursor without their arms.
Ling showed video of monkeys using their thoughts to move robotic arms for rewards.
He then showed amputees and paralyzed patients using prosthetic arms the research program has been able to develop in a five-year project. DEKA Research and Development Corp. -- which brought the world the Segway scooter -- is involved in the project, as is the Johns Hopkins University Applied Physics Lab, Ling said.
"We went out and got the best folks to work with," he said.
In the video, amputees were seen pouring water from a bottle into a cup, picking up grapes, eating cereal and using chopsticks with a "strap and go arm."
Ling said the production line is already set up to make the prosthetic arm, which is before the U.S. Food and Drug Administration, awaiting approval. He expects that approval to come in the next two or three weeks, and the prostheses to be available by fall.
"It went from an idea to a commercial FDA-approved product in five years," Ling said.
He is also working on a more anthropomorphic neural arm. Ling showed footage of paralyzed patients using their thoughts to move a robotic arm. They had a little device implanted in their brain.
"If you want to know how related we are to the monkey, the monkeys thinking of moving their arms...those are the mathematical algorithms we used to translate those brain symbols into action," Ling said.
He concluded his presentation with another anecdote from Iraq. His patient, a California reservist, didn't want to return home to his job as a fast-food assistant manager.
"Here in Iraq, I get to help the Iraqis build a country of their own," Ling quoted the soldier as saying.
He said people may ask why the Department of Defense is spending money on prosthetic research.
"And my answer is, 'It's obvious,'" Ling said.
Contact staff writer Sally Voth at 540-465-5137 ext. 164, or firstname.lastname@example.org