Doctoral Dissertation Research: Understanding the Brain-Machine Interface in the Engineering of Prosthetic Technologies

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People suffering from traumatic limb loss often experience both withdrawal and heightening of sensation. Deprived of the limb's sensory feedback, roughly 80% of amputees experience intense, mysterious phantom limb pain. Scientists are developing brain-controlled prosthetics that enable patients to move their prosthetic limbs through thought, while also receiving sensory feedback (touch) from the environment back into the body. Yet touch, pain, and sensation are difficult to quantify, deeply subjective experiences, requiring a delicate process of communication, collaboration, and translation among patients, scientists, and engineers. How do patients' sensory experience, their sense of being in a body in space, and their awareness of their phantom limb, influence the development of such biotechnologies? How do patients actively participate, and even intervene, in the design of human-machine interfaces? These are the questions addressed in this project, to inform the development of biotechnologies. In addition to providing funding for the training of a graduate student in anthropology, the project will broadly disseminate its data and findings to aid organizations in developing more effective biotechnology design and clinical practice to improve the lives of disabled individuals.Graduate student, Alexandra Middleton, under the supervision of Dr. Joao Biehl of Princeton University, will investigate the role of patients as simultaneously experimental subjects and active co-innovators in human-machine interface design. To understand how the brain-machine interface is engineered, the project examines the role of patient experience and feedback in the development of biotechnology. This ethnographic research will be conducted in Gothenburg, Sweden, a global epicenter of engineering brain-machine interface prosthetic technologies. The researcher will follow two clinical trials, accompanying patients as they engage with experimental neuroprosthetics in the laboratory, clinic, and their homes. These devices are the first in the world of their kind to travel outside the laboratory for home use in everyday life. Ethnographic focus will be placed on the home as a key site of science-in-the-making. Through participant observation in patients' homes and interviews with both patients and family members, the researcher will investigate how everyday experiences constitute a particular type of expertise about the use and possibilities of these devices. Circling back to the clinic and laboratory, the researcher will trace how these forms of expertise inform decisions in design as well as therapeutic communication. Archival research will examine the particular economic and social contexts that make such experimentation and development possible. Findings from this research will offer insight into the ways that human perspective and technology use can inform laboratory development and clinical communication, as well as highlighting the importance of involving disabled individuals in the design of technologies aimed at enhancing their lives. These insights will inform clinical trial design and practice among scientists, clinicians, and patients, as well as human-machine relations generally.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.