Conference Session B2 Paper # 2192 THE USE OF NEURAL IMPLANTS IN THE TREATMENT OF PARKINSON’S DISEASE Hailee Kulich (hrk6@pitt.edu), Rebecca Miller (rlm80@pitt.edu) Abstract—Diseases of the nervous system, such as Parkinson’s disease, epilepsy, Alzheimer’s and clinic depression, often have crippling effects on the human body. Patients diagnosed with these disorders frequently experience confusion, memory loss, muscle weakness, fatigue, headaches, changes in vision, loss of balance, seizures, and ultimately death. Sadly, there are few effective treatments for such ailments, causing patients to greatly suffer. Fortunately, a new biomedical technology is being developed with the potential to effectively treat and possibly cure some of these progressive and devastating neurodegenerative diseases. Neural, or brain, implants are essentially small chips inserted into a portion of the brain. These chips send out electrical impulses that communicate with surrounding neurons. In theory, neural implants can be integrated into the patient’s degenerating nervous system to provide symptom relief. This paper will discuss the design, mechanics, and function of neural implants, and how they allow for effective treatment of neurological disorders. Specifically, this paper will focus on the prospective benefits that neural implants can provide to patients with Parkinson’s disease. It will examine the effectiveness of neural implants in the treatment of Parkinson’s disease in the past and their implementation in the future. Finally, the ethical concerns surrounding this technology will be analyzed. welfare of patients is the neural implant. This small device uses electrical signals to communicate with surrounding neurons, stopping or even reversing the damage done by disorders of the nervous system. While this is a relatively new technology, neural implants, in theory, may be able to cure a number of degenerative neurological disorders, providing relief to thousands of patients. To be functional, neural implants must have a very specific design. Because each disease affects the brain differently, neural implants must be modeled differently as well. Mechanical design as well as placement with in the nervous system varies greatly between diseases. This presents challenges in the treatment of neurological disorders with neural implants due to the specificity needed for each disease. Perhaps the disease with the most successful history of neural implantation is Parkinson’s disease. Parkinson’s disease is a hypokinetic disorder, making it hard to initiate movement, or even move at all. When a portion of the brain known as the substansia nigra fails to produce dopamine, a neurotransmitter responsible for movement, patients lose their ability to control their own bodies [3]. Neural implants have been implemented in the treatment of Parkinson’s, but their use has not been completely successful. However, this treatment provides one of the best examples of the potential neural implants have in the treatment of disease. Although neural implants show much promise, there are many ethical concerns associated with their use. In the field of bioengineering, those researching new technology must fully comply with all legal and ethical, research guidelines, while respecting the rights of all test subjects [4]. There is much risk associated with the use of neural implants due to their electrical properties and the fragile nature of the nervous system. However, their potential to treat and even reverse some of the most deadly and painful diseases would be incredibly beneficial to patients worldwide who suffer from a neurological disorder. Because of them promise they show in one day being able to treat many neurological disorders, neural implants are a technology that is worth researching. Key Words—Key Words- bioengineering, bioelectrical engineering, brain implant, nervous system, neural implant, Parkinson’s disease NEURAL IMPLANTS One of the main goals of bioengineering is to provide improved or expanded treatment for commonly encountered medical disorders [1]. Neurological disorders, such as Parkinson’s disease, are examples of situations where the application of bioengineering may lead to an improvement in treatment options. Diseases of the nervous system are common medical conditions that currently have limited remedies. They often have crippling effects on the human body, causing headaches, impaired metal ability, loss of coordination, and eventually death [2]. Despite the severity of these symptoms, most neurological disorders have few, if any effective treatment options, causing patients to suffer greatly. Because of the demand for more viable options, much research is being done to relieve and hopefully cure patients suffering from neurological disorders. One option that has been developed in the hopes of improving the WHAT ARE NEURAL IMPLANTS? The use of electrical impulses to cure disease has been in practice for thousands of years. One prominent example of this in history can be seen by the Romans, who used applied current by electrical fish to alleviate pain caused by common disorders such as gout and rheumatism. While the Romans did not have a scientific understanding of why this treatment was effective, scientist today are able to use this bioelectric University of Pittsburgh Swanson School of Engineering February 10, 2012 1 Hailee Kulich Rebecca Miller phenomena to provide relief to thousands of patients who suffer from various diseases [5]. Neural implants are one type of technology that makes use of electrical properties to treat disease. By definition, a neural implant is an artificial extension of the body used to restore or enhance functions of the nervous system lost due to disease or injury [6]. They interact with various parts of the brain to enhance electrical communication between neurons. In doing this, neural implants seek to stop and in some cases reverse damage done by neurological disorders. coordination, back pain, and impaired mental ability. These symptoms are brought on by various reasons, including trauma, infection, blood flow disruption, tumors, and autoimmune disorders. However, perhaps the most common cause for neurological disorders has to do with neuron dysfunction or degeneration [2]. The electrical impulses given off by neural implants can improve or even replace the signaling between these defective neurons. In theory, this technology holds the potential to treat or even cure patients suffering from neurological disorders, greatly improving the quality of life for those impaired by diseases of the nervous system. The Function The nervous system is a complex network of organs that coordinates bodily activities while maintaining homeostasis. It is comprised of two different parts: the central nervous system, consisting of the brain and spinal cord, and the peripheral nervous system, containing all other neural elements [2]. The main functional unit of the nervous system is the neuron, which receives information from other parts of the nervous system, processes it, and then outputs it to surrounding neurons. Each neuron is connected to about 5,000 to 200,000 surrounding neurons, meaning the magnitude of information processed by the nervous system at one time is colossal [7]. There are three regions in a neuron that allow it to communicate with surrounding cells: the dendrites, axon, and axon terminal. Neurological signals are received by the dendrites, travel along the axon, and are sent to surrounding neurons through the axon terminal. Neurons can communicate either chemically or electrically through a process better known as neurotransmission. Chemical neurotransmission occurs at chemical synapse between an axon and a dendrite. This process is controlled by neurotransmitters, which act as chemical messengers between cells. Electrical neurotransmission occurs at electrical synapse, located between two dendrites. The neurons are physically connected to each other at a location known as a gap junction. This allows electrical signals to flow freely between neurons [7]. Neural implants simulate the process of electrical neurotransmission. In people who suffer from neurological disorders, the electrical communication between neurons may be damaged or inefficient [2]. Neural implants modulate electrical activity of neurons, mimicking the process that patients with damaged neurons cannot perform [6]. DESIGN OF NEURAL IMPLANTS The design of a neural implant depends upon the specific intended function of that implant. Neural implants have the potential to treat many different neurological diseases. For each disease, the mechanical designs, placement in the brain, and processes to improve symptoms are very dissimilar. This is because neurological disorders target various parts of the brain, requiring electrical stimulation in a location specific to each disease. The corresponding neural implant used to treat a specific neurological disorder has its own mechanical design and compositional materials. These should mimic the biological structure of the targeted tissue [5]. For example, a neural implant known as a deep brain stimulator is used specifically in the treatment of Parkinson’s disease. Mechanical Designs There are many basic units common among neural implants that are independent of the disease being treated. The main electronic components in every neural implant are the battery, receiver, amplifier, and current source, which are usually placed in a hermetically sealed titanium or ceramic housing. The electrical connections lead to electrodes or a coil placed outside the housing for continuous data transfer and energy supply. There are measures put into place that prevent failure of neural implants and facilitate surgical procedures for implantation and replacement [5]. Neural implants specific to the treatment of Parkinson’s disease involve deep brain stimulation. The bilateral implantation of a needle-like electrode in the areas of the brain containing the basal ganglia, thalamic nuclei, or subthalamic nuclei helps to suppress dyskinesia, or lack of muscle control. This needle-like implant is connected to a titanium housed stimulator and battery which is located in the chest area. The electrodes of the power supply in the chest are connected to the implant in the brain via intravenous cables and plugs [5]. This effective design allows for successful improvements in those patients with Parkinson’s disease. The Purpose The main objective of a neural implant is to stimulate, record, or block electrical signals from surrounding groups of neurons [6]. By doing this, communication within the nervous system improves greatly. Patients with diseases of the nervous system experience many crippling symptoms, including chronic headaches, loss of sensation, muscle fatigue and weakness, tremors, seizures, lack of 2 Hailee Kulich Rebecca Miller Many tests have been done with polymers, analyzing the best layout for the neural implant with these specified materials, and research has shown that it is possible to maximize flexibility and minimize instability [9]. Many different types of polymers have been tested such as, Polymide, Parylene C, PDMS, SU-8, and LCP. Although they all may behave slightly different, they have all been found to be successful in neural implants. Polymers have been enabling neural implants to develop and produce the vast majority of neural-technical interfaces that exist today. The ability of certain polymers to adapt to the conditions of the surrounding tissue is vital to manufacture stable interfaces that can work dependably over countless years without harming the body. The success stories of any neural implants in clinical practice show that polymers can fulfill the surface, structural, and stability requirements need for an effective technology [8]. Compositional Materials It is very important that a neural implant creates an effective interface between the nervous tissue of the brain and the technical material of the device. This interface determines the success or failure of the implant, as the recording of nerve signals and stimulation of nerve cells take place there. The mechanical properties of the biological tissue and the physical limitations of the implant site such as space and movement of the nerves versus muscles, skin, and bones need to be taken into account when choosing materials for implant manufacture. The initial reaction of the immune system to a foreign species is to attack it. The biocompatibility of certain polymers is much greater than other materials, and thus makes polymers one of the best materials to choose to develop the most successful interface [8]. Any implant is intended to have minimal anatomical impact on the body. However, any type of surgical intervention to initially embed the implant will cause a swelling response. In the presence of a foreign body, such as the implant, this response tends to be heightened and extended. Also, the initial immune response to rid the body of the foreign species will occur. By analyzing surface biocompatibility, one can choose a material that deals with all viewpoints of chemical and biological interaction with the implant. The materials and coatings must be chosen so that the reaction after implantation is minimized and that reactive cells are transferred into their inactivated state after the healing reaction is terminated. The material must not cause large inflammation after surgical intervention and cell behavior must not be altered by toxic products diffusing from the material itself. If these specifications are met, a material can be considered a reasonable biomaterial [8]. Structural biocompatibilty is another aspect of choosing the proper material for an implant. This refers to the mechanical interaction of the tissue with the implant, including weight, shape, and flexibility. Poor structural biocompatibility will lead to a greater immune response to the implant, decreasing its efficiency. Also, it will lead to chronic inflammation that causes glial scars to form around electrodes, causing eventual electrode failure [8]. Biostability is the third and final aspect that must be considered when choosing materials for neural implants. Most of the implants stay within the human body for years. The battery powered electronics often get replaced after five to 10 years; however, the neuro-technical interface remains intact for decades. Biostability refers to the different chemical aspects with respect to material stability and system integrity. Metals should not corrode, and substrate and insulation layers should not delaminate or degrade [8]. Perhap the best materials currently being developed for use in neural implants are polymers. Polymers are shown to have high surface biocompatibility, insulation which is good for mounting electronic devices, and structural biocompatibility, having ideal weight, shape and flexibility. PARKINSON’S DISEASE Parkinson’s disease is a hypokinetic movement disorder, meaning that the ability to start movement and move smoothly is affected. It is the most common hypokinetic movement disorder, affecting over 1.2 million Americans. Parkinson’s disease affects a portion of the brain known as the basal ganglia. The cells of the basal ganglia maintain muscle tone as well as allow for smooth, controlled movement. A portion of the basal ganglia, known as the substantia nigra is responsible for the production of a neurotransmitter known as dopamine. While dopamine serves several purposes, one of its main functions is to control voluntary movement. As the cells in the substantia nigra begin to die, the production of dopamine decreases. When dopamine levels in the brain reach too low of a level, the ability to control movement is greatly hindered [3]. Signs and Symptoms There are four main signs that make Parkinson’s disease easily identifiable: tremor, rigidity, bradykinesia, and difficulties with balance [3]. A tremor is a rhythmic, involuntary shaking of part of the body, most commonly affecting the hands and feet. However, tremors can affect almost any part of the body, including the lips, chin, and jaw. About 75 percent of patients with Parkinson’s disease experience tremors at some point during their illness [10]. Rigidity occurs when the natural contracting and relaxing of opposing muscles fails to occur. Muscles are almost always found in pairs. In order for normal motion to occur, one muscle contracts while the other relaxes. When this fails to occur, patients experience difficulty with movement and often complain of stiffness [3]. Bradykinesia describes slowness in movement with initiation and repetition of movement [Parkinson’s disease]. It is often characterized with slow speed, irregularity of 3 Hailee Kulich Rebecca Miller movement, and pauses in ongoing movement [3]. Fatigue and reduction in amplitude during repeated activity are also common in patients experiencing bradykinesia [10]. This causes difficulty in many everyday tasks, including walking. Instability, or a loss of balance, is caused by the loss of postural reflexes. Postural reflexes refer to the brain’s ability to keep the body upright. Patients with Parkinson’s often do not lean far enough forward due to loss of muscle control. This causes the center of gravity to fall behind the feet, putting the patient at high risk of falling [3]. The four main signs are responsible for a variety of symptoms characteristic to those with Parkinson’s disease. Most patients complain of muscle soreness, muscle weakness, and fatigue due to loss of muscle function. As the disease progresses, everyday tasks become increasingly difficult, and mobility decreases. Patients may begin to experience soft, slurred, or slow speech due to loss of muscle control in the face. This can also affect the ability of patients to swallow, leading to excessive drooling. The muscles of the gastrointestinal tract are affected later in the disease, causing bloating and constipation. Finally, many mental health issues have been linked to Parkinson’s disease, such as anxiety and depression [3]. the basal ganglia. However, these surgeries have not yet proven to be effective. Perhaps the most well known surgeries for patients are the pallidotomy and the thalamotomy. Both surgeries seek to destroy a portion of the basal ganglia that is known to cause Parkinson’s. For example, a pallidotomy targets a portion of the brain known as the globus pallidus, which is responsible for collecting information, processing it, and sending it to other parts of the brain. If successful, this process decreases tremors, rigidity, and bradykinesia. A thalamotomy creates a lesion in the thalamus, a part of the brain responsible for muscle and limb control. Patients who experience severe tremors are normally good candidates for this process. While both of these processes significantly decrease symptoms, they are risky procedures that may cause the patient to have permanent brain damage [3]. Neural Implants to Treat Parkinson’s Neural implants that specifically treat Parkinson’s disease make use of deep brain stimulation. Deep brain stimulation occurs when an electric current is applied to one of several locations in the basal ganglia [11]. The electric impulses are thought to block the signals of crippling motor symptoms in those suffering from Parkinson’s disease [3]. Compared to other surgical procedures, deep brain stimulation leads to little, if any, tissue damage to the brain [11]. The size of the lesion can easily be controlled, causing less risk of permanent brain damage [3]. While this treatment is effective, it is not recommended for everyone due to the risk involved with implantation. Patients with extreme tremors are often good candidates for deep brain stimulation. However, patients who do not respond well to medication, such as levodopa, are discouraged from deep brain stimulation. Most patients who do not respond well to this treatment also do not respond well to the neural implant. Other qualities that would make a patient a poor choice for deep brains stimulation is being over 75 years of age, chronic autoimmune suppression, distinct brain atrophy, and having a severe psychiatric disorder [11]. If a patient with Parkinson’s disease qualifies for a neural implant, they must undergo a long, complicated surgery. First, electrodes are implanted in the brain. During this procedure, patients are given anesthetic and sedation, but are mostly awake due to the need for patient cooperation. When the battery is implanted under the collarbone, patients are but under general anesthesia. Several weeks after the surgical procedure is completed, the patient must return to a neurologist to have the stimulator turned on. The strength and magnetic field of the machine must be modified for optimal treatment. One the machine is turned on after surgery, symptoms from Parkinson’s disease are expected to decrease significantly [3]. Current Treatment Options Although there has been much speculation, the cause of Parkinson’s disease is currently unknown. This makes it difficult to cure the disease. However, many treatment options are currently in place for those suffering from Parkinson’s. The first effective treatment for Parkinson’s disease was levodopa, a natural precursor to dopamine [3]. Developed in the 1960s, levodopa provided a form of dopamine replacement therapy, providing effective relief of symptoms in the early stage of the disease. However, the natural progression of the disease makes the drug less effective, and the treatment eventually becomes ineffective [11]. There are a variety of drugs available to stimulate the production of dopamine as well as block receptors that allow for muscle tremor. However, there are no available medications to stop the progression of Parkinson’s disease [3]. Physical, occupational, and speech therapy are also common forms of treatment for the symptoms of Parkinson’s. Continued physical therapy may prevent falls during the early stages of the disease, but is often futile in the later stages. Occupational therapy focuses on allowing patients to continue daily activities. However, like physical therapy, occupational therapy loses its effectiveness as the disease progresses. Speech therapists are able to work with patients to strengthen the muscles used for speech and swallowing. This therapy can delay dangers that occur in the later disease, such as difficulty eating and breathing [3]. Finally, surgical options are available to patients suffering from Parkinson’s. Many forms of surgery are experimental and involve the implantation of stem cells into 4 Hailee Kulich Rebecca Miller Over 20,000 neural implants have been placed into patients since their development [5]. Many studies have been done to prove or disprove their effectiveness. In a study conducted in 2001, scientists found that on average, common symptoms of Parkinson’s disease were reduced by 60 percent after the implantation of a deep brain stimulator. Also, side effects caused by taking the medication levodopa were reduced by 80 percent. This study also focused on long-term improvement after implantation. After one year of treatment with deep brain stimulation, 66 percent reported a better quality of life. However, after five years, the number of patients who reported a better quality of life dropped to 54 percent [11]. While much success has been reported from the use of neural implants to treat Parkinson’s disease, this procedure can have harmful side effects. During surgery, there is always a high risk due to the complexity of the procedure. The risk of infection during the procedure is high, especially if the body recognizes the neural implant as a foreign object. Perhaps the worst risk associated with this surgery is intracerebral hemorrhaging. If this occurs during the procedure and the patient survives, he or she is often left with persistent neurological defects [11]. Other complications can arise post surgery that effect the way the patient behaves. Because the brain is a sensitive area, many patients have reported personality changes, brought on by depression, mania, and aggression. It can also lead to a deficit in language if not successful [5]. There also may be an increase risk of suicide due to the psychiatric damage that may occur. Because of these possibilities, it is important for a patient to receive postoperative follow up to give a reliable psychiatric screening [11]. Stimulation side effects might also occur if the electrode placement causes neighboring structures to be stimulated as well. Typical symptoms associated with this problem include muscle contractions, nausea, dizziness, problems with vision, and speech defects. Weight gain and mood swings are also problems associated with implant placement. Because these symptoms can be devastating to and may cause patients to have trouble readjusting to everyday life, both preoperative and postoperative preparation and care and encouraged and allow for the most successful cases of neural implantation [11]. Ethics, as defined in the National Society of Professional Engineers Code of Ethics, are the expectations to exhibit the highest standards of morality and truthfulness in all provided services while keeping the health, safety, and welfare of the public protected [12]. The question at stake concerning neural implants is ‘Do all aspects of the research, development, and implementation of neural implants correspond with the parameters in the code of ethics’? The Concerns One of the many concerns relating to neural implants is the physical dependence a patient will develop to the technology. Is living a life with technological enhancements even worth living? Is a life dependent on technology less dignified than an independent, unassisted, more “natural” life? The mental state a patient may have to attain to live with these enhancements is very different than the mental state of someone without them [13]. The patient may begin to question whether they are actually cured, or just enhanced. Another ethical concern of neural implants is the permissibility of enhancing human capabilities. The brain is considered the “center of control” of the body, so its technological enhancement can have far reaching consequences for human interaction. This social concern is based on the idea that if a human’s faculties are heightened beyond the normal level, equal opportunity and “justice of fairness” are no longer held in society. It is very difficult to determine who can receive neural enhancements based on normality. If a “normal” human being obtains these implants, their radically improved brain capabilities will place them above the rest of society. This will challenge the widely accepted principles of equality, independence, and non-violence [14]. It is understood, however, that this is a long-term perspective, and could only result from the misuse of this medical technology. A third ethical concern of neural implants is the possible medical side effects. Clinical practice of deep brain stimulation neural implants (used to treat Parkinson’s) has been shown to cause depression, mania, aggression, and deficits in language [5]. Sometimes, these implants can completely affect psychic functions that are the foundations of personality, altering personality altogether. It is concerning that neural implants can change mental functions and personal identity. Is the pre-implant patient really that damaged by a neurological disorder that they would risk modifications in their entire personality [6]? ETHICS Research and development of neurological technologies have almost become a moral obligation. The potential benefits that neural implants could have are numerous, not only for patients with Parkinson’s disease, but also many other diseases of the nervous system. Of course, however, the study and development of brain implants stretches a lot of social, legal, and ethical boundaries. But, one must determine whether the potential benefits of neural implants outweigh the ethical concerns. The Answer To determine if neural implants are ethical, one must ask the question, ‘Do the potential benefits of neural implants outweigh the ethical concerns?’ Well, not everybody will have the same answer to this question; the response is a matter of opinion. Some people may feel that the ethical concerns are greater, while others may think that the 5 Hailee Kulich Rebecca Miller advantages from neural implants are worth the ethical risks. The real answer is that much more research and testing needs to be done to determine the true ethical, social, and moral effects of neural implants. For now, the only stipulation that must be maintained is corresponding with the engineering code of ethics. The research, development, and implementation of neural implants must exhibit the highest standards of honesty and integrity while protecting the health, welfare, and safety of the public [12]. The potential for neural implants to treat and even cure neurological disorders is remarkable. This seemingly minute piece of technology holds the power to improve lifestyles of millions of people worldwide. If given the proper amount of research, neural implants have the ability to be the most effective treatment for any neurological disorder. REFERENCES SUMMARY: A NEW TECHNOLOGY [1] [1] (2011) “Introduction to the Grand Challenges for Engineering.” National Academy of Engineering Grand Challenges for Engineering. [Online: Web site]. Available: http://www.engineeringchallenges.org/cms/8996/9221.aspx [2] (2011).”About the Nervous system.” The Ohio State University Medical Center. [Online], Available: http://medicalcenter.osu.edu/patientcare/health_services/nervous_system/ab out/Pages/index.aspx [3] Sharma, Nutan. (2008). Parkinson’s Disease. Westport, CT: ABCCLIO,LLC. [Online]. Available: http://go.galegroup.com/ps/infomark.do?eisbn=9780313342189&userGroup Name=upitt_main&prodId=GVRL&action=interpret&type=aboutBook&ve rsion=1.0 [4] ”Biomedical Engineering Society Code of Ethics” Biomedical Engineering Society. [Online Article]. Available: http://www.bmes.org/aws/BMES/pt/sp/ethics [5] Stieglitz, T. Meyer, J. (2006), “Neural Implants in Clinical Practice.” BioMEMS. [Online]. http://dx.doi.org/10.1007/978-0-387-28732-4_3 [6] Decker, M. and Fleischer, T. (2008), Contacting the brain – aspects of a technology assessment of neural implants. Biotechnology Journal, 3: 1502– 1510. doi: 10.1002/biot.200800225 [7] “Neurons, Synapses, Action Potentials, and Neurotransmission.” Consortium on Cognitive Science Instruction. (2008). [Online] http://www.mind.ilstu.edu/curriculum/neurons_intro/neurons_intro.php [8] Hassler, C., Boretius, T. and Stieglitz, T. (2011), Polymers for neural implants. Journal of Polymer Science Part B: Polymer Physics, 49: 18–33. doi: 10.1002/polb.22169 [9] J.P.F Spratley, M.C.L. Ward, P.S. Hall, C. Thursfield (2007), Flexible SU-8 Microstructures for Neural Implant Design. School of Engineering, The University of Birmingham, Birmingham, UK. [Online]. Available: http://www.sciencedirect.com/science/article/pii/S092442470700756X [10] Behari M, Bhattacharyya KB, Borgohain R, Das SK, Ghosh B, Kishore A, Krishnan S, Mridula KR, Muthane U, Pal PK, Sankhla C, Shukla G. Parkinson's disease. Ann Indian Acad Neurol [serial online] 2011 [cited 2012 Jan 25];14:2-6. Available from: http://www.annalsofian.org/text.asp?2011/14/5/2/83083 [11] Groiss, S. Wojtecki, L. Südmeyer, M., Schnitzler, A. (2009 November), “Deep Brain Stimulation in Parkinson’s Disease.” Ther Adv Neurol Disord. [Online]. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002606/?tool=pmcentrez [12] "NSPE Code of Ethics for Engineers." Nspe.org. Web. 28 Feb. 2012. Available: http://www.nspe.org/Ethics/CodeofEthics/index.html [13] Bostrom, N., Sandberg, A. (2009, June 19), “Cognitive Enhancement: Methods, Ethics, Regulatory Challenges.” Science and Engineering Ethics. [Online]. Available: http://www.springerlink.com/content/95x26x07q5014r57/fulltext.pdf [14] Berger, F., Gevers, S., Siep, L., and Weltring, KM. (2008, October 11), “Ethical, Legal, and Social Aspects of Brain-Implants Using Nano-Scale Materials and Techniques.” Nano Ethics. [Online]. Available: http://www.springerlink.com/content/r687534t64334n83/ Neural implants are one of the most promising new technologies of the near future. They have the potential to treat, and hopefully cure some of the most awful and progressive diseases affecting people in the world. Over 20,000 patients suffering from Parkinson’s disease have been equipped with a neural implant [5]. While the success rate of neural implants varies among patients, constant improvements are being made to make these devices more effective. Continued research and development of this technology is imperative as the number of patients around the world diagnosed with Parkinson’s disease is increasing rapidly [3]. The other current treatment options for Parkinson’s disease are not as effective long-term as neural implants could be. Because they target the specific areas of the brain known to cause Parkinson’s while inflicting minimal tissue damage, neural implants provide a more direct treatment proven to be the most effective. The ultimate goal of a bioengineer is to ethically improve public welfare worldwide through the development of better medicine. The application of engineering to biology and medicine creates a profession that will improve the quality of life for many people universally. If the proper research is conducted, neural implants will be more than fit to achieve this goal. By electrical stimulation of surrounding cells, neural implants seek to treat and even cure disease of the nervous system caused by damaged neurons. This will significantly impact the lives of patients who suffer from these diseases, leading to an overall improvement of health. Although neural implants show great promise, ethical concerns must be taken into account. As an engineer, one must hold themselves to high moral standards, and place value on all forms of life. They must keep all aspects of public health, welfare, and safety completely protected [12]. As long as these conditions are met, forging ahead with research on neural implants could benefit society greatly. Despite impending physical dependence, increased mental capacity, and possible medical side effects, the advantages to neural implants may outweigh these ethical concerns. Under the stipulation that the research, development, and implementation of neural implants complies with the parameters set by the National Society of Professional Engineers Code of Ethics, the progress of neural implants can continue without bound. ADDITIONAL RESOURCES B. He. (2006), Neural engineering. University of Minnesota Minneapolis. [Online]. Availabe: http://www.springerlink.com/content/n53231/#section=538453&page=1 6 Hailee Kulich Rebecca Miller Graham-Rowe, Duncan. "Brain implants that move: neural implants that respond to changes in the brain could finally meet the needs of people with paralysis." New Scientist 184.2473 (2004): 25. Academic OneFile. Web. 11 Jan. 2012. Wang, M. Wang, B. Zou, J. Zhang, J.; Nakamura, M.; , (2011),"Effectiveness research of deep brain stimulation operation for patients with Parkinson's disease based on polar coordination system with varied origin," Biomedical Engineering and Informatics (BMEI) [Online] http://ieeexplore.ieee.org/stamp/stamp.jsp?tp=&arnumber=609838 6&isnumber=6098366 ACKNOWLEDGMENTS We would like to thank our conference chair, Joseph Lombardo, for his help in gaining a better understanding of bioengineering and how it relates to this topic, We would also like to thank our co-chair, Michael Randazzo, for his assistance in the creation of this paper. We thank our writing instructor, Barbara Edelman, for her helpful insight and constructive criticism that made this paper possible. Finally, we would like to thank the Benedum Library staff for their instruction that lead to the sound research done for this topic. 7