P. Hunter Peckham received his undergraduate degree in mechanical engineering from Clarkson College of Technology, Potsdam, NY, and his MS and PhD degrees in biomedical engineering from Case Western Reserve University (CWRU), Cleveland, OH. He is currently a Professor of Biomedical Engineering and Orthopaedics at CWRU and also directs the Rehabilitation Engineering Center in the Department of Orthopaedics based at MetroHealth Medical Center (MHMC), Cleveland OH.

He is Director of the Veterans Affairs (VA) Center of Excellence in Functional Electrical Stimulation (FES) and the Cleveland FES Center, a consortium involving the Cleveland VA Medical Center, CWRU, and MHMC. The FES Center focuses on the clinical development and implementation of systems employing FES to restore control of movement in paralysis.

Dr. Peckham has devoted his career not only to developing FES technology, but also to identifying and overcoming the barriers that sometimes prevent new technology from reaching the people who can most benefit from it. To accomplish his goals, he has melded technical expertise in multiple engineering disciplines (electrical engineering, mechanical engineering, materials engineering, computer engineering) with applied expertise in neuroscience, physiology, neurology and rehabilitation.

4.10.01 Sandra asked:
Do you think that it might be possible that one day paralyzed people will be able to move, just using brain signals? How will they be able to do that if their body is paralyzed?
Curiously, Sandra

Peckham's response:
Dear Sandra,
I am quite certain that it will be possible for people who are paralyzed to use brain signals to control their movement. Already in the laboratory, researchers have shown that it is possible for people who have no movement in their body to use their brain signals for communication-such as to select an alphabetical character or symbol that can be used to generate a sentence or a symbolic representation for communication. This same type of information can be used to control movement. The concept is that the brain is still active and the electrical activity of the brain cells can be recorded and used. It is not known where the electrodes that do the recording will need to be placed. Researchers are now investigating whether the best place is within the brain, on the brain surface but under the skull, or on top of the skin surface. Each of these three locations has some advantages and disadvantages. Some researchers have shown that monkeys with electrodes implanted in the brain are able to control simple movements of a robotic arm.

In our research at the Cleveland FES Center, we recorded electrical potentials from the firing of the brain nerve cells, processed the recorded signal, and used it to control the electrical stimulation that is applied to an individual's paralyzed muscles using FES implants. (The brain waves can be recorded in a person with a spinal cord injury because, even if they are paralyzed, their brain still functions as it did before their injury.) This was a laboratory feasibility experiment. Normally, the individuals with paralysis who use our implantable stimulation devices control them by a physical movement, such as movement of the shoulder or wrist. In the future, when the brain interface is developed, it will substitute for the control by shoulder or wrist movement so that the brain signals will directly supply the control information. The brain interface would then make it possible for people with more extensive paralysis, who can't easily move a shoulder or wrist, to use signals recorded from their brain to control their stimulation devices, generating coordinated muscle movements that will help them accomplish their activities of daily living.

4.10.01 Daniel asked:
Would be possible, if one practiced enough, to play musical notes through a computer that uses different brain waves to play different notes? If so, is the potential for accuracy high enough to play quickly and skillfully?

Peckham's response:
Dear Daniel,

Yes, it would be possible to play musical notes through a computer using brain waves. But you point to the key limitation, and that is speed and accuracy. As you know, music is a very complex combination of notes, timing, loudness, etc, and in order to create music, these notes must be generated very accurately and rapidly. This is a fundamental limitation of the information that is available from brain waves. At the current time with the technology available today, only six or so different selections per minute can be made with brain control, and so it would be virtually impossible to create music unless the brain control speed was significantly increased.

4.10.01 Henri asked:
Can a layman find and purchase the brain-wave modulation technology you are using with FES on your patients? Have you used a calibrated scale based on the kinetic movements of an individual who is adept at alpha-wave modulation to fine tune the degrees of electrical stimulation applied to the muscles of the patients you were treating?

Peckham's response:
Dear Henri,

The equipment that we used for recording the electrical potentials from the brain is expensive and is specially constructed from various recording and display devices and computers. We are grateful to the Department of Veterans Affairs, the National Institutes of Health, the Ron Shapiro Charitable Foundation, and the Movement Disorders Foundation for helping to fund our work. I understand that several companies make brain control interface systems, including BrainMaster Technologies and Brain Actuated Technologies, but I have not used their equipment.

In our FES experiments in Cleveland, we first trained the research participant to accurately change the electrical potentials recorded from the scalp, and then we used the potentials to control the stimulation supplied to the paralyzed muscles via our FES implant. For example, when the potentials are in a low state the stimulation is applied to the muscles to gradually close the hand, and when the biopotentials reach a high state, the stimulation is reversed to decrease the amount of hand closing and increase the amount of hand opening. Thus, with these two states the person is able to open and close their hand.

4.10.01 John asked:
Why don't the researchers record the brainwaves of a test subject when he/she thinks of a certain image, word or action then program that brainwave pattern into their own control computer? Thus linking that pattern to a specific action.

Peckham's response:
Dear John,

Thanks for your question. It shows a lot of insight as to how a brain interface can actually work. The approach that you have proposed is essentially the way that the Cleveland FES Center's current interface operates. When the person achieves one state (say high) the electrical stimulation is gradually applied to the muscles that open the hand, called the extensor muscles. When the person achieves the opposite state (call this the low state) the control is reversed so that the muscles that flex the hand are increased and the muscles that extend the hand are decreased. In this way two states of control can govern the full opening and closing of the hand, and do this in a way in which the person is able to adjust the strength of their hand grasp to be as great or as small as they require.