The Bionics Man
U professor Richard Normann's brain electrode array has created possibilities for patients.
The Utah Electrode Array is a tiny little thing. Placed on a penny, it’s about the size of Lincoln’s face. Magnify it, though, and you can see a hundred needles reaching upwards like skyscrapers. The idea is this: Implant that array into the brain of a paralyzed person, and she’ll be able to move her arms and legs with nothing more than her thoughts. Implant the array in the brain of a blind man, and he’ll be able to see. This is pretty far-out stuff (headline writers often invoke the word “miracle”), but University of Utah professor Richard Normann is confident that his electrode array will help make all this happen.
Normann began thinking about the array in the mid-1980s, a few years after arriving at the University of Utah as a professor of bioengineering. He had been doing basic science research and was interested in how photoreceptors worked, but when he got to the U, there was a different bioengineering buzz on campus: artificial hearts and kidneys, and bioengineered eyes and ears. “I couldn’t find graduate students interested in basic research; I realized to survive, I had to put an applied spin on it,” Normann remembers with his characteristic candor. So he decided to tackle blindness.
At the time, he says, he was “a retina guy,” which was different from being what he calls “a brain guy.” But he knew that if scientists wanted to help blind people see, the answer lay in finding ways to communicate more effectively with the visual areas of the brain. The problem was that no one had figured out how to have a conversation with more than a few neurons at a time—and there are billions of neurons in the central nervous system, each firing off electrical signals in an effort to talk to each other. Picture a planet full of people chattering, in a language that’s hard for a newcomer to understand.
What exactly is it that neurons are saying in that micro-moment between the impulse to lift your hand and the actual lifting? What exactly is it that neurons are doing as they recreate a detailed visual perception of the outside world? And how do you begin to replicate that?
Artificial vision researchers at the time, including William Dobelle at the University of Utah in the early 1970s, were stimulating small groups of neurons by placing electrodes on the surface of the visual cortex. With this method, they could get their volunteer subjects to see vague blobs of light. But activating the brain a few neurons at a time, says Normann, is like trying to watch a program on a high-definition TV and only being able to see a couple of pixels.
So, in the mid-’80s, Normann came up with the idea of rows of electrode needles that could penetrate a millimeter and a half into the brain and thus either listen to or excite many individual neurons at a time. For a long time, all he had was a drawing. Then, on a trip to Washington, D.C., in 1987 to attend a neuroscience conference, he wandered one afternoon over to the National Science Foundation and managed to get an impromptu meeting with a program manager. Normann drew a picture of the array and explained his idea. The program manager said, “If you can figure out how to build that, I’ll support you to the hilt.”
One of Normann’s favorite words is “serendipity.” A week or two after his meeting at the NSF, a bioengineering student walked into Normann’s office at the U looking for work. Patrick Campbell BS’85 MEn’88 PhD’90 had just been laid off from the artificial organ company Symbion, after it had moved its operations from Utah to Arizona. He’d been working on cochlear implant technology. Normann told him about the electrode array idea, and Campbell said he thought he could get it to work. Within a year, they had a simplified model.
The Utah Electrode Array has since inspired other, similar devices. But Normann’s design is currently the only one approved by the FDA for implantation in humans.
Like any scientist, Dick Normann likes to think about cause and effect. In his own life, there was, for example, the pinball machine. Normann’s father was an immigrant from Denmark, a poorly educated man who eventually owned a walnut farm in northern California but supported his family for many years with the pinball machines he owned and installed. That meant young Dick was the beneficiary of hundreds of little pinball parts from defunct machines, parts he used to make his own rudimentary switching circuits. He discovered that he loved “gadgeteering.”
After high school, he entered the University of California at Berkeley as an engineering major. “I’m ashamed to say I didn’t really know much about what an engineer did,” Normann recalls. “I didn’t have any academic role models in my life. There were no professional people in my family.” At Berkeley, he studied electrical engineering but liked physiology even more. Electrical engineering, he decided, “wasn’t about the great mysteries of life,” whereas “at every physiology lecture I attended, the professors were apologizing about what they didn’t know yet.”
He went on to get master’s and doctoral degrees in electrical engineering from Berkeley, with a physiological bent. After that, he spent five years at the National Institutes of Health, where he studied retinas, sometimes with a lively retinal anatomist, Helga Kolb, who worked in the lab across the hall. They soon married, and their plan, after the NIH, was to become professors in California, but the closest they could get geographically in 1979 was the University of Utah, where they both received academic appointments. Utah was just supposed to be a stop on the way, but soon the U and the state won them over. At a 70th birthday celebration/symposium held in Normann’s honor in February 2013, one former graduate student after another stood at the podium and showed pictures of river trips and mountain climbing with Dick and Helga: Here was Dick and his pop-up camper in Canyonlands, and Dick with a river raft, and Dick on skis.
Students and colleagues also listed what they had learned from him: Be persistent, dream big, don’t be afraid to fail or change course. Former student Shane Guillory MS’11 summed up Normann with an image: a photo of the Grand Jedi Master Yoda.
Normann had wanted to use the Utah Electrode Array to create sight, which meant implanting the array in people’s brains. But he says he soon realized that he needed to start in a part of the body “that people don’t feel so passionate about.” And, too, he realized the lab could get more bang for the buck by using the array in cases where more people needed help: amputees, people who were paralyzed, people who had lost bladder control.
Amputees were the easiest, because the nerves all the way from the brain to the surviving part of the limb were still intact. Normann and his grad students invented a variation of the electrode array—the Utah Slanted Electrode Array—with gradations of needle sizes that could successfully penetrate peripheral nerves. The researchers then could record the firings of nerve signals as the amputee thought about what it would be like to move the missing arm and hand. Then the scientists decoded those signals, figuring out which firing patterns were associated with each motion and creating a map of how a particular part of the brain and muscles spoke to each other. Normann and his students then passed electrical current back through the electrodes, using the signal patterns they had decoded, so that this time, a thought alone could move prosthetic fingers.
The next generation prosthetic hand will have sensors in the fingers, Normann says, allowing an amputee to be able to feel when the prosthesis touches something. It won’t be long, he says, before amputees will be able to have fine motor skills using artificial limbs. “It will have the same capabilities that this thing does,” he says, opening and closing his own hand. “Instead of feeling like a piece of hardware, they’ll be thinking of the prosthesis as them, as being an extension of them.”
The Utah Electrode Array has also been implanted in paralyzed volunteers, in labs at Brown and Harvard universities and the University of Pittsburgh. The array “is an engineering tour de force,” says John Donoghue, director of Brown’s Institute for Brain Science. “Dick has had a revolutionary effect on the way people study the brain.”
At first, Donoghue says, scientists weren’t even sure if a paralyzed person’s brain could send out signals for movement. But it turns out that, yes, the motor part of the brain still functions, as do the peripheral nervous system and musculature. One of his patients implanted with a Utah Electrode Array has learned, by intention alone, to manipulate a robotic arm to grab a coffee cup, bring it to her mouth, and drink from it.
Eventually, researchers expect that paralyzed people using the array and something like Brown University’s computerized BrainGate system will be able to move their own arms. Normann guesses this is still 10 years away, but says, “I’m pretty confident it will happen.” Clinical trials have proved successful on a stroke patient and a volunteer with amyotrophic lateral sclerosis (ALS), as well. Also on the horizon: managing incontinence and erectile dysfunction, aiding people with spastic muscles to move effortlessly, and helping paralyzed people stand. (Walking unaided will be more problematic, Normann says, because it also involves balance.)
Eventually, the Utah Electrode Array may help some blind people see, by stimulating the same neurons that, in sighted individuals, would normally be stimulated by input from the retina. In German trials using another electrode array in retinal implants, blind volunteers were able to recognize simple objects and discriminate small words. In animal experiments at the U, Normann has sought to determine how much current is required to “see” an electrically induced spot of light. His aim with the visual research has been to eventually develop a way for a blind patient to be able to “see” images by wearing a special pair of glasses containing a video camera that would then send wireless electrical signals of the images to the implant in the visual cortex, so the patient could “see.”
In 2013, Normann was one of 15 neuroscience stars who were appointed to the National Institutes of Health’s new BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative, whose aim is to map the brain for the first time and reveal how individual cells and complex neural circuits act and interact. He only mentions this in passing, in the same way he downplays being named a University of Utah Distinguished Professor in 2008. “I don’t regard myself as being a particularly clever person,” he says. “I’ve just had some good students.”
Other people might point out that his textbook Principles of Bioinstrumentation is now a classic in the field; that his “positive energy and vision are transformative,” as U Neural Plasticity Laboratory director Gregory Clark says; that Normann brought more than $22 million in research funds to the U; that he was a pioneer at the U in transfer of technology into profitable products.
The University of Utah is known now for its helpful commercialization environment (for several years, it has remained either No. 1 or 2 in the nation in number of spin-off companies created by its faculty). But in 1997, when Normann and Brian Hatt formed Bionic Technologies to market the array and other technology, “starting a company with the goal of sticking brain probes into humans was truly a bold move,” says U College of Engineering Dean Richard B. Brown PhD’85. (Bionic Technologies was later sold and then sold again, and now operates as Blackrock Microsystems, which continues to market and sell the Utah Electrode Array and Utah Slanted Electrode Array to researchers all over the world.) Normann says the experience with Bionic Technologies taught him that he had little aptitude for business: “I couldn’t wait to get back to the lab.”
This summer he is retiring, becoming a Professor Emeritus along with his wife. It’s time, at 71, to let younger professors use the University’s resources, he says. “I don’t want to be a burden on the system. I wish more of our faculty felt that way.”
But that doesn’t mean he won’t be driving down to the U several times a week from his home in Park City to observe experiments and offer ideas. He is eager, after all the years of preparation, to be a part of the future. “This really is the beginning of achieving my dream of helping people with disabilities,” he says. “I foresee in the next few years that the seeds we’ve planted will bear fruit. I’m really optimistic.”
—Elaine Jarvik is a Salt Lake City-based freelance journalist and playwright and a frequent contributor to Continuum.