Silvestro, what is the real life issue that your project addresses?
What we are after is the restoration of fine grasping. Let me explain what this means. A human hand can gather a huge amount of data, often without its owner being aware of this: about the shape, texture, weight and other characteristics of what it touches. As a result, if a limb is missing, extremely valuable data is also missing and the person has to rely on vision. Unfortunately, the prostheses generally used today cannot replicate this information-gathering role, and this makes the life of the patients much more limited than we usually imagine. Our goal is to not only give patients a replacement hand, but also gather information with it for better navigation.
The solution will help patients not only physically, but also psychologically, won't it?
Yes: for example, people who suffer the loss of a lower limb often don't use their prosthesis, and they wonder what the point is of spending money on a prosthesis that is not much better than a merely cosmetic one. If you are not able to provide a real clinical physiological benefit then your solution is not going to work. That is what makes the NEBIAS hand different – the patients really feel the solution is part of their body and can use it accordingly. They see it as something new and natural. They can use their hand in a better way and they are happy about it.
What motivated you personally to pursue this research into prostheses?
For me, NEBIAS is a product of a child's dream and a man's desire to help people. First, I like to work on ideas that make patients' lives better and more enjoyable by giving them back at least bits of what they've lost. Second, when I was a teenager I used to read a lot of comic books and watch science fiction movies, and so the idea of a 'bionic man' truly fascinated me.
What stage is the project at?
We are now at a turning-point; we have both the technology and the knowledge to develop an electrical neuro-prosthesis that can actually be used. This kind of technology is now ready to have a clinical impact. If we are lucky, in around three years from now there will be a number of patients with the technology fully implanted, hence with all the electronics fully "inside". That will be the end of my work as a scientist. The next step, which would be implantation on a larger scale into 20-100 people, has to be done by a separate start-up company (which we recently created, also with the help of the FET Programme).
Often the commercial clinical availability of technology like yours is hampered by astronomical costs linked to the production of each individual piece. Is it not the case with the NEBIAS hand?
Frankly, no. If the innovation is taken up all over the industry and gets produced on a large scale, the cost per piece is not astronomical at all. We are talking about approximately 25 to 30 thousand EUR. That is a lot of course, and the patient needs help of insurance or public health funding, but this is already the case for similar technology applications such as cochlear implants (for deaf people). People might ask me: so why did you get 4 million EUR to do that? The answer would be: to cover expenses for the human resources who designed, developed, and tested all our technologies. Good technology on the scale of research is developed by people, not machines.
What are your ambitions for new work once you are finished with the NEBIAS hand?
My personal ambition is to use what we learned from NEBIAS to advance the field of sensory restoration further in as many directions as possible. We have already kicked off a project focusing on the restoration of lower limbs after paralysis, we have received funding for research into eyesight restoration, and we are looking into the restoration of the ability to grasp things after paralysis. This is all part of the “umbrella project” that I call “i4LIFE”.
Your project is one of the success stories of the EU's FET programme. How do you feel about working with FET?
I have been working with FET for the past 20 years and I very much like the FET approach to science. The cool thing about FET is that it allows you to test things that might seem crazy to a non-visionary eye. Of course, it would not allow the pursuit of something completely impossible like tele-transportation, which is very implausible from a physics point of view (although who knows…?). But even with its feet on the ground FET sees only the sky as the limit.
The only concern I have is that FET programme does not seem to be getting the funding it should. Increasing levels of funding for blue sky projects will power innovation in five, ten or even fifteen years, which clearly is a very long term investment. However, if we do not fund this kind of project now, we will not get any ground-breaking innovation in fifteen years.