Chronic multisite brain recordings from a totally implantable bidirectional neural interface: experience in 5 patients with Parkinson's disease.
Chronic multisite brain recordings from a totally implantable bidirectional neural interface: experience in 5 patients with Parkinson's disease.
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DOI：
10.3171/2016.11.jns161162
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发表时间：
2018-03
影响因子：
4.1
通讯作者：
Starr PA
中科院分区：
文献类型：
--
作者：
Swann NC;de Hemptinne C;Miocinovic S;Qasim S;Ostrem JL;Galifianakis NB;Luciano MS;Wang SS;Ziman N;Taylor R;Starr PA
分布式神经网络的功能障碍是许多大脑疾病的基础。神经调节疗法的发展取决于对这些网络的更好理解。侵入性人脑记录对于网络现象的分析具有有利的时间和空间分辨率，但通常限于急性术中记录或通过暂时外部化的导联的短期记录。在这里，我们描述了我们的初步经验，研究，完全植入式，第一代，双向神经接口，允许连续的治疗刺激和记录场电位在多个地点的神经网络。我们为5名帕金森病患者植入了Activa PC+S（Medtronic Inc.），根据医生赞助的食品和药物管理局研究器械豁免。将该器械连接到放置在运动皮质上方硬膜下空间中的四极电极导线上，用于记录皮质电图（ECoG）电位，并连接到丘脑底核（ECOG）中的四极电极导线上，用于治疗刺激和记录局部场电位（LFP）。我们在一年多的时间点记录了每位患者的情况。没有严重的手术并发症或DBS治疗中断。尽管电极阻抗逐渐增加，但皮质和皮层中的信号随着时间的推移相对稳定。我们能够在大多数但不是所有的记录中识别运动皮层中特定频带的典型运动相关变化。人类慢性多部位场电位的采集是可行的。这里描述的设备性能特征可以为下一代完全植入式神经接口的设计提供信息。该研究工具提供了一个平台，用于将大脑网络动力学的发现转化为改进的神经刺激范例。
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. 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. 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. 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.