Unusual as it may seem, there’s a direct link between curing feline incontinence and treating movement disorders, such as Parkinson’s Disease, in humans. And, it’s ongoing work at Duke University that has made this investigational transition possible.

It all boils down to knowing which spot in the brain to activate. For the past two decades, Duke researcher and faculty member Warren Grill, Ph.D., has used neural engineering – techniques to understand and control neural function – to pinpoint which brain locations control which activities. His research aims to advance the understanding of neural prostheses, a developing technology that uses electrical activation of the nervous system to restore function lost due to neurological impairment. The long-term goal, Grill said, is to recapture abilities through an advanced neural prostheses that can interface with the central nervous system.

“Our first work was to restore continence and emptying of the bladder in preclinical studies by putting electrodes in the grey matter of the spinal cord, and it worked very well,” he said. “But I didn’t see a translational path to putting electrodes like we were using in cats into humans and having them stay there for decades. How else could we get access to the same spinal circuits?”

The answer was using sensory fibers in the periphery to connect circuits via the synapses. Stimulating the sensory fibers in a certain pattern activates the same circuits that produce continence. This discovery led Grill to launch his first company, NDI (Neuro Device Innovations), in 2002.

The company, which was later purchased by Medtronic, produced a battery-powered, programmable and rechargeable electrode that can be implanted just below the beltline. The silver-dollar sized devices were clinically-proven to effectively treat overactive bladder, he said.

Grill also used the same neural prosthetic technology to create a second company, DBI (Deep Brain Innovations), that offers a new approach to the existing deep brain stimulation therapy for movement disorders. The current strategy works much like a pacemaker, sending a constant, rhythmic pulse to the brain. Grill’s device is different.

“It’s a novel way to do the same thing by changing the temporal pattern or stimulation,” he said. “It’s analogous to Morse Code. Instead of constantly sending dot-dot-dot, which can make it very difficult to communicate, we can pattern the stimulation so that it’s more effective.”

Varying the time between pulses creates a nearly infinite number of pulse patterns for treating movement disorders, he said. Using a generic mathematical algorithm with each patient helps pinpoint which pattern will be most effective and efficient for that individual. As a result, symptom suppression improves, and the device’s battery last longer than those used with conventional methods.

DBI’s next step, Grill said, will be to implement this strategy in clinical practice, and, then, partner with a larger medical device company.

And, at each step, Duke has provided significant support, he said. In addition to helping him navigate patents and licensing, the University also helped him manage any conflicts of interest.

“As a faculty member who’s conducting research and involved in the commercialization process, there are conflicts of interest,” Grill said. “The University has a system in place to manage those and allow faculty to play both of those roles in a forthright way.”

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Written by Whitney L.J. Howell

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