Intracranial neuronal ensemble recordings and analysis in epilepsy

Pathological neuronal firing was demonstrated 50 years ago as the hallmark of epileptically transformed cortex with the use of implanted microelectrodes. Since then, microelectrodes remained only experimental tools in humans to detect unitary neuronal activity to reveal physiological and pathological brain functions. This recording technique has evolved substantially in the past few decades; however, based on recent human data implying their usefulness as diagnostic tools, we expect a substantial increase in the development of microelectrodes in the near future. Here, we review the technological background and history of microelectrode array development for human examinations in epilepsy, including discussions on of wire-based and microelectrode arrays fabricated using micro-electro-mechanical system (MEMS) techniques and novel future techniques to record neuronal ensemble. We give an overview of clinical and surgical considerations, and try to provide a list of probes on the market with their availability for human recording. Then finally, we briefly review the literature on modulation of single neuron for the treatment of epilepsy, and highlight the current topics under examination that can be background for the future development

Implantable Asynchronous Epilectic Seizure Detector

RÉSUMÉ Plusieurs algorithmes de détection à faible consommation ont été proposés pour le traitement de l'épilepsie focale. La gestion de l'énergie dans ces microsystèmes est une question importante qui dépend principalement de la charge et de la décharge des capacités parasites des transistors et des courants de court-circuit pendant les commutations. Dans ce mémoire, un détecteur asynchrone de crise pour le traitement de l'épilepsie focale est présenté. Ce système fait partie d'un dispositif implantable intégré pour stopper la propagation de la crise. L'objectif de ce travail est de réduire la dissipation de puissance en évitant les transitions inutiles de signaux grâce à la technique du « clock tree » ; en conséquence, les transistors ne changent pas d'état transitoire dans ce mode d'économie d'énergie (période de surveillance des EEG intracrâniens), sauf si un événement anormal est détecté. Le dispositif intégré proposé comporte un bio-amplificateur en amont (front-end) à faible bruit, un processeur de signal numérique et un détecteur. Un délai variable et quatre détecteurs de fenêtres de tensions variables en parallèles sont utilisés pour extraire de l’information sur le déclenchement des crises. La sensibilité du détecteur est améliorée en optimisant les paramètres variables en fonction des activités de foyers épileptiques de chaque patient lors du début des crises. Le détecteur de crises asynchrone proposé a été implémenté premièrement en tant que prototype sur un circuit imprimé circulaire, ensuite nous l’avons intégré sur une seule puce dans la technologie standard CMOS 0.13μm. La puce fabriquée a été validée in vitro en utilisant un total de 34 enregistrements EEG intracrâniens avec la durée moyenne de chaque enregistrement de 1 min. Parmi ces jeux de données, 15 d’entre eux correspondaient à des enregistrements de crises, tandis que les 19 autres provenaient d’enregistrements variables de patients tels que de brèves crises électriques, des mouvements du corps et des variations durant le sommeil. Le système proposé a réalisé une performance de détection précise avec une sensibilité de 100% et 100% de spécificité pour ces 34 signaux icEEG enregistrés. Le délai de détection moyen était de 13,7 s après le début de la crise, bien avant l'apparition des manifestations cliniques, et une consommation d'énergie de 9 µW a été obtenue à partir d'essais expérimentaux.----------ABSTRACT Several power efficient detection algorithms have been proposed for treatment of focal epilepsy. Power management in these microsystems is an important issue which is mainly dependent on charging and discharging of the parasitic capacitances in transistors and short-circuit currents during switching. In this thesis, an asynchronous seizure detector for treatment of the focal epilepsy is presented. This system is part of an implantable integrated device to block the seizure progression. The objective of this work is reducing the power dissipation by avoiding the unnecessary signal transition and clock tree; as a result, transistors do not change their transient state in power saving mode (icEEG monitoring period) unless an abnormal event detected. The proposed integrated device contains a low noise front-end bioamplifier, a digital signal processor and a detector. A variable time frame and four concurrent variable voltage window detectors are used to extract seizure onset information. The sensitivity of the detector is enhanced by optimizing the variable parameters based on specific electrographic seizure onset activities of each patient. The proposed asynchronous seizure detector was first implemented as a prototype on a PCB and then integrated in standard 0.13 μm CMOS process. The fabricated chip was validated offline using a total of 34 intracranial EEG recordings with the average time duration of 1 min. 15 of these datasets corresponded to seizure activities while the remaining 19 signals were related to variable patient activities such as brief electrical seizures, body movement, and sleep patterns. The proposed system achieved an accurate detection performance with 100% sensitivity and 100 % specificity for these 34 recorded icEEG signals. The average detection delay was 13.7 s after seizure onset, well before the onset of the clinical manifestations. Finally, power consumption of the chip is 9 µW obtained from experimental tests

Automatic Detection and Classification of Neural Signals in Epilepsy

The success of an epilepsy treatment, such as resective surgery, relies heavily on the accurate identification and localization of the brain regions involved in epilepsy for which patients undergo continuous intracranial electroencephalogram (EEG) monitoring. The prolonged EEG recordings are screened for two main biomarkers of epilepsy: seizures and interictal spikes. Visual screening and quantitation of these two biomarkers in voluminous EEG recordings is highly subjective, labor-intensive, tiresome and expensive. This thesis focuses on developing new techniques to detect and classify these events in the EEG to aid the review of prolonged intracranial EEG recordings. It has been observed in the literature that reliable seizure detection can be made by quantifying the evolution of seizure EEG waveforms. This thesis presents three new computationally simple non-patient-specific (NPS) seizure detection systems that quantify the temporal evolution of seizure EEG. The first method is based on the frequency-weighted-energy, the second method on quantifying the EEG waveform sharpness, while the third method mimics EEG experts. The performance of these new methods is compared with that of three state-of-the-art NPS seizure detection systems. The results show that the proposed systems outperform these state-of-the-art systems. Epilepsy therapies are individualized for numerous reasons, and patient-specific (PS) seizure detection techniques are needed not only in the pre-surgical evaluation of prolonged EEG recordings, but also in the emerging neuro-responsive therapies. This thesis proposes a new model-based PS seizure detection system that requires only the knowledge of a template seizure pattern to derive the seizure model consisting of a set of basis functions necessary to utilize the statistically optimal null filters (SONF) for the detection of the subsequent seizures. The results of the performance evaluation show that the proposed system provides improved results compared to the clinically-used PS system. Quantitative analysis of the second biomarker, interictal spikes, may help in the understanding of epileptogenesis, and to identify new epileptic biomarkers and new therapies. However, such an analysis is still done manually in most of the epilepsy centers. This thesis presents an unsupervised spike sorting system that does not require a priori knowledge of the complete spike data