Chronic multisite brain recordings from a totally implantable bidirectional neural interface: experience in 5 patients with Parkinson's disease

Abstract

OBJECTIVE Dysfunction of distributed neural networks underlies many brain disorders. Development of neuromodulation therapies depends on a better understanding of these networks. Invasive human brain recordings have a favorable temporal and spatial resolution for the analysis of network phenomena, but have generally been limited to acute intraoperative recording or short term recording through temporarily externalized leads. Here we describe our initial experience with an investigational, totally implantable, first generation, bidirectional neural interface that allows for both continuous therapeutic stimulation and recordings of field potentials at multiple sites in a neural network. METHODS We implanted five Parkinson’s disease patients with Activa PC+S (Medtronic Inc.), under a physician-sponsored Food and Drug Administration investigational device exemption. The device was attached to a quadripolar lead placed in the subdural space over motor cortex, for recording of electrocorticography (ECoG) potentials, and to a quadripolar lead in subthalamic nucleus (STN) for both therapeutic stimulation and recording of local field potentials (LFPs). We recorded from each patient at multiple time points over a one year period. RESULTS There were no serious surgical complications or interruptions of DBS therapy. Signals in both cortex and STN were relatively stable over time, despite a gradual increase in electrode impedance. We were able to identify canonical movement related changes in specific frequency bands in motor cortex in most but not all recordings. CONCLUSION Acquisition of chronic multisite field potentials in humans is feasible. Device performance characteristics described here may inform the design of the next generation of totally implantable neural interfaces. This research tool provides a platform for translation of discoveries in brain network dynamics to improved neurostimulation paradigms.

Deep Learning provides exceptional accuracy to ECoG-based Functional Language Mapping for epilepsy surgery

“…Moreover, deep learning-based ECoG-FM approaches can be successfully applied in various fields of adaptive neurotechnologies (e.g., neuromodulation), where ECoG-based mapping is performed to determine the best area for responsive stimulation. For example, for defining the neural correlates of tics to be used for responsive stimulation in patients with Tourette's syndrome 42,43 and for bidirectional neurostimulation via fully implantable neural interfaces in Parkinson's disease 44 . The applicability of our proposed approach extends as well towards the fields of developmental disorders (e.g., autism) 45,46 , psychiatry (e.g., major depression 47 and obsessive-compulsive disorder (OCD) 48 , addiction 49 , eating disorders and obesity 50,51 , where neurostimulation can be potentially utilized to provide treatment and improve patients' quality of life.…”

Proceedings of the Seventh Annual Deep Brain Stimulation Think Tank: Advances in Neurophysiology, Adaptive DBS, Virtual Reality, Neuroethics and Technology

“…Potential uses of bidirectional interfaces include the identification of electrophysiologic signatures of specific signs or symptoms of brain disorders, and the development of aDBS (Modolo et al, 2012;Swann et al, 2018b). However, the first-generation devices (that have been available since 2013) had limitations in signal quality, management of stimulation artifact, and the capability for continuous collection of brain data in home environments (Swann et al, 2018a). Toward closing these gaps, we have gained experience with a newly available second-generation device, Summit RC+S (Medtronic) in five patients with PD (Stanslaski et al, 2018).…”

Home Use of a Wireless Intracortical Brain-Computer Interface by Individuals With Tetraplegia

“…Recently, deep brain stimulators (DBS) have served as a convenient, clinically accepted platform upon which fully implanted wireless BCIs have been developed [57]- [59]. A wireless BCI, configured from a bi-directional fully implanted DBS device (Activa PC+S, Medtronic, Inc.) was used to sample field potential data (0.8kS/s) from a bipolar pair of chronic subdural ECoG electrodes in a person with ALS [58].…”