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The Bionic Frontier

While Actor Christopher Reeve Has Focused Public Attention on the Distant Potential of Spinal Cord Regeneration, the Less Glamorous Science of Neuroprosthetics Is Quietly Remaking Broken Lives.

March 14, 2004|Simon LeVay | Simon LeVay was until 1992 a neuroscientist at the Salk Institute in La Jolla, and is best known for his research into the biological basis of sexual orientation. He is the co-author, with Curt Freed, of "Healing the Brain" and lives in West Hollywood.

Katie Lee Anderson doesn't say much on the July 2003, day when she arrives at St. Vincent Medical Center in downtown Los Angeles. Kirk and Laura Lee Anderson, parents of the slender, blond 19-year-old from Orem, Utah, do most of the talking. But Katie is definitely the focus of conversation, because later that day--if all goes well--she will make medical history. An array of electrodes will be inserted into the base of her brain, and she will become a living, breathing bionic woman.

Katie's hearing problem became apparent five years earlier, when she was 14. "She was no longer racing her siblings to answer the telephone," says her father. "When we asked her why, she said she couldn't hear on the phone." An MRI scan revealed the cause: noncancerous tumors were compressing the nerves that connected her inner ears to her brain. Her condition, called neurofibromatosis type 2, is genetic, but Katie is the only member of her large family to have it. Her hearing continued to deteriorate despite two operations. By the time she arrives in Los Angeles, she can't even hear claps of thunder. She speaks quite normally, but she can't follow the conversation well enough to join in.

Still, Katie opened up in a series of e-mails about the toll that deafness had taken on her life. "I wasn't a popular kid at school," she wrote, "and at some point I felt that I was a ghost because I didn't have a lot of friends. I would just sit there and be quiet...I couldn't really hear the teachers." After graduating, she worked for a while as a teacher's aide but eventually was laid off. Her co-workers were "complaining that I couldn't answer the phone and that it was a burden on them. I feel somewhat isolated from my friends' lives--because I'm hardly ever invited to do stuff with anyone."

Because Katie's auditory nerves no longer function, hearing aids or even cochlear implants can't help. Her world has grown excruciatingly small. So when her parents heard about a startling option in Los Angeles that hinted at the emerging science of "neuroprosthetics"--the use of electronic devices to substitute for damaged neural tissue--they began asking questions. The Andersons eventually brought their daughter here for a revolutionary treatment--one that offers a glimpse into what may be possible for those, like Katie, who have been betrayed by their bodies and can't wait for the nascent promise of brain or spinal-cord regeneration.

Since becoming a quadriplegic in 1995, actor-director Christopher Reeve has dedicated himself to the quest for spinal cord regeneration, the Holy Grail of neurology. The bulk of the money generated by the Christopher Reeve Paralysis Foundation has promoted research into biologically based therapies, such as stem-cell research that could regenerate damaged brain cells and possibly restore lost functions to patients such as Katie.

Given that, the decision to implant an electronic device into Katie's brain may come across as Rube Goldbergian, inadequate or unnecessary. Yet the biological therapies have been much slower to develop than researchers had hoped five years ago. Stem cells have proven tricky to control, and early clinical tests of gene therapy have caused at least one death and two cases of leukemia.

Neuroscientist Terry Hambrecht, a longtime researcher at the National Institutes of Health, understands why Katie and those like her pursue potential solutions now rather than wait for the next wave of scientific progress. "Regeneration, stem cells--they have tremendous promise, but I'm very skeptical that they are going to do anything useful in our lifetime," Hambrecht says. "Neuroprosthetics not only promises, but has delivered." Ross Nathan, a Long Beach-based hand surgeon who has implanted neuroprosthetic devices, echoes the point. "It's hard to get up there and criticize Reeve," he says. "You feel bad for him, and he does have good intentions. But his efforts are not improving anyone's quality of life, I believe."

Although Katie's operation was to be a world's first, scientists have been developing the field of neuroprosthetics for many years. Hambrecht, who started the NIH's neuroprosthetics program in 1972 and ran it until 1999, recalls an account of an experiment performed around 1800 by electricity pioneer Alessandro Volta. The ever-curious Italian put wires in each of his ear canals and connected them to his newly invented battery, which put out about 60 volts. "I received a shock in the head," wrote Volta, "and a few moments later, I began to be conscious of a sound, or rather a noise, in my ears that I cannot define clearly. Because of the disagreeable, and I feared dangerous, sensation of the jolt in the brain, I did not repeat the experiment." What Katie's doctors planned to do to her was, in principle, what Volta did to himself, but refined by two centuries of advances in neuroscience and electrical engineering.

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