CD- Laboratory for Restoration of Extremity Function Annual Report 2017 Annual Report 2017 of the Christian Doppler Laboratory for Restoration of Extremity Function Report Authors: Oskar C. Aszmann, Clemens Gstöttner, Aron Cserveny Head and Address of the Christian Doppler Laboratory Prof. Dr. Oskar C. Aszmann Division of Plastic and Reconstructive Surgery Department of Surgery Medical University of Vienna Spitalgasse 23 1090 Vienna, AUSTRIA Phone: +43 1 40400 69940 / 68290 Fax: +43 1 40400 69820 Email: [email protected] Web: www.bionicreconstruction.com Table of Contents Introduction 5 Press Highlights 2017 7 2017 – A Year in Numbers 8 Vienna – Bionic Capital of Europe 10 Projects Overview 12 Scientific Output 20 Funding 29 Awards & Scholarships 30 Cooperations 32 Teaching & Public Relations 34 Impressions of a Great Year 36 People 38 2018 – An Outlook 48 Annex – Projects in Detail 50 Introduction 2017 has been the sixth year since the inauguration of the With her special gift of writing she has compiled their CD-Laboratory for Restoration of Extremity Function. The amazing stories in our textbook “Bionische Rekonstruk- foundations have been laid out wide and well providing a tion – Wieder herstellung an der Grenze zwischen Mensch solid structure for the current tasks and future growth. In und Maschine”, which will be published by the Manz Verlag the life-cycle of the Lab we have reached a plateau and in March 2018. The psychological dimension of losing bodily steady-state both in regards to the number of PhD students integrity and finding restoration in mechatronic parts has and projects that are under way. Including various colla- also been explored scientifically together with Laura and borations, we currently supervise 10 PhD and 6 Diploma clinical Psychologist Anna Pittermann – a report that was students in our Lab. Three of these will have finished their just published in PlosOne, proving the effectiveness of this doctoral thesis by January 2018, with several publications treatment both in regards to functional restoration and listed, in press or in submission. Those who finished their psycho logical wellbeing. MD-PhD Program (N790 or N094) in the past have easily found training positions here and abroad with highest Regaining function and replacing body parts via complex rankings among their peers and I have no doubt will do mechatronics require novel learning strategies – a task that extremely well in their respective academic careers. is all but trivial. Here last year a major breakthrough has been achieved by the work of Agnes Sturma and Cosima Prahm, who have devised virtual, EMG-based rehabilita- tion tools helping patients to make best use of their termi- nal devices. Their work has been published in the renowned Journal of Medical Internet Research and recently won the Research Prize of the German Association for Microsurgery. Along the same lines, Dr. Gesslbauer’s work demonstrated that from an organizational point of view movement control requires a lot more afferent feedback than efferent control and muscles are actually more intelligent than one would think. This work was published in Annals of Neurology and Dr. Bergmeister’s respective PhD thesis is currently under review in Nature Neuroscience. A major challenge has been signal extraction and signal transmission. Drs. Aman and Sporer have devised various Prof. O. C. Aszmann at the DGH Conference in Munich animal models to improve signal extraction for high fidelity prosthetic control. In a collaboration with Prof. Hoffmann Our Laboratory has steadily generated 40+ annual impact from the Fraunhofer Institut intraneural electrodes have factor for the last 3 years, with a 5-year cumulative total been tested and with Drs. Ivan Vujaklija and Silvia Muceli of 175.50! This year yet another 16 Pubmed listed citations from Imperial College, who have joined us for parts of 2017, were added with an impact of just under 50. Some of the various implantable epimysial high-density EMG electrodes more prominent publications this last year (Science, Scien- were implanted in some of these animals. Preliminary tific Reports, PlosOne and Nature) have given us continued experiments are promising and are a centerpiece of the international visibility and a great platform to work from, opening exciting new avenues of international research col- laborations and patient care. Last year our collaborations with the Department of Biomedical Engineering at Imperial College, UK and the Center of Osseointegration Research at UCSF were intensified through PhD exchange, resulting in superb publications such as Nature Biomedical Engineering and most recently Science Robotics. Furthermore, our expertise as a group caring for patients with critical loss of extremity function has been well ap- preciated in national and international medical networks, resulting in numerous consultations and treatment re- commendations so that we have indeed advanced to being The Reference Center for Bionic Reconstruction in Europe. Some of the patients that were treated here through- out the last years have been interviewed by Laura Hruby. Prof. O. C. Aszmann congratulating Dr. S. Salminger on receiving his PhD Christian Doppler Laboratory for Restoration of Extremity Function | Annual Report 2017 5 Press Highlights 2017 “It all seemed to come together. I went for the fitting and I see my arm physically working. I’d had nothing there and all of a sudden my arm is bending and I could move the hand.” First british patient about his elective amputation Celebrations with C. Prahm MSc after winning the award for best clinical talk at the DAM conference ERC Synergy Grant Proposal which we successfully sub- Krisztina Szalai and Anna Willensdorfer have worked hard mitted on November 14th. Clinically we have successfully on the research floors, helping to maintain clean infrastruc- “…first Briton to choose to have his implanted wireless sensors after nerve transfers in three ture, data security, organizing regular lab meetings, jour hand amputated and replaced with a human amputees in a pilot trial – a work that is currently fix, formal and informal PhD meetings, numerous meetings bionic limb …” under review in Science Translational Medicine. Dr. Stefan ”across the hall” or in our small offices and thus keep a Salminger who has been mainly involved in this work has healthy, informative, encouraging spirit that make our Lab, “After learning of pioneering surgi- been awarded the Theodor Billroth Preis of the Austrian despite the complexity of our work, so exciting. cal techniques, he contacted the man Chamber of Physicians just a few weeks ago for his tre- behind them, Oskar Aszmann of the mendous work on prosthetic outcome studies. Finally, a big thanks to Dr. Johannes Mayer, who, beside Medical University of Vienna,…” his research work helped me maintain structure and sanity Throughout the entire last year, we have invested a lot of time in the midst of controversy and reminds me to buy flowers “It’s amazing,” she said. “To be able to hold a tube of toothpaste and undo in our Springer Book on “Bionic Extremity Reconstruction”. for my wife. This work will have 25 chapters and will entail all aspects the lid instead of using my teeth. I’ve not stopped grinning. It’s like rebuild- of this dynamic research field. Dr. Salminger has been very So have fun reading, or just browsing through these pages strict in collecting the material from the team, which will be and witness the inquisitive spirit that permeates our lab ing yourself and coming to the pinnacle of what you’ve always worked for.” compiled by me and Prof. Farina within the next few weeks, and the scientific and clinical benchmarks that document Prof. Aszmann’s patient describing her experience with bionic reconstruction with a prospective first draft in March 2018 and final version its effectiveness. in May 2018, just in time for the 2nd International Symposium on Innovations in Amputation Surgery and Prosthetic Tech- nologies (IASPT) here in Vienna. “Imagine having increased hand-like “...Oskar Aszman, together with his “...After the workshop in Professor As you can tell this Annual Report looks quite different function and less deafferentation pain. british colleague Dario Farina (Depart- Aszmann’s Laboratory a pupil from a from the previous versions. This we owe to Dr. Clemens Would you trade in your useless biolog- ment of Bioengineering, Imperial Col- primary school said: “I will definitely Gstöttner, who recognized some room for improvement ical hand for a bionic hand if one was lege, London) managed to decode in- become a scientist”...” in earlier reports, and Aron Cserveny, our faithful graphic offered? For some, the choice may be formation from neurons in the spinal From an article on ORF.at about the Open Science artist who helps us illustrate and communicate our easier than you think. cord, which are responsible for the Project with school children research work so beautifully. Univ. Prof. Dr. Oskar C. Aszmann movements of the arm...” When asked about the study, the senior Der Standard article on our man-machine-interface investigator, Oskar C. Aszmann, M.D., publication in Nature Ph.D., stated, “For more than 25 years, I have dealt with patients suf- “...For this a team led by Oskar Aszmann fering from devastating peripheral at the University Clinic for Surgery at the nerve lesions. Bionic reconstruction, Medical University of Vienna has devel- as described in this paper, has been a oped a psychosocial assessment proce- real game