The future of biomedicine: 4 questions with Chad Bouton of the Feinstein Institute

Researchers at the Feinstein Institute for Medical Research in Manhasset, N.Y., are learning a new language to communicate with the body and redefine treatment of disease and injury — the language of bioelectronic medicine.

Bioelectronic medicine uses device technology to control cell behavior by analyzing and reproducing signals sent by the nervous system to the rest of the body. By delivering calculated electronic stimulations through small devices implanted under the skin, researchers can modify organ function, unlocking the potential to treat inflammatory diseases or even restore movement in paralyzed patients.

Chad Bouton serves as vice president of advanced engineering for the Feinstein Institute — the research branch of Great Neck, N.Y.-based Northwell Health — and as the managing director of the institute's Center for Bioelectronic Medicine.

Prior to joining the Feinstein Institute's team in 2015, Mr. Bouton spent 18 years researching and developing biomedical technology at the Battelle Memorial Institute, the largest independent research and development organization in the world. Last April, a team of researchers led by Mr. Bouton pioneered a neural bypass technology that allowed a paralyzed man to regain hand movement after a small device was implanted in his brain.

Mr. Bouton spoke with Becker's Hospital Review about his career in biolectronic medicine and where he sees the field moving to in the future.

Responses have been lightly edited for length and clarity.

Question: What first sparked your interest in the field of bioelectronic medicine?

CB: I've participated in medical device research and development for almost 20 years. About 10 years ago, I became very interested in trying to decode brain waves, particularly in the motor area responsible for movement. We were working with study participants who had experienced a stroke or conditions like ALS. I started to realize if we could decipher some of these brain signals in people living with debilitating conditions, we could start to use bioelectronic technology to restore movement by rerouting signals in the brain. I became enthralled in the entire field, which combined my background in signal processing — now called machine learning — with medicine.

Q: What research are you currently working on at the Center for Bioelectronic Medicine right now?

CB: About 80 percent of the fibers in the Vagus nerve are sensory fibers that carry information from little receptors in organs throughout the entire body up to the brain. If you can stimulate and crack this neural code to learn the language of the nervous system, you can not only understand the messages going back and forth in the body, you can also learn how to speak the language.

To crack the neural code, we use machine learning — a branch of artificial intelligence that relies on computers and algorithms to decode neural messages and patterns. By listening in and understanding neural messages, we can then discover how to make adjustments for stimulations and create devices that close the loop, allowing the mind to send signals to the rest of the body, even in cases where a severed spinal cord has previously blocked this signal.

We have very specific projects in developing core technologies to help us better understand and recreate this language. One includes a high-resolution neural interface that allows us to tap into those signals and nerves. We're also looking at technology to listen in on brain signals. These are both going to be really important core technologies.

We're also developing biosensors to measure various body processes. For example, we could use biosensors as an internal glucose reader for people with diabetes, an area I'm really interested in. We believe we can use bioelectronic medicine to treat type 2 diabetes and maybe even find a way to treat type I, as well.

The ultimate goal is to create one tiny chip that can be implanted into a patient to listen to the brain and make necessary adjustments on its own. We hope to reach this within the next five to 10 years, depending on the condition or disease it's intended to treat.

Q: How do you think bioelectronics will affect the future of healthcare in terms of costs and quality of care?

CB: Bioelectronic devices could have a dramatic impact on quality of care and the ability to manage different diseases by monitoring biomarkers in at-risk patients. Listening to the body's clues, methods and signals, could help us better diagnose disease, create technology that could create real-time diagnostics, track the progress and recovery of a patient and warn individuals of risk for cancer, diabetes, etc.

Looking further into the future, there's been a lot of great research and work done in the area of paralysis. While there are some treatments for spinal cord injuries and strokes, there's still room for improvement. Bioelectronic medicine offers the opportunity to take state-of-the-art technology and advancements and combine them with a greater understanding of molecular biology to treat injuries and diseases in a completely new way.

Q: What excites you the most about the field of bioelectronic medicine?

CB: Two things: The fact that there seems to be no limit to what's possible in this field, but also the fact that at the end of the day, we can see the tangible effects we have on improving a patient's quality of life. We've opened up so many more doors for new treatment options for patients.

It's why I got involved in medical devices 20 years ago. I knew if we worked hard and created devices the right way, we could make things that had unlimited possibilities to help patients.

To access an interview with Kevin Tracy, MD, president and CEO of the Feinstein Institute, click here.

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