Engineers Help Fight Opioid Addiction, Part 2

May 30, 2018

by Tim Sprinkle ASME.org

Part 1 of “Engineers Help Fight Opioid Addiction” covered how medical researchers are developing new treatments to lessen our dependence on opioid painkillers and prevent overdoses. This part looks at the technology’s different applications.

Chronic pain affects over 100 million Americans and its causes include everything from neuropathic pain from spine disorders, to diabetic nerve pain, to chronic migraine, which affects as many as 30 million patients in the U.S. alone.

Other sources of chronic pain are post-surgical and post-amputation pain caused by trauma to the severed nerves at the amputation or surgical sites. These two types of pain impact nearly 500,000 Americans each year, and most of these patients are being treated with pharmaceuticals and other traditional pain management methods.

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“The amputation pain market is a large market, and the market drivers are really diabetes and peripheral vascular disease,” says Jon Snyder, CEO of Neuros Medical, a startup based in Cleveland that has licensed the kilohertz neurostimulation technology from Case Western since 2009, using it in its Altius treatment system. “They're projecting market numbers basically to double by the year 2050, so this will continue to be a really underserved market that needs new solutions.”

The Neuros Altius System consists of an implantable generator with an integrated rechargeable battery, cuff electrode, and external devices. Image: Neuros Medical

The Neuros system consists of an implantable generator that’s about the size of a pacemaker, with an integrated rechargeable battery, cuff electrode, and external controllers that allow the patient and their doctor to manage the system remotely. It is installed in the body alongside the peripheral nerve that needs treatment. When the patient needs pain relief they simply switch the system on, with what looks like a small television remote, for an automated treatment session of 30 minutes. Once that’s over, the system shuts down and the nerve itself comes right back on and starts transmitting again as normal, though the effects of treatment have been show to linger well after treatment ends.

“Our system produces a high-frequency electrical signal in the 5-10 kHz range that's directed via the nerve cuff lead, which is placed around a nerve or targeted set of nerves that we're looking to block,” Snyder says. “It stops the potassium channels from opening and closing, so the nerve is rendered intransmissible. It’s very similar to the effect of lidocaine on the nerve, as far as what's happening.”

The only functional difference is that neurostimulation achieves this effect via an electrical nerve block, whereas lidocaine is based on a chemical nerve block. According to the company’s internal testing, the treatment has shown pain reduction of about 75 percent to 80 percent, along with narcotic pain medication reduction of about 90 percent.

Other commercial uses for kilohertz frequency alternative current blocking include the vBloc Therapy system, which is making use of the technology to partially block the vagus nerve in the digestive tract to help control obesity, as well as Nevro, used to treat chronic back and leg pain.

“The body is a natural system,” Bhadra says. “This is what biomedical engineers do. We come up with things that work on that million-year-old system and get results.”

Tim Sprinkle is an independent writer.

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