The Debrief: Chris Czura has the pulse of the future

The Feinstein Institute's Chris Czura.

Healthcare and data-driven tech are the cornerstones of the innovation economy, making the Feinstein Institute for Medical Research, the R&D wing of the North Shore-LIJ Health System, the public face of Long Island’s best economic hope. More than that, it’s a hotbed of really cool science – and none cooler than the “neural tourniquet,” a nerve-stimulation device that promises to change how doctors staunch blood loss in the field and the operating room. As the tourniquet’s co-inventor, the executive publisher of the Feinstein’s international journals Molecular Medicine and Bioelectronics Medicine and overseer of the institute’s $95 million annual budget, few help shape the Island’s economic future like Christopher Czura. In his words:

TOURNIQUET COUNTDOWN: The research and development continues, with a lot of success. We continue to study the mechanisms of how the technology actually works, but we know enough at this point to go to clinical trials relatively soon – I’d hope within two years.

BUT FIRST: The prototype we use in the laboratory is not appropriate for clinical use. It’s big and super-complex and it needs to be heavily programmed to operate. So we’re prototyping simpler versions, 3D-printing new electrodes and designing a new external pulse generator, which is what actually sends out the electrical pulse to stimulate the nerve. The generator we wind up with will be much simpler and much safer, with safe levels of maximum electrical current coming out.

TOO REAL FOR DARPA: The Defense Advanced Research Projects Agency no longer has a role in the project. We’ve been working on this for 12 years and DARPA initially funded our research. They like to fund research projects that are a bit out of reach – interesting and exciting hypotheses for which there normally isn’t financial support. Understand, when we started this, the thinking was electrical stimulation would actually promote bleeding, so we were going against the dogma. But DARPA loved the idea of a simple nerve-stimulating device that applied to the skin and could control bleeding. So they jumpstarted the project until we generated sufficient data and were able to move on with other investors.

SPINNING OFF SOON: A new spinoff company to move the neural tourniquet to clinical trials should form within the next three months. We don’t have a name for the company yet, but we are talking with a candidate CEO and we hope to sign an executive agreement soon. I actually think we can shorten the timetable on clinical trials a bit. We’re designing the trials now – what patient populations to use to study the device with, for instance. We’re definitely fast-tracking the clinical development.

THE NEW GUY: Bringing over Chad Bouton [from the Battelle Memorial Institute, where he was a senior scientist] was a great opportunity for Feinstein. Chad and I started working together on the neural tourniquet project about a year-and-a-half ago. He’s done some amazing work on what he calls “neural decoding” – basically, interpreting nerve signals.

CONSCIOUS EFFORT: Working with neurosurgeons, he implanted a small array of electrodes – about the size of the fingernail on your pinky – in the motor cortex, the part of the brain that controls movement. He was able to interpret and decode conscious thought control, run it through a computer and actually distinguish various patterns that control different motions, like flexing your wrist or fingers. Then he reinserted those thought patterns into a cuff worn on the forearm of the user and stimulated the nerves to recreate those movements in patients with spinal cord injuries. He actually restored functions to a patient’s hand – the first time that was ever done in humans.

BOLD BIOELECTRONICS: Other projects on the horizon for us and for Chad include using conscious thought, with an implant in the brain, to control prosthetics. We absolutely will be able to do that. And all of that is similar to the work we’re doing across bioelectronics medicine, the difference being that instead of restoring the functions of your hand, we’re restoring the functions of your spleen, or your pancreas, or other organs that are malfunctioning and causing diseases.

TRACEY’S WORLD: The things that Kevin Tracey [Feinstein’s president and CEO] has been able to do across his career are phenomenal. I’ve worked with him long enough now to appreciate that he has a special quality: a great intuition for understanding how the human body works and how we can modify it and regulate it to treat diseases. Years ago, it was experimenting with novel drugs. Now it’s discovering new pathways and methods to treat inflammation. He also has a great personality. Not only is he really smart, he’s really funny. Intelligence and innovation and creativity is one thing, but the positive environment we work in is unparalleled.

MAN OF WORDS: Probably on the order of 15 percent of my time is spent on publishing the journals, and the biggest issue is the state of financing around publishing. The entire publishing industry has been struggling for a decade now to generate enough revenue to cover expenses, and our journals are no different. From a content perspective, we’re having the same problem with Bioelectronics Medicine now that we had with Molecular Medicine 20 years ago: bringing together fields that don’t always communicate with each other. Twenty years ago, physicians didn’t think about disease at the molecular level and molecular biologists didn’t really understand medicine. We had to get those two groups together to come up with new ways to treat patients.

PLAY NICE: Now we have to bring together several different groups: the molecular medicine audience we’ve been cultivating for 20 years, the neurophysiologists who understand how to interpret neural signals and the engineers who can make the electrodes that interface with those nerves and can design the circuitry to stimulate and block those nerves, as well as statisticians and theoretical physicists who understand very complicated algorithms and can mine the data we accumulate. Bringing these disparate fields together is the challenge. Bioelectronics is our major strategic initiative, and we really need these groups to communicate with other for this field to grow.

Interview by Gregory Zeller