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COSMIIC tSNIP to Treat Chronic Knee Pain

Award Number: R01EB039066
ORGANIZATION: NATIONAL INSTITUTE Of BIOMEDICAL IMAGING & BIOENGINEERING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2026
PERIOD OF PERFORMANCE END DATE: 07/31/2030

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COSMIIC tSNIP to Treat Chronic Knee Pain - Summary Chronic knee pain affects over 15 million Americans, costing billions annually and severely diminishing mobility and quality of life. Current standard treatments offer only temporary relief and carry significant risks. Thus, there's a critical need for continuous, localized treatments that selectively inhibit pain signals without impairing motor or tactile functions. We propose to develop and validate transient selective neural inhibition via photobiomodulation (tSNIP) to block C-fiber–mediated pain in the saphenous nerve to relieve chronic knee pain. By integrating optimized tSNIP parameters into the FDA-qualified COSMIIC modular platform, already proven safe for electrical stimulation and sensing in humans, this approach promises precise, adjustable, and durable pain relief with minimal systemic exposure. The long-term objective is to create a human-grade device capable of sustained analgesia for chronic knee pain and a flexible foundation for broader neuromodulation applications. Aim 1 will optimize the optical specifications of the COSMIIC tSNIP system. Wavelengths spanning the red to near-infrared spectrum will be evaluated for peak small fiber inhibition efficiency, and illumination geometries will be compared to determine the optimal circumference and length of nerve exposure. Photon propagation measurements in ex vivo rat nerve tissue will support internal irradiance estimates, informing the irradiance requirements for an implantable design targeting the ovine saphenous nerve. Aim 2 will translate these findings into hardware: designing and fabricating a hermetically sealed light-delivery cuff with side-emitting, optical waveguides for circumferential nerve wrapping, and a control module compatible with COSMIIC's networked interface. This module will drive miniature laser diodes with programmable parameters. Bench testing will then verify optical output accuracy, thermal safety, and electronic stability under physiologic loads. Aim 3 will establish initial feasibility in an ovine mid-body transection (MBT) of the medial meniscus model. Two cadaveric sheep will be used to refine surgical implantation techniques, followed by three live animals for procedural validation. A subsequent pilot study will involve six Merino ewes undergoing unilateral MBT; three will receive active COSMIIC tSNIP implants and three will receive sham devices. Behavioral assessments, including pressure-platform gait analysis and accelerometer recordings, will quantify analgesic efficacy, and comprehensive histopathology after humane euthanasia will evaluate biocompatibility and device integrity. Successful completion will yield a fully integrated, implantable tSNIP system optimized for selective C-fiber blockade, ready for an expanded GLP large-animal study. This multidisciplinary effort leverages proven techniques and advanced engineering to deliver a transformative therapy for chronic knee pain and accelerate translation of implantable neuromodulation therapies for various chronic pain and neurological disorders.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $3,778,614 )
2026	2026	CASE WESTERN RESERVE UNIVERSITY	10900 EUCLID AVE	CLEVELAND	OH	44106	CUYAHOGA	USA	The National Institute of Neurological Disorders and Stroke (NINDS) Helping to End Addiction Long-term® (HEAL) Initiative	000	1	7/30/2026	NEW	$3,778,614
2026	2026	CASE WESTERN RESERVE UNIVERSITY	10900 EUCLID AVE	CLEVELAND	OH	44106	CUYAHOGA	USA	The National Institute of Neurological Disorders and Stroke (NINDS) Helping to End Addiction Long-term® (HEAL) Initiative	001	1	9/15/2026	NEW	$0
														Subtotal = $3,778,614

Grand Total All Awards = $3,778,614

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COSMIIC tSNIP to Treat Chronic Knee Pain

Award Number: R01EB039066

ORGANIZATION: NATIONAL INSTITUTE Of BIOMEDICAL IMAGING & BIOENGINEERING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2026

PERIOD OF PERFORMANCE END DATE: 07/31/2030

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