Kai J. Miller, M.D., Ph.D.

Why did you choose to study clinical and translational research?

Kai J. Miller, M.D., Ph.D., is a scholar in the CCaTS KL2 Mentored Career Development Program at Mayo Clinic.

I have been curious about how things work for as long as I can remember, and actively working as a scientist of one kind or another since high school. Throughout my intellectual development, I was drawn by a desire to understand the mind and to understand the world around me with the physics toolbox. In the academic realm, I found I had a talent for both of these.

When events in my life inspired me to become a physician, my hope was to continue to develop my scientific talents alongside my medical training. I obtained doctorates in physics and neuroscience, researching the statistics of the signals recorded from the brain surface. My colleagues and I found that movement and perception could be reliably decoded from these signals.

I have always felt that science is an important facet of what I can contribute, but that I should also use my life to help people directly and individually. By combining my neurosurgery training with an understanding of large-scale brain dynamics, I believe researchers can make therapeutic cybernetics a reality to meaningfully improve patients' quality of life.

What type of research are you doing?

Amyotrophic lateral sclerosis (ALS) is a disease characterized by progressive loss of muscle function due to death of motor neurons. Generalized weakness leads to complete peripheral paralysis (locked-in state), respiratory failure and death. However, many patients in locked-in state describe a positive quality of life, with degrees of happiness correlated to the degree they can communicate independently.

In light of this, the lab where I spent my Van Wagenen Fellowship in Utrecht, Netherlands, recently began implanting the first off-the-shelf brain-computer interface (BCI) devices for patients with ALS during their transitions to locked-in states.

I am translating my electrophysiological expertise to pursue a research initiative that will further refine this technology and ultimately build a clinical trial at Mayo Clinic. My team will be using 7T fMRI to characterize the hand motor area and ultimately to stereotactically guide high-density electrode placement. Additionally, by studying the electrophysiology of high-density brain surface electrodes, we will be able to configure more optimal recording arrays for more nuanced device control.

These insights will facilitate an improved BCI, which we can then implement and validate with a U.S. clinical trial based at Mayo.

Why Mayo Clinic?

Mayo Clinic is a world-class institution that draws unique patients from around the world, and many patients come here for the last word in their health. The motto "The needs of the patient come first" pervades the work environment here, and it means everything to me to know that my colleagues take this to heart, as I do.

My desire is to use the unique nature of Mayo Clinic to develop therapies that might not be possible elsewhere. I am grateful to be building my practice and research program under the guidance of Mayo's CCaTS.

What are you looking forward to as a KL2 scholar?

My scientific background and experimental foundation in human electrophysiology is extensive, and I believe it will serve me well in this and future endeavors. However, I do not have experience with functional imaging and, more importantly, I do not have experience translating scientific work into clinical reality.

The KL2 provides me with a structured mechanism to add this training into my repertoire and make this research endeavor into a concrete therapy for patients at Mayo Clinic.

Review Dr. Millers' publications on Google Scholar.

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