SciTech Now Episode 308

In this episode of SciTech Now, developing methods to improve cochlear implants; invisibility cloaks may be more than science fiction; how dysphagia patients are recovering quicker, thanks to a new biofeedback machine; how dopamine works in our brains; and an underwater virtual reality game that’s helping patients with multiple sclerosis gain mobility.

TRANSCRIPT

♪♪

Coming up, women in science.

It was sort of like one of those literally aha moments that you get a handful of times in your career.

We'll take everybody's individual anatomy and function and really develop a cochlear implant program that can maximize their hearing capabilities.

Creating your own invisibility cloak.

You can think of light as a stream of water.

If water's moving this way and I'm over here, I have no idea that it went around this object because it looks straight.

So by going around the object, I can't see it.

Biofeedback, changing the face of rehab.

In the past, you would say, 'Do an effortful swallow,' and they say, 'Okay, I did it.'

And you thought they did it, but, I mean, really how can you objectively know if they really did it or not?

And this gives you a visual that you can see.

And finally, virtual reality goes underwater.

You have a head-mounted display on and you have -- there's a cellphone that sits in your head-mounted display, which it's really just a cellphone that is mounted to the front of your dive mask.

You wear a little cellphone around your chest, and when the shark bites you, then you'll get a little buzz.

It's all ahead.

Funding for this program is made possible by...

Hello. I'm Hari Sreenivasan.

Welcome to 'SciTech Now,' our weekly program bringing you the latest breakthroughs in science, technology, and innovation.

Let's get started.

Science Friday is premiering a new series that follows the innovative research of women scientists.

The first episode follows Dr. Rene Gifford and her colleague, Dr. Allyson Sisler-Dinwiddie, who together developed methods to improve cochlear implants.

Science filmmaker Emily Driscoll brings us the story of how these scientists turned an accident into an opportunity for innovation.

My name is Ally Sisler-Dinwiddie.

I'm a pediatric audiologist here at Vanderbilt.

Being an audiologist, it'll send me from the schools to the clinic, back to the OR doing cochlear implant surgery.

My job is to check the integrity of that cochlear implant before the surgeon implants the device.

When I was young, my hearing was tested for the very first time, and we walked away with hearing aids.

I had hearing loss growing up, but the car accident made it so much worse.

I remember my father saying to me, 'Ally, promise me that you will never, ever let your hearing loss get in the way of anything you want to do.'

In 2003, I started my first year of graduate school with my hearing aids, but between my first and second year, I got in the car accident and there was no more sound.

That's when I realized I want to try to find a way to keep on keeping on.

I want to be an audiologist, and there's got be a way.

Ally had basically almost no sound detection whatsoever.

We're talking about the most severe types of hearing loss.

My name is Rene Gifford.

I run a large research program.

I teach in the graduate school program here.

I also direct a large portion of the clinic, I see patients.

I was actually raised by my grandparents.

My grandmother incurred very severe hearing loss during World War II, and so you had to speak loudly, you had to speak clearly, you had to get his attention.

It absolutely shaped sort of my desire and my interest that would come into play many years later.

He wants you to be looking forward.

Like Tim said, you want to look straight until the noise is played.

Ready, bearing go to white 5 now.

Helping people who have hearing loss is pretty complex.

We've got the outer ear, of course, that everybody's familiar with.

You got the ear canal.

At the very edge of the ear canal is the tympanic membrane or as we call it, the eardrum.

Connected to the tympanic membrane are the three smallest bones in the body.

The very smallest bone in the body is then connected into the inner ear.

The inner ear is the cochlea.

Within this cochlea, it's three small chambers that are filled with highly conductive fluids.

And then you have a number of hair cells, and their vibration creates this electrochemical reaction through the auditory nerve and then ultimately up to the brain.

When I was 25, I started losing my hearing, and for no reason at all, pretty much.

The most common type of hearing loss that we see is the deficit of the cochlea.

It's a deficit of those hair cells that are dysfunctional or completely destroyed.

As hearing loss gets worse, you lose the ability to piece things together.

There's just not enough information.

The cochlear implant definitely has the ability to provide sound, a very different kind of sound.

It's an electronic device, but it's in the brain where all of the magic really happens.

Cochlear implants bypass the outer and the middle ear entirely.

The actual implant itself is placed beneath the skin, and then the electrode array enters the cochlea through the middle ear.

Each of those individual tiny electrodes are actually stimulating auditory nerve fibers from within the cochlea itself.

That device receives input from the external processor that's worn on the outside of the ear.

This is connected through a magnet.

When I got my first cochlear implant, I went from nothing to a world that's so far beyond what my hearing aids were ever able to provide.

I had no idea how much I missed growing up.

No idea.

Cochlear implants are a miraculous technology, but when you stimulate an electrode, even though you're wanting to stimulate just a narrow population of cells, what happens is it spreads.

It's got kind of a background noise I hear when I'm talking.

We know that's one of the biggest culprits for why our patients struggle for communication and noise, why they struggle with music perception.

So a piano would sound a little different, or, like, a violin would sound different.

If you think of electrical spread of activity causing a smearing of the incoming frequencies and pitches, more could potentially be less.

Now with the cochlear implant, you can see the electrode array as you're inserting it, but beyond the first turn of the cochlea, you're basically blind.

The engineering group was looking at 3D reconstruction of the internal ear, and we just kind of said, we know the distance between each one of those electrodes and those neuron targets that we're trying to stimulate.

Now let's selectively deactivate some of those electrodes.

What we have suggested is turning off 6, 9, and 10.

Mm-hmm.

Fewer number of electrodes, but the right ones.

It was sort of like one of those literally aha moments that you get a handful of times in a career.

We'll take everybody's individual anatomy and function and really develop a cochlear implant program that can maximize their hearing capabilities.

I had heard this research was going on.

I was here on staff, but as a patient, to hear that we're going to turn stuff off, even though I know, even though I knew it was going to be for the best, I was very nervous.

Ally was the first or second participant.

I kept thinking, we are all here to make this experience better for everyone else.

If we don't do this, we will never know.

With her, I recall it was just two electrodes we deactivated.

I turned off those two electrodes and she said, 'It's like you took a pillow off my head.'

That program ended up being so far beyond my other program that I had before.

I am, like, very much a skeptic.

You know, I just -- unless I see data, I don't believe it.

So she came into the lab.

At her baseline, she was getting about 38% word recognition.

And we just ran that test again.

She was at 88% overnight, by just turning off two electrodes.

We were just so excited.

So it's been four years.

The number of patients that have been able to take part in this, it has gone on and on, and so they're not going to stop here.

Okay. So you're ready?

Yeah.

Yeah? Okay.

An activation can be a very emotional experience.

This is something they've been waiting for.

They've had surgery and now they want to know how well it's going to work.

So I'm going to have you just turn around and talk to your parents and just kind of see what their voices sound like, and kind of get used to the sound.

Okay.

Hi.

Hi, Morgan.

You sound the same.

I sound the same?

You remember my voice?

[ Laughs ]

Can you hear me now?

Mm-hmm.

Is it the same?

Is it better?

I love it.

I mean, that's the moment.

[ Laughter ] One of the goals is to try to get this technology into the hands of people who need it.

The Mama Lere Hearing School at Vanderbilt, we've enrolled about 30 children, and the children actually show even greater outcomes than the adults.

Boom, boom.

Beautiful, Laura.

Okay, and this...

And we are really hopeful that in the future, we'll really develop a cochlear implant program that can maximize their hearing capabilities.

[ Laughs ]

Yay.

The patients that I have the opportunity to see every day, help me just as much as I'm hopefully able to help them.

Let's put it on your head first.

What a role model for these little patients of ours who see that, 'Gosh, look, Dr. Ally's got implants just like I do, and I can grown up and I can help other people, too.'

I mean, we couldn't ask for a better job.

Everybody's got challenges.

Everybody's got things that they want to overcome.

It's just all about your perspective.

Ainissa Ramirez is a scientist, author, and self-proclaimed science evangelist.

She's calling for big changes in science education and is a creator of a podcast series called Science Underground.

Here to discuss one of her latest podcast episodes about invisibility cloaks is Ainissa Ramirez.

All right.

With what you have on the table, I want to see how this works.

Well, I'm not going to be able to make anything invisible.

[ Laughs ]

But what I'm just doing is I'm using this paperweight as an object.

Okay.

To show you how we can make something invisible.

Invisibility is actually just, we're fooling the eye, we're fooling the brain.

When I'm looking at an object, when you're looking at this subject, light's bouncing of that into our eye, and our eyes and our brains are smart enough to register that that's the object.

With you so far.

That's right.

However, if we can have light go around the object, we can't see it, and that's what they're doing with invisibility cloaks.

So you're bending the light that's hitting that object.

That's right.

So at least that it's not coming to our eye.

To our eye.

Yeah, you can think of light as a stream of water.

If water's moving this way and I'm over here, I have no idea that it went around this object because it looks straight.

So by going around the object, I can't see it.

So we have a gazillion lights on in the studio.

Uh-huh.

How would you possibly figure out a way to shield the light, all those lights that are bouncing into my eyeballs?

That's right.

So right now they're doing things in the laboratory, and in one group in Rochester, what they've done is they've used a series of lenses, and this is just a simple magnifying glass.

They're using high-tech lenses.

And they're putting them in certain positions, so what happens is the light is corralled, and then bent around the object.

And then they can make something as big as a hand invisible.

Wow.

So that's pretty amazing.

The other thing you can do, is there's special materials that bend light differently, and we've seen this.

If you put a spoon into half a glass of water, you'll see that the spoon kind of looks big on the bottom and smaller at the top.

It has a different index of refraction.

So if you have materials that have different indices of refraction, they, too, can bend light around that object, so that you can't see it.

So it's still on a small scale, like I said, the size of your hand, and you can tile those things to make something a little bit bigger.

But it's not something you can purchase except for a kit that is available from Rochester, but...

So what do you get for 50 bucks if you buy this thing online?

What kind of -- I mean, it is not the Harry Potter cloak or the 'Lord of the Rings'' ring.

No. [ Chuckles ] No.

You're not going to be able to make a car go away, but what it is, is it's a set of these lenses and they're set at a certain distance apart.

That's very important.

So that what you're able to do is bend the light and then focus it around.

I mean, when I think about that, it's almost like the first people who looked through a telescope and figured out what those lenses were able to do, right?

Right.

And are we kind of there in an invisibility lens technology?

Kind of the very early stages where eventually now we take for granted this magnifying glass that you have.

That's right.

But it's a long time for people to figure out how to grind everything down and how to make this look what it is right now.

If you went back in time and you had this, you would be blowing people's minds.

Yeah.

I'd be creating fire with -- Wah!

That's right. That's right.

Yeah, but what's so interesting is light is a very old friend.

We've been studying it.

You know, Newton wrote a book about it.

Einstein showed that there were really funky things you can do with light.

And what we're doing is we're actually fulfilling what Einstein had predicted, that you can bend light in this way.

So, yeah, this is new.

You know, it's still at an experimental level, but, you know, it's happened.

It was something that was in science fiction and in fantasy, and now it's actually a possibility.

All right. Ainissa Ramirez talking about the possibilities of science and invisibility cloaks.

Thanks for joining us.

Thank you.

♪♪

Patients diagnosed with dysphagia suffer from extreme nerve or muscle damage and often need to learn how to swallow again.

Biofeedback technology is helping speech pathologists visualize what's going on in a patient's body, and offering a roadmap to rehab.

Here's the story.

Let's bring it all the way back down.

My swallowing problems started about a little over two years ago.

Richard Kennedy has dysphagia, a swallowing disorder usually caused by muscle or nerve damage.

Over the age of 60, half of all people will experience some kind of difficulty swallowing.

So it really is an issue that we should all care about and be aware of.

Oh, I'm feeling great.

Are you ready to do a little bit of exercise?

Yes.

Okay.

Like anyone would be, it really affected him not being able to eat or drink.

He would tell me stories about, 'Oh, we used to go.

I used to go with my dad to the ballpark and eat hot dogs, and I wish I could have a hot dog,' or, you know, 'my mom made the best hamburgers, and I wish I could have a hamburger,' and you hurt for them.

Okay, so I'm just putting this on.

This is a sensor.

It's going to tell me and tell him about muscle movement.

The system is called Synchrony, and what it is, is it's a biofeedback machine.

So we place an electrode on the neck.

When she put the electrode on me, it tickles me.

Synchrony uses biofeedback signals to create a visual representation of what's happening when a patient swallows.

It provides information that is translated through a wireless connection to a computer screen.

And then it gives us a printout that we can see in real time, and that helps the therapist to see and it also helps the patient to see.

Wait until you get there and then take a drink.

By incorporating game-based exercise activities, the program assists speech language pathologists in getting patients to reestablish normal nerve and muscle firing patterns.

If you can show them with that visual, 'Okay, that was close, but not quite,' and then finally they get it and you're like, 'That was it!'

And they can see it, and then they try to replicate that same pattern on the graph.

They really can make some quick progress.

They don't have as much guesswork, and you don't have as much guesswork as we used to.

Only after she put electrodes on me did I see the graph to actually see the results of me swallowing slower.

When you see what you're doing on a graph -

Wait a minute.

It simplifies it.

A long time ago, we really didn't have much to offer people with swallowing problems.

Then electrical simulation came along, and that was a really big step forward.

The component that we are lacking is some kind of objective data that you can have on a session by session basis, to see what was actually happening, and that's what this has provided.

In the past, you would say, 'Do an effortful swallow,' and they say, 'Okay, I did it.'

And you thought they did it, but, I mean, really, how can you objectively know if they really did it or not?

And this gives you a visual that you can see.

Relax, though, and then a hard swallow.

All the time that I couldn't swallow, I missed water.

And then when my throat was eligible for real water, just swallowing real water today, it's wonderful.

[ Chuckles ]

To see him progress from not having anything, to the point he is now, where he can have anything he wants to eat or drink.

It's really a wonderful thing, and he's just thrilled with it.

He's come out of his shell and just loving life.

We're a story to tell to the nation, that I want everybody to know that this lady knows how to get me to swallow.

♪♪

Dopamine is a neurotransmitter.

It's a chemical that's produced in a very small subset of neurons in the brain, and it is projected and sent to very specific targets in the brain.

It's interesting that it's, of all the neurotransmitters, one that people -- non-scientists talk about a lot.

There's a lot of referral to, 'That must be dopamine.'

And that's partly related to the fact that dopamine is implicated in almost all recreational drugs.

One of the interesting things about dopamine is that very early work implied at only in addiction and abuse, and for many years we thought it's probably kinda like the pleasure juice of the brain.

The idea was that if you have more dopamine that we'll feel better and that people will seek to increase dopamine in the brain.

In the past 15 to 20 years, we've learned that actually the story is much more complicated, but in many ways much more interesting.

And especially for someone like me who is interested in learning and memory, because it turns out that one of the main things dopamine does is not just that we release dopamine when we feel good, is that dopamine is released when something unexpectedly good happens.

Really, what dopamine is doing is telling us when we should update our expectations about future good outcomes.

And that's really what learning is.

Learning, if you think about it, is really the ability to predict what's going to happen.

And if you know when and where something good will happen, you can then seek it and try to obtain it.

♪♪

At the University of Texas at San Antonio, one scientist is combining aquatic physical therapy with virtual reality to help multiple sclerosis patients through an underwater game.

Up next, the story of how a pool game called Shark Punch is making a splash.

A lot of what I do, I mean, what I'm largely focused on at UTSA is research and virtual reality for rehabilitation.

So, yeah, it kind of did lead into this in some sense because we already had been trying to figure out, 'Well, how can we make better rehabilitation, better visual rehabilitation games for people with various kinds of disabilities?'

We've largely focused on people with multiple sclerosis, largely because that's what I have.

So I'm aware of it and, you know, I'm aware of the problems that people have.

If you get hot, something really common for people with MS is that those all get way, way worse.

So, exercising in a pool is a good way of getting around that, so then you can exercise to, you know, the level of intensity that you want without overheating.

But there weren't any virtual reality games for in the pool.

There weren't any underwater virtual reality games, because basically virtual reality systems don't work in the water.

I thought, 'Well, yeah, I could just take a couple of cellphones that were waterproof and make it work in the water, and punch some sharks because that makes sense.'

It made sense because you're gonna get a bunch of sensory feedback from the water anyway.

And punching sharks is fun.

[ Laughs ]

I mean, I don't have any personal experience with actually punching sharks, but, you know, it's a thing that they tell you to do if a shark attacks you, I guess.

The other nice thing about virtual reality is that you can do things in virtual reality that you would never do in real life because they're too dangerous.

So you can kind of see the -- It's going to make it more exciting, it's going to make it more fun if there's a little bit of, you know -- Your brain knows it's not really dangerous.

But you're still gonna respond when that shark comes around and comes up, and you don't quite see it, and you go, 'Oh!'

You know, that happens.

You see people do it all the time.

It's really funny.

You'll see me do it.

[ Chuckles ] You know?

So the way the game works is you have a head-mounted display on and there's a cellphone that sits in your head-mounted display, which really it's just a cellphone that is mounted to the front of your dive mask.

You wear a little cellphone around your chest, and when the shark bites you, then you'll get a little buzz.

And I wish phones were -- Honestly kind of wish that, like, I could shock myself or something.

[ Laughs ]

'Cause it would be a little bit more like, you know, it wouldn't hurt me, but it would be more realistic.

The shark kind of circles you, and you kind of have to wait.

And then usually you want to kind of track him because he'll come and bite you from behind.

You won't necessarily know it if you don't keep your eye on it.

So, eventually he'll come down and try to -- he'll speed up and try and come and attack you.

And you have to throw a punch, and you can't just throw, like, a little -- ehh -- you can't just throw a little punch.

It has to be a serious punch.

Otherwise the system will not know, recognize that you punched.

But if he does bite you, you'll hear a little kkkrrrsshh!

and your character in the game will like, 'err!'

Right?

It's also filtered to sound like it's underwater.

I'm hoping that, you know, more people get interested in it and, you know, can actually take this thing to where it will actually being used in real physical therapy clinics that have underwater rehabilitation or aquatic rehabilitation capabilities.

I guess I don't have that stress that, what am I doing with my life, because I'm doing something that actually helps people.

[ Laughs ] In the face.

And that wraps it up for this time.

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Until next time, I'm Hari Sreenivasan.

Thanks for watching.

Funding for this program is made possible by... ♪♪