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New Brain-Computer Interface Allows Man with ALS to ‘Speak’ Again

The AHA! Team — Fri, 11 Oct 2024 08:20:41 +0000

UC Davis Health via Newswise – Technology developed by UC Davis Health restores interpersonal communication A new brain-computer interface (BCI) developed at UC Davis Health translates brain signals into speech with up to 97% accuracy — the most accurate system of its kind. The researchers implanted sensors in the brain of a man with severely impaired speech due to amyotrophic lateral sclerosis (ALS). The man was able to communicate his intended speech within minutes of activating the system. A study about this work was published today in the New England Journal of Medicine. ALS, also known as Lou Gehrig’s disease, affects the nerve cells that control movement throughout the body. The disease leads to a gradual loss of the ability to stand, walk and use one’s hands. It can also cause a person to lose control of the muscles used to speak, leading to a loss of understandable speech. The new technology is being developed to restore communication for people who can’t speak due to paralysis or neurological conditions like ALS. It can interpret brain signals when the user tries to speak and turns them into text that is ‘spoken’ aloud by the computer. “Our BCI technology helped a man with paralysis to communicate with friends, families and caregivers,” said UC Davis neurosurgeon David Brandman. “Our paper demonstrates the most accurate speech neuroprosthesis (device) ever reported.” Brandman is the co-principal investigator and co-senior author of this study. He is an assistant professor in the UC Davis Department of Neurological Surgery and co-director of the UC Davis Neuroprosthetics Lab. The new BCI breaks the communication barrier When someone tries to speak, the new BCI device transforms their brain activity into text on a computer screen. The computer can then read the text out loud. To develop the system, the team enrolled Casey Harrell, a 45-year-old man with ALS, in the BrainGate clinical trial. At the time of his enrollment, Harrell had weakness in his arms and legs (tetraparesis). His speech was very hard to understand (dysarthria) and required others to help interpret for him. In July 2023, Brandman implanted the investigational BCI device. He placed four microelectrode arrays into the left precentral gyrus, a brain region responsible for coordinating speech. The arrays are designed to record the brain activity from 256 cortical electrodes. “We’re really detecting their attempt to move their muscles and talk,” explained neuroscientist Sergey Stavisky. Stavisky is an assistant professor in the Department of Neurological Surgery. He is the co-director of the UC Davis Neuroprosthetics Lab and co-principal investigator of the study. “We are recording from the part of the brain that’s trying to send these commands to the muscles. And we are basically listening into that, and we’re translating those patterns of brain activity into a phoneme — like a syllable or the unit of speech — and then the words they’re trying to say.” Faster training, better results Despite recent advances in BCI technology, efforts to enable communication have been slow and prone to errors. This is because the machine-learning programs that interpreted brain signals required a large amount of time and data to perform. “Previous speech BCI systems had frequent word errors. This made it difficult for the user to be understood consistently and was a barrier to communication,” Brandman explained. “Our objective was to develop a system that empowered someone to be understood whenever they wanted to speak.” Harrell used the system in both prompted and spontaneous conversational settings. In both cases, speech decoding happened in real time, with continuous system updates to keep it working accurately. The decoded words were shown on a screen. Amazingly, they were read aloud in a voice that sounded like Harrell’s before he had ALS. The voice was composed using software trained with existing audio samples of his pre-ALS voice. At the first speech data training session, the system took 30 minutes to achieve 99.6% word accuracy with a 50-word vocabulary. “The first time we tried the system, he cried with joy as the words he was trying to say correctly appeared on-screen. We all did,” Stavisky said. In the second session, the size of the potential vocabulary increased to 125,000 words. With just an additional 1.4 hours of training data, the BCI achieved a 90.2% word accuracy with this greatly expanded vocabulary. After continued data collection, the BCI has maintained 97.5% accuracy. “At this point, we can decode what Casey is trying to say correctly about 97% of the time, which is better than many commercially available smartphone applications that try to interpret a person’s voice,” Brandman said. “This technology is transformative because it provides hope for people who want to speak but can’t. I hope that technology like this speech BCI will help future patients speak with their family and friends.” The study reports on 84 data collection sessions over 32 weeks. In total, Harrell used the speech BCI in self-paced conversations for over 248 hours to communicate in person and over video chat. “Not being able to communicate is so frustrating and demoralizing. It is like you are trapped,” Harrell said. “Something like this technology will help people back into life and society.” “It has been immensely rewarding to see Casey regain his ability to speak with his family and friends through this technology,” said the study’s lead author, Nicholas Card. Card is a postdoctoral scholar in the UC Davis Department of Neurological Surgery. “Casey and our other BrainGate participants are truly extraordinary. They deserve tremendous credit for joining these early clinical trials. They do this not because they’re hoping to gain any personal benefit, but to help us develop a system that will restore communication and mobility for other people with paralysis,” said co-author and BrainGate trial sponsor-investigator Leigh Hochberg. Hochberg is a neurologist and neuroscientist at Massachusetts General Hospital, Brown University and the VA Providence Healthcare System. Brandman is the site-responsible principal investigator of the BrainGate2 clinical trial. The trial is enrolling participants. To learn more about the study, visit braingate.org or contact braingate@ucdavis.edu. A complete list of coauthors and funders is available in the article. Caution: Investigational device. Limited by Federal law to investigational use. To read the original article click here.

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Breakthrough UC San Diego Brain Recording Device Receives FDA Approval for a Clinical Trial

The AHA! Team — Fri, 02 Aug 2024 08:21:00 +0000

University of California San Diego via Newswise – The Federal Drug Administration approved a clinical trial to test the effectiveness of an electronic grid that records brain activity during surgery, developed by engineers at the University of California San Diego. The device with nanoscale sensors records electrical signals directly from the surface of the human brain in record-breaking detail. The grid’s breakthrough resolution could provide better guidance for planning and performing surgeries to remove brain tumors and treat drug-resistant epilepsy. The grid’s higher resolution for recording brain signals could improve neurosurgeons’ ability to minimize damage to healthy brain tissue. During epilepsy surgery, the novel grid could improve the ability to precisely identify the regions of the brain where epileptic seizures originate for safe and effective treatment. The new brain sensor array, known as platinum nanorod grid (PtNRGrid) features a densely packed grid of a record-breaking 1,024 embedded electrocorticography (ECoG) sensors. The device rests on the surface of the brain and is approximately 6 microns thin–smaller than one tenth of the human hair–and flexible. As a result, it can both adhere and conform to the surface of the brain, bending as the brain moves while providing high-quality, high-resolution recordings of brain activity. In contrast, the ECoG grids most commonly used in surgeries today typically have between 16 and 64 sensors. These grids are rigid, stiffer and more than 0.5 mm in thickness and do not conform to the curved surface of the brain. The PtNRGrid was invented by Shadi Dayeh, a Professor in the Department of Electrical and Computer Engineering at the University of California San Diego and members of his team. Over the years, the team developed the PtNRGrid technology in collaboration with neurosurgeons and medical researchers from UC San Diego, Massachusetts General Hospital (MGH) and Oregon Health & Science University (OHSU). “This accomplishment ushers in a new era of clinical neuroscience and neuromonitoring,” Dayeh said. “We are very excited to receive the FDA approval to apply our groundbreaking PtNRGrid in a clinical setting. It is a credit to the hard work of my team members who worked tirelessly to meet the quality criteria mandated by the FDA. I am also grateful to my clinical partners, the support of the NIH, and to the campus leadership that fostered an impactful ecosystem across engineering and medicine to transform the future of healthcare.” The FDA approved an investigational device exemption (IDE) for a “pivotal study [titled] “Systematic Evaluation of Platinum Nanorod Grids (PtNRGrids) for Intraoperative Mapping and Neurophysiological Monitoring (IONM) During Brain Surgeries.” Specifically, the clinical trial is designed to demonstrate the effectiveness of the PtNRGrid device to map both normal and pathological brain activity. During the trial, UC San Diego engineers will partner with clinician-scientists: Drs. Sharona Ben-Haim and Eric Halgren at UC San Diego, Dr. Sydney Cash at MGH, and Dr. Ahmed Raslan at OHSU. In a first phase, surgeons will implant the PtNRGrid in 20 patients, then measure and compare the grid’s performance with the present state-of-the-art. The PtNRGrid will be deployed in surgeries to remove brain tumors and to remove tissue that causes epileptic seizures. Record-breaking density Dayeh’s team has pioneered human brain and spinal cord mapping with thousands of channels since 2019, and has reported early safety and efficacy results in a series of articles published in Science Translational Medicine in 2022 in human subjects. PtNRGrid is the only device with thousands of channels to demonstrate in peer-reviewed publications that it can map motor and language brain activity, as well as epileptic discharges, by producing panoramic videos of brain waves over 10 square centimeters of the brain’s cortex while maintaining resolution at a microscopic level. Currently, Dayeh’s research group holds the world record of recording brain activity from a single cortical grid with 2,048 channels on the surface of the human brain published in Science Translational Medicine in 2022. The device was used in the operating room of Dr. Ahmed Raslan of the OHSU. Since then, the team has increased the number of recording channels to 4,096 and continues to work on increasing the number of channels in the grid to monitor brain activity in even higher resolution. Pending success of this staged trial, the team will transition to the next crucial step of making the PtNRGrid available for commercial use at scale. Demonstrating that ECoG grids with sensors in the thousands of channels record brain activity with high fidelity also opens new opportunities in neuroscience for uncovering a deeper understanding of how the human brain functions. Basic science advances, in turn, could lead to improved treatments grounded in enhanced understanding of brain function. “Our goal is to provide a new atlas for understanding and treating neurological disorders, working with a network of highly experienced clinical collaborators at UC San Diego, MGH, and OHSU,” Dayeh said. Dayeh’s work toward the FDA approval is supported by an NIH BRAIN® Initiative award # UG3NS123723. To read the original article click here.

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Surprising Reasons You May Be Anxious + How to Use the Neurocycle to Manage & Reduce Anxiety

AHA Publisher — Thu, 24 Jun 2021 07:00:33 +0000

Dr. Caroline Leaf – In this podcast (episode #286) and blog, I am going to talk about anxiety. I get asked so many questions about anxiety, what it is, and how to manage it that I decided to dedicate a whole podcast to this topic. Here are some examples of the questions I have received: Why do I feel anxious in certain situations and not others? Why does my whole body react (to the point where I feel sick) when I am anxious? Why do some situations result in more anxiety than others? What do I do when I feel constantly anxious around a loved one or work colleague? What do you tell your mind to ward off PTSD-related anxiety when emotionally triggered? Can you give insight into how to control anxiety or being panicked when left alone and how to keep your mind at peace? Is anxiety genetic? Can it be wired in relation to a specific fear? What is hypervigilance? Everyone experiences a level of anxiety from time to time; this is completely normal. Often, there are times in our life where “stuff” really accumulates, and it is okay to be anxious occasionally. However, if left unmanaged, this “stuff” can progress to a point where we feel so overwhelmed with anxiety that our ability to go about daily life is obstructed, especially if it results in debilitating anxiety or a panic attacks. The key word here is “managed”. How we manage anxiety will be based on how we view anxiety. If we just see anxiety as a “disease” or “biochemical medical illness”, it can be pretty scary! This label can lock us in, potentially shaping the way we see ourselves and our capacity, or stigmatizing our biology—some people may view us as inherently lacking control and potentially unstable or even dangerous to ourselves and others. But there is another way to look at anxiety, one that I believe is more hopeful, kinder and less stigmatizing. Anxiety can be seen as a warning signal—a helpful messenger. It is telling us there is something going on in our lives that needs attention because it’s threatening our peace and survival. It’s pointing to the narrative that is related to our anxiety, that is what has happened to make us feel this way, rather than just focusing on a biological root as the cause of the anxiety. Indeed, what we think and experience affects our biology, so of course we will experience anxiety as physical symptoms. The cause isn’t necessarily in the brain, although, of course, physical brain damage or ill-health can affect how we feel and make us anxious. However, if we think the anxiety we are feeling and experiencing is just because we have a damaged brain or body, we can lose hope and a sense of agency, which may make our anxiety worse. We need to remember that the brain is not a preprogrammed body of grey matter. We do not just “dance to our DNA”, as the popular saying goes. Anxiety isn’t just a broken brain or illness waiting to manifest. Anxiety means that we, as thinking beings, are responding intelligently to threats to our existence. When there is a foreboding change in our environment, we experience this change through our mind. The mind is the power mechanism by which we experience life, but it is experimental because it’s always hypothesizing and working things out. This means things can get messy, but that’s okay—the point is to look at the messiness of life and learn how to manage, repair and grow through it. This is mind-management in action, which I discuss in detail in my latest book Cleaning Up Your Mental Mess. The experiences we have are then wired into the brain by the mind. Subsequently, the brain sends signals to all the cells of the body that there is a change in the mind and brain, and, in the case of a negative experience, that change is a threat to our survival. This generates an immune system response, and the entire body responds, including the release of cortisol, homocysteine, prolactin, as well as a biological impact on our telomeres and a change in brainwaves. These responses are communicated back to us through our emotions (anxiety), body (heart palpitations, stomach aches and so on), behaviors (such as panic attacks, withdrawal, or hasty decisions), and perspective, which is a warning signal of this imbalance as a threat to or survival and the desire to restore balance in the brain and body. This is why it is so important to embrace, not suppress, anxiety. We need to acknowledge the abovementioned signals, process what they mean and reconceptualize them – make them work for us instead of against us. When we learn how to do this, we can start to manage, although not necessarily solve, our anxiety. Indeed, sometimes it’s the pure acceptance of the uncertainty of life and the reality of anxiety as a normal part of being human that becomes our reconceptualized understanding—our way of moving forward! Anxiety is a feeling that needs to be understood, not just eradicated. Why? We cannot ignore the connection between our perceptions and our understanding of our experiences to our biology. This link, otherwise known as the mind-brain-body connection, helps us to predict what we need as individual organisms to cope, or to modulate our biochemistry, physiology and our behavior to make sure our body has just enough resources to deal with both acute and chronic life challenges. For example, when we find ourselves in an anxiety-inducing situation, the brain signals the kidneys, telling them that we are going to need a healthy blood supply for the acute situation we find ourselves in. Consequently, the kidneys start pumping in salt water, which constricts the blood vessels and raises our blood pressure. However, if we are on alert every second of the day, especially during a chronic situation, this experience will be wired into the brain repeatedly, which can become a habit if this occurs over 9 weeks (for more on this my book Cleaning Up Your Mental Mess). Essentially, during this time the mind is continually sending a response to the brain and body that something scary is going to happen, which can result in hypervigilance if left unmanaged, putting the brain and body into an emergency state. To cope with these feelings, our level of alertness and various bodily activities must respond to this state of being. Using the same example above, this means the brain is continually telling our kidneys that we need more blood supply, so the kidneys are continually pumping in salt water to constrict the blood vessels, which can have negative repercussions, such as high blood pressure, if we do not learn how to manage this response. If we’re constantly living in a high-alert state, the natural mechanisms of the brain and body stay in high alert, which can have all sorts of mental, emotional and physical consequences. Of course, many people suffer from anxiety, and there are manifold reasons why someone may experience anxiety, such as divorce, poverty, racial inequality, bullying, and war. Getting to the root of these reasons is essential when learning how to manage anxiety. There are also a few surprising reasons why we may be experiencing anxiety, such as: 1. Bad digestion: The gut microbiome, which is the world of bacteria living in our digestive system, doesn’t just exist to help us break down food. There is a constant conversation going on between the brain and gut, which also has its own amazing neurons, just like the spinal cord! This relationship is incredibly important when it comes to our mental health, which is both directly and indirectly affected by what we eat. In fact, a growing body of research shows that certain gut bacteria not only influence thought processes and the physical structure of the brain, but also that our thought processes and physical structure of the brain affect our gut bacteria. As I told all my patients in my clinical practice (and anyone who asks me today), what we eat affects how we think, and how we think affects what we eat and how we digest food! So, watch what you eat—try to avoid too much processed food, eating too fast, eating on the go and eating too much, all of which can contribute to increased anxiety levels! 2. Multitasking: When we multitask, we end up with what I call “milkshake thinking”, which is the opposite of mindfulness. Every rapid, incomplete, and poor quality shift of thought makes a “milkshake” with our brain cells and neurochemicals, which is the opposite of how the brain is designed to function. When we consciously try to jump rapidly from one task to another, we essentially cloud our ability to concentrate and think deeply, which impacts our ability to do a task well, leading to unnecessary levels of anxiety in our life. This is why I always recommend choosing to focus on one thing. Where you direct your mind is a choice, one that can affect you in either a positive or negative direction. This is especially the case with multitasking. You can reduce the anxiety that comes from decision fatigue—the feeling of being overwhelmed by the plethora of “would” or “could” choices we all face daily—by choosing, in the moment, to stay focused on a task and disregard less urgent demands. When you do this, you actually build up your mental strength and resilience, which will help you better deal with disappointment, failure and the daily anxieties of life! 3. The search and reward circuit: There is a special circuit in the brain that helps us search for food, comfort, love, relationships, friendships, peace, and so on, called the search and reward circuit. (Much of the research in this area of neuroscience has been done by Peter Sterling.) When we experience these positive experiences, dopamine is released and we can relax until we start the next search. Essentially, we are built to seek out a way of life that rewards us with a dopamine rush—the little searches and little dopamine rushes drive us to seek these rewards, which has a cumulative effect. Often, we are driven by these frequent, small surprises, and if we don’t find them, we can get agitated or anxious. This is especially true if we are in a chronic, unmanaged stress state—we don’t experience this rush as much as we need to, which can make us anxious. 4. Not daydreaming enough: When we don’t give our minds a break and let them just wander and daydream, we can end up feeling really anxious and stressed out. This kind of thinking is not just “nonsense” or “distracted” thinking. When we daydream, we essentially reboot our mind, as talked about in Cleaning Up Your Mental Mess. These moments give your brain a rest and allow it to heal, which increases your clarity of thought and organizes the networks of your brain by balancing alpha activity, helping create an optimal state of relaxation and alertness and bridging the divide between the conscious and nonconscious mind. This, in turn, puts you in a state of peacefulness, readiness, meditation, and beta activity, which is important for processing information, being alert, working through something challenging, focusing, and developing sustained attention. This balanced energy, in turn, increases blood flow to the brain, which helps it function better and helps you deal with mental challenges and manage anxiety. The opposite happens if you don’t take regular thinker moments. Not giving the mind a rest and letting it daydream can reduce blood flow by up to 80 percent in the front of the brain, which can dramatically affect cognitive fluency and the efficient, associative thinking required at home, school or in the workplace. Cumulatively, this can lead to unprocessed thoughts and nightmares, affecting your overall quality of sleep, performance and mental health. To do a thinker moment, simply close your eyes and let your mind wander. Daydream, listen to some music, take a walk outside,...

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BrainGate: First Human Use of High-Bandwidth Wireless Brain-Computer Interface

AHA Publisher — Wed, 07 Apr 2021 07:00:48 +0000

Brown University via Newswise – PROVIDENCE, R.I. [Brown University and Providence Veterans Affairs Medical Center] — Brain-computer interfaces (BCIs) are an emerging assistive technology, enabling people with paralysis to type on computer screens or manipulate robotic prostheses just by thinking about moving their own bodies. For years, investigational BCIs used in clinical trials have required cables to connect the sensing array in the brain to computers that decode the signals and use them to drive external devices. Now, for the first time, BrainGate clinical trial participants with tetraplegia have demonstrated use of an intracortical wireless BCI with an external wireless transmitter. The system is capable of transmitting brain signals at single-neuron resolution and in full broadband fidelity without physically tethering the user to a decoding system. The traditional cables are replaced by a small transmitter about 2 inches in its largest dimension and weighing a little over 1.5 ounces. The unit sits on top of a user’s head and connects to an electrode array within the brain’s motor cortex using the same port used by wired systems. For a study published in IEEE Transactions on Biomedical Engineering, two clinical trial participants with paralysis used the BrainGate system with a wireless transmitter to point, click and type on a standard tablet computer. The study showed that the wireless system transmitted signals with virtually the same fidelity as wired systems, and participants achieved similar point-and-click accuracy and typing speeds. “We’ve demonstrated that this wireless system is functionally equivalent to the wired systems that have been the gold standard in BCI performance for years,” said John Simeral, an assistant professor of engineering (research) at Brown University, a member of the BrainGate research consortium and the study’s lead author. “The signals are recorded and transmitted with appropriately similar fidelity, which means we can use the same decoding algorithms we used with wired equipment. The only difference is that people no longer need to be physically tethered to our equipment, which opens up new possibilities in terms of how the system can be used.” The researchers say the study represents an early but important step toward a major objective in BCI research: a fully implantable intracortical system that aids in restoring independence for people who have lost the ability to move. While wireless devices with lower bandwidth have been reported previously, this is the first device to transmit the full spectrum of signals recorded by an intracortical sensor. That high-broadband wireless signal enables clinical research and basic human neuroscience that is much more difficult to perform with wired BCIs. The new study demonstrated some of those new possibilities. The trial participants — a 35-year-old man and a 63-year-old man, both paralyzed by spinal cord injuries — were able to use the system in their homes, as opposed to the lab setting where most BCI research takes place. Unencumbered by cables, the participants were able to use the BCI continuously for up to 24 hours, giving the researchers long-duration data including while participants slept. “We want to understand how neural signals evolve over time,” said Leigh Hochberg, an engineering professor at Brown, a researcher at Brown’s Carney Institute for Brain Science and leader of the BrainGate clinical trial. “With this system, we’re able to look at brain activity, at home, over long periods in a way that was nearly impossible before. This will help us to design decoding algorithms that provide for the seamless, intuitive, reliable restoration of communication and mobility for people with paralysis.” The device used in the study was first developed at Brown in the lab of Arto Nurmikko, a professor in Brown’s School of Engineering. Dubbed the Brown Wireless Device (BWD), it was designed to transmit high-fidelity signals while drawing minimal power. In the current study, two devices used together recorded neural signals at 48 megabits per second from 200 electrodes with a battery life of over 36 hours. While the BWD has been used successfully for several years in basic neuroscience research, additional testing and regulatory permission were required prior to using the system in the BrainGate trial. Nurmikko says the step to human use marks a key moment in the development of BCI technology. “I am privileged to be part of a team pushing the frontiers of brain-machine interfaces for human use,” Nurmikko said. “Importantly, the wireless technology described in our paper has helped us to gain crucial insight for the road ahead in pursuit of next generation of neurotechnologies, such as fully implanted high-density wireless electronic interfaces for the brain.” The new study marks another significant advance by researchers with the BrainGate consortium, an interdisciplinary group of researchers from Brown, Stanford and Case Western Reserve universities, as well as the Providence Veterans Affairs Medical Center and Massachusetts General Hospital. In 2012, the team published landmark research in which clinical trial participants were able, for the first time, to operate multidimensional robotic prosthetics using a BCI. That work has been followed by a steady stream of refinements to the system, as well as new clinical breakthroughs that have enabled people to type on computers, use tablet apps and even move their own paralyzed limbs. “The evolution of intracortical BCIs from requiring a wire cable to instead using a miniature wireless transmitter is a major step toward functional use of fully implanted, high-performance neural interfaces,” said study co-author Sharlene Flesher, who was a postdoctoral fellow at Stanford and is now a hardware engineer at Apple. “As the field heads toward reducing transmitted bandwidth while preserving the accuracy of assistive device control, this study may be one of few that captures the full breadth of cortical signals for extended periods of time, including during practical BCI use.” The new wireless technology is already paying dividends in unexpected ways, the researchers say. Because participants are able to use the wireless device in their homes without a technician on hand to maintain the wired connection, the BrainGate team has been able to continue their work during the COVID-19 pandemic. “In March 2020, it became clear that we would not be able to visit our research participants’ homes,” said Hochberg, who is also a critical care neurologist at Massachusetts General Hospital and director of the V.A. Rehabilitation Research and Development Center for Neurorestoration and Neurotechnology. “But by training caregivers how to establish the wireless connection, a trial participant was able to use the BCI without members of our team physically being there. So not only were we able to continue our research, this technology allowed us to continue with the full bandwidth and fidelity that we had before.” Simeral noted that, “Multiple companies have wonderfully entered the BCI field, and some have already demonstrated human use of low-bandwidth wireless systems, including some that are fully implanted. In this report, we’re excited to have used a high-bandwidth wireless system that advances the scientific and clinical capabilities for future systems.” To read the original article click here.

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Researchers Discover Stem Cells in Optic Nerve That Preserve Vision

AHA Publisher — Fri, 31 Jul 2020 07:00:03 +0000

University of Maryland School of Medicine via EurekAlert – Researchers at the University of Maryland School of Medicine (UMSOM) have for the first time identified stem cells in the region of the optic nerve, which transmits signals from the eye to the brain. The finding, published this week in the journal Proceedings of the National Academy of Sciences (PNAS), presents a new theory on why the most common form of glaucoma may develop and provides potential new ways to treat a leading cause of blindness in American adults. “We believe these cells, called neural progenitor cells, are present in the optic nerve tissue at birth and remain for decades, helping to nourish the nerve fibers that form the optic nerve,” said study leader Steven Bernstein, MD, PhD, Professor and Vice Chair of the Department of Ophthalmology and Visual Sciences at the University of Maryland School of Medicine. “Without these cells, the fibers may lose their resistance to stress, and begin to deteriorate, causing damage to the optic nerve, which may ultimately lead to glaucoma.” The study was funded by the National Institutes of Health’s National Eye Institute (NEI), and a number of distinguished researchers served as co-authors on the study. More than 3 million Americans have glaucoma, which results from damage to the optic nerve, causing blindness in 120,000 U.S. patients. This nerve damage is usually related to increased pressure in the eye due to a buildup of fluid that does not drain properly. Blind spots can develop in a patient’s visual field that gradually widen over time. “This is the first time that neural progenitor cells have been discovered in the optic nerve. Without these cells, the nerve is unable to repair itself from damage caused by glaucoma or other conditions. This may lead to permanent vision loss and disability,” said Dr. Bernstein. “The presence of neural stem/progenitor cells opens the door to new treatments to repair damage to the optic nerve, which is very exciting news.” To make the research discovery, Dr. Bernstein and his team examined a narrow band of tissue called the optic nerve lamina. Less than 1 millimeter wide, the lamina lies between the light-sensitive retina tissue at the back of the eye and the optic nerve. The long nerve cell fibers extend from the retina through the lamina, into the optic nerve. What the researchers discovered is that the lamina progenitor cells may be responsible for insulating the fibers immediately after they leave the eye, supporting the connections between nerve cells on the pathway to the brain. The stem cells in the lamina niche bathes these neuron extensions with growth factors, as well as aiding in the formation of the insulating sheath. The researchers were able to confirm the presence of these stem cells by using antibodies and genetically modified animals that identified the specific protein markers on neuronal stem cells. “It took 52 trials to successfully grow the lamina progenitor cells in a culture,” said Dr. Bernstein, “so this was a challenging process.” Dr. Bernstein and his collaborators needed to identify the correct mix of growth factors and other cell culture conditions that would be most conducive for the stem cells to grow and replicate. Eventually the research team found the stem cells could be coaxed into differentiating into several different types of neural cells. These include neurons and glial cells, which are known to be important for cell repair and cell replacement in different brain regions. This discovery may prove to be game-changing for the treatment of eye diseases that affect the optic nerve. Dr. Bernstein and his research team plan to use genetically modified mice to see how the depletion of lamina progenitor cells contributes to diseases such as glaucoma and prevents repair. Future research is needed to explore the neural progenitors repair mechanisms. “If we can identify the critical growth factors that these cells secrete, they may be potentially useful as a cocktail to slow the progression of glaucoma and other age-related vision disorders.” Dr. Bernstein added. The work was supported by NEI grant RO1EY015304, and by a National Institutes of Health shared instrument grant 1S10RR26870-1. “This exciting discovery could usher in a sea change in the field of age-related diseases that cause vision loss,” said E. Albert Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. “New treatment options are desperately needed for the millions of patients whose vision is severely impacted by glaucoma, and I think this research will provide new hope for them.” To read the original article click here.

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