Q&A with Dr. Timothy Constandinou, Next Generation Neural Interfaces and the Ecosystem

Q&A with Dr. Timothy Constandinou

Dr. Timothy Constandinou is a Reader in Neural Microsystems at Imperial College London and also Deputy Director of the Centre for Bio-inspired Technology. He leads the Next Generation Neural Interfaces (NGNI) Lab at Imperial, where his group creates innovative electronic and microsystem technologies to empower next generation tools for neuroscience and medical devices for neural applications. Within the IEEE he serves on several committees and panels, regularly contributing to conference organization, technical activities and governance. He currently serves on the Board of Governors of the IEEE Circuits & Systems Society, is associate editor of IEEE Trans. Biomedical Circuits & Systems (TBioCAS), chairs the IEEE CASS Sensory Systems Technical Committee, and serves on the IEEE Brain Initiative Core Team and IEEE CASS BioCAS Technical Committee. Dr. Constandinou received BEng and PhD degrees in Electronic Engineering from Imperial College London in 2001 and 2005, respectively. 


What led you to your educational choices and a career in neural microsystems?

Timothy Constandinou: Growing up, my hobby and my passion was always electronics—making robots and radio-controlled cars and taking apart the radio, taking apart the TV, anything I could take apart—I was really passionate about electronics. And at the same time, I’ve always had a fascination with the brain, which has all of this electrical activity and so to me represented a big circuit. I always had an ambition and desire to get into my current field, but my training and my education was in electronic engineering. It wasn’t until I got into my PhD, which was exploring how we can make intelligent “cameras” inspired by the way the human eye functions, where I saw and opportunity and that you don’t necessarily have to be a medical doctor to work in this field. You do have to be adaptive to learning all the discipline’s language and talking to other professionals from other disciplines.

Following my work with vision sensors, I became involved with a few medical devices, including one project where we were developing a fully implantable cochlear prosthesis for profound deafness. That was followed by another project that was more closely related to my PhD—one that worked to develop retinal prosthesis for vision. After my PhD, I become more interested in the medical applications and got involved with collaborators on applying the same kind of technology that we use for cochlear implants but to the vestibular system for addressing problems with the vestibular organ in the inner ear, which is responsible for balance and when there’s a problem it can lead to such things as vertigo and blurred vision. What we found is that it’s possible to bypass that part of the inner ear with electronics and sort of plug into the nerve to give the perception of balance. I worked in that space for a number of years and that led to new opportunities in the brain machine interfaces fields, where I’ve been focused the past decade.

What are some of the more recent innovations in neural microsystems and what’s driving innovation?

Tim Constandinou: There’s been a lot more activity internationally over the past five years in trying to better understand the brain, although that’s an effort that has been ongoing for some time. We now have the U.S. BRAIN Initiative, the E.U. Human Brain Project, and just about every country has its own large-scale brain project. And, it’s through these projects that there’s been a lot of emphasis on developing new tools. For example, how can we look at activity in the brain at higher resolutions? Can we get more data to help foster understanding? One key element that has inspired such new technologies is that we need to make things smaller in order to have more recording points. So, a lot of those efforts started off, initially, in the development of research tools, but they are now being translated to applications where there is an underlying kind of neurological condition or injury. For example, we have a project called Empowering Next Generation Implantable Neural Interfaces (ENGINI), where we’re making probes very, very small at the millimeter scale. So, while the project is partly technology driven, there’s also an application pool. In effect, what we see is a great push from the neuroscience community to create these tools, as well as to develop medical devices for neural applications.

What are some of the challenges faced in advancing the technology?

Tim Constandinou: Clearly, the cochlear implant represents a big success story, but we also have had success with deep brain stimulation for conditions like Parkinson’s, essential tremor, dystonia and more recently epilepsy. That said, if you look at these technologies, they haven’t really improved over the past two or three decades. They’re fundamentally the same, using very similar types of electronics, electrode contacts, very similar types of packaging, similar types of stimulation pulses. The only change that’s just now starting to happen is for devices to explore closed-loop operation instead of being just like open-loop pacemakers. So, I’ve been asking why the human medical grade systems haven’t improved? There’s been such great advances in the neuroscience tools space. It’s important to identify the challenges in translating these very exotic technologies to human applications and ensuring that they are safe and can be used chronically for decades. This is what inspired my research in trying to take very advanced technologies to clinical applications. While much of the efforts are being driven by the neuroscience field, over the last decade, quite a few commercial ventures, such as Facebook, Elon Musk’s Neuralink, and Kernel by Brian Johnson, have appeared in the space and are working at developing next-generation technologies. Having said that we don’t really know what they are working on except what they communicate through the media – they have yet to show anything.

How is IEEE Brain helping to advance technology in the neural microsystem space?

Tim Constandinou: IEEE Brain is a new initiative that came along a couple of years ago with an objective to harness all the expertise within all the different IEEE societies and to have like a single voice and a single community. The IEEE is a huge organization with lots of different societies all working in different areas. For example, there’s the Circuits and Systems Society, the Signal Processing Society, the Engineering in Medicine and Biology Society, and all these societies individually had strands of research related to brain. What was missing was a coherent body or overarching umbrella that could reach out to harness the expertise and pull in experts from the individual subdomains all working in this area applied to neuroscience or brain.  The emergence of IEEE Brain serves to define standards, provide guidance on education, oversee publications, arrange meetings and conferences, oversee engagement with industry, really be influential in all aspects where we can make an impact to neuroscience advancement. IEEE Brain has really pulled together all the key resources that have been out there already, but perhaps that had been working in siloes.

Any final thoughts you would like to share?

This is a tremendously exciting time to be in the field–there is so much going on. That said, there are also so many challenges. There is currently a huge gap between innovative neurotechnologies that have been demonstrated in the lab, or even through first-in-human trials, and medical devices out there in everyday use. What makes or breaks a new technology is not considering what I call the “neural interfaces ecosystem”. For a new technology to be successful there is so much more than just securing the funding and then developing and testing the device. In the medical space, it is essential to engage with end-users and care givers, consider ethical implications, start the regulatory process sooner rather than later, figure out the business model for sustainability and the value proposition, consult with healthcare professionals and, of course, ensuring it does what it says and that it is safe and secure.