Online Master's in Biomedical Engineering @ Case.edu
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A Visionary Leader

 

As a forerunner in neuromodulation, Hunter Peckham advocated interdisciplinary collaboration and clinical research.

For nearly 50 years, Hunter Peckham has been a pioneer in the field of rehabilitation engineering. He developed the first commercially-available neuroprosthesis for people with spinal cord injury (SCI) and has received 11 patents for functional neural stimulation systems and neural prostheses. However, Peckham’s true gift as an innovator may not be his technical prowess, but rather his work as a bridge builder among people.

 

 

“Hunter believes in people and the necessity of connecting people – especially those in disparate fields – to change the world for the betterment of all humanity by innovating and translating innovations into clinical practice and standard of care,” says John Chae, MD, Vice President of Research and Sponsored Programs for the MetroHealth System and Co-Director of the MetroHealth Rehabilitation Institute alongside Peckham.

During his career, Peckham has collaborated with countless people, from engineers and physicians to students and entrepreneurs. Working together, they transformed the field of biomedical engineering and functional electrical stimulation. Although Peckham retired from Case Western Reserve University on June 30, 2020, his legacy lives on.

“Hunter invented the words, concepts and technology – and made clinical translation possible – by building companies, partnerships and collaborations across academic, institutional and departmental lines,” says Michael Keith, MD, an orthopaedic surgeon at MetroHealth. “He was the ambassador-at-large for engineering.”

 

Embedding a Lab within a Hospital

When Peckham was an undergraduate student in engineering at Clarkson College of Technology in the mid-1960s, biomedical engineering wasn’t a formal discipline. While studying mechanical engineering, he read a journal article that caught his attention. “It was about the Starr-Edwards aortic valve, one of the first artificial heart valve replacements,” recalls Peckham. “I thought, ‘Wow! You can actually makes things that go into the body.’ That was an eye-opener.”

After earning his bachelor’s degree, Peckham began looking for educational institutions where he could receive training on medical devices such as valve replacements. “Case was one of the few options,” he says. “Shortly after I arrived, the Department of Biomedical Engineering was created. I was one of the first ‘test pilots’ of BME.” Peckham earned his master’s degree in mechanical engineering from the Case Institute of Technology in 1968 and his doctorate degree in biomedical engineering in 1972 from Case Western Reserve University.

As a doctoral student, Peckham began research at Highland View Hospital that shaped the remainder of his career. In class, he was studying how to change the properties of muscles by stimulating them, and he wondered if the technology could be used to help people with SCI. The rehabilitation hospital east of Cleveland, which later was integrated with MetroHealth, had a program to help SCI patients gain greater independence and functionality. With funding from a few small grants, Peckham set up a lab within the hospital.

“I was an anomaly at the hospital. At the time, people thought, ‘What’s an engineer doing on the unit?’” says Peckham. “The arrangement was a mystery to many people, but the lab was accessible to people being treated for SCI and their nurses, doctors and therapists.”

Peckham teamed with clinicians and patients from day one. Among those he worked with was Alvin A. Freehafer, MD, a pioneer in tendon transfer surgery to restore partial function to paralyzed hands and arms. Peckham often joined Dr. Freehafer in the operating room. The engineer’s research on mapping muscle properties helped the physician fine tune his surgical techniques and produce better patient outcomes. One of the biggest coups for Peckham’s program was landing an award from the NIH’s National Institute of Neurological Disorders and Stroke in 1972.

Freehafer later introduced Peckham to Dr. Keith, and the two began collaborating in 1979 on functional electrical stimulation (FES) – the application of electrical currents to the nervous system to generate activity in paralyzed limbs. “I provided the problems to be solved, and Hunter created new electronic devices that could be implanted. He innovated new, safe ways of animating paralyzed muscles,” says Keith, who developed surgical techniques to implant the devices and influenced their design.

The work on implantable devices with Dr. Keith marked a pivotal shift. “There is a big difference between studying how muscles move in response to stimulation and creating a device that enables a person to have function as a result of that,” says Peckham. “I gravitated toward clinical research with human subjects that nobody else in the world was doing.”

 

Creating the FES Center

Peckham focused his research on neuromodulation for upper extremities, specifically the hand. With support from the Department of Veterans Affairs, the NIH, the Food and Drug Administration and numerous colleagues, Peckham developed the FREEHAND system. The neuroprosthesis sends electrical signals to muscles in the hand, causing it to open and close. In 1986, the eight-electrode device was implanted in the first patient, Jim Jatich (below), who sustained a cervical-level spine injury from diving into a pool nearly a decade prior. The system functioned well for 27 years until Jatich’s death in 2013.

“To create a working device for someone like Jim and see how it changed his life – see him pick up things – was tremendous,” says Peckham. But Jatich was more than just a clinical subject to Peckham. “He befriended Jim, and together they shared knowledge,” says Keith. “Their relationship influenced other practitioners to commit their careers to persons with spinal cord injury."

Researchers and physicians who worked alongside Peckham in the 1970s and 1980s at Highland View Hospital moved to other facilities, such as the Louis Stokes Cleveland VA Medical Center. While Peckham focused on upper extremities, others concentrated on lower extremities. Innovators in the field remained in close contact, yet separate groups adopted different approaches to their work. Then Peckham had an “aha” moment to create a center devoted to neuromodulation.

“We needed to consolidate efforts to build a better environment with more cohesiveness in the engineering development approach,” says Peckham. The Cleveland FES Center was founded in 1991 with three institutional partners: Case Western Reserve University, the Louis Stokes Cleveland VA Medical Center and MetroHealth Medical Center. Later, University Hospitals and the Cleveland Clinic Neurological Institute joined the consortium. Peckham served as executive director of the center for more than 20 years.

Dedicated to introducing functional electrical stimulation into clinical practice, the FES Center has garnered national attention and attracted top-notch researchers. Many of them subsequently obtained faculty positions in biomedical engineering at Case Western Reserve University, including Robert Kirsch, current Chair of the Department of Biomedical Engineering and Executive Director of the FES Center.

“The whole core of the neural engineering group at Case is based on the kind of recruitment we were able to do at the FES Center,” acknowledges Peckham. “That has had a long-lasting impact on the BME Department. Neural engineering is a strength of the department.”

 

Focusing on Technology Transfer

With a strong team in place at the FES Center, the researchers began attracting the attention of organizations striving to commercialize cutting-edge technology. Between 2003 and 2010, Peckham was the principal investigator on grants from the state of Ohio’s Biomedical and Research Technology Transfer (BRTT) program and Biomedical Research and Commercialization Program (BRCP). In 2013, he landed $3 million in funding from the Ohio Third Frontier program to commercialize neuromodulation and neurostimulation technology platforms.

“At the time, it was hard getting money to do translational work. You had to be headstrong – and sort of crazy – like me,” recalls Peckham. “Getting that money from the state allowed the faculty [at Case Western Reserve University] to work on things that were more translational.” Based upon the BRTT, the Department of Biomedical Engineering received funding from the Coulter Foundation to support the Case-Coulter Translational Research Partnership (CCTRP) to advance biomedical products to the marketplace.

This was not Peckham’s first foray into commercialization. In 1993, he founded NeuroControl Corporation, which brought two Food and Drug Administration-approved products for people with SCI to market – the FREEHAND system and a bladder control system. “In order to get technology to people, we needed to have a company partner with us on commercialization,” says Peckham.

NeuroControl raised $30 million in startup funding from venture capitalists, and approximately 300 people worldwide were implanted with the FREEHAND system. But in 2002, the company folded. “Clinically, the product was changing lives for patients every day. We proved we could do this,” says Peckham. “But we also proved the startup business model was wrong.”

Despite the company failing, Peckham says it validated the value of the technology, which in turn led to the grants from the state of Ohio and the CCTRP. And he was not willing to give up on commercialization. “If the startup model was wrong and no big company was going to commercialize the product, then what model would work?” questioned Peckham. “That’s when we came up with the idea for a non-profit institute operating within the university.”

In 2013, Peckham launched the Institute for Functional Restoration (IFR) at Case Western Reserve University. “The idea was to create an incubator model that would move this technology further along the translational spectrum and reduce risks for a commercial partner with parallel interests,” says Peckham. In 2018, the IFR received the Gold Electrode Award from Neurotech Reports for being the most valuable nonprofit.

 

Writing the Next Chapter in Neuromodulation

Although Peckham has retired as a professor from Case Western Reserve University, he is not stepping away from his life’s work. He continues to serve as co-director of the MetroHealth Rehabilitation Institute and the Institute for Functional Restoration. “I still have a tremendous commitment to people with spinal cord injury and getting these neuromodulation systems out,” he says.

Through the years, Peckham has collected numerous accolades acknowledging his body of work. He received a Lifetime Achievement Award from the North American Neuromodulation Society earlier this year and the same award from the American Spinal Injury Association in 2015. He was elected to the National Academy of Engineering and is a fellow of the National Academy of Inventors and the International Academy of Medical and Biomedical Engineering.

Peckham has worn many hats: engineer, scientist, inventor, professor and entrepreneur. The list goes on. “I never had just one job. As my interests changed and my skills developed, Case gave me the opportunity to do many different things,” he says. “I tell young faculty that they can do virtually anything at Case Western Reserve University if they take the initiative.”

Hunter Peckham serves as an exemplar of just how far initiative can take you – and the tremendous impact it can have on the world.