Effective Treatment of Currently Intractable Brain Disorders

Many neurological and psychiatric disorders with predominantly cerebral cortical pathology, including most severe strokes, traumatic brain injuries, malignant brain tumors, intractable focal epilepsies and dementias such as Alzheimer’sdisease are currently difficult, if not impossible, to treat. This causes suffering in almost 100 million people worldwide. 

We propose that bioengineered cranial bones with multiple intelligent functions, including sitespecific transmeningeal drug delivery and neurotoxin drainage with EEG feedback, can provide effective treatment of these brain disorders by drug combinations that act on both synapses and genes with concomitant selective drainage of harmful extracellular molecules. After examining and summarizing the rationale andfeasibility of this proposal, we suggest novel methods for extending the functions of the involved components including synergies with existing devices and we highlight relevant preclinical results, discussing medical prospects of this novel neurotherapeutic approach. Finally, we discuss key engineering, scientific, clinical and ethical challenges to introducing bioengineered cranial bones with multiple intelligent functions to the clinic within a decade.