OMNI: Open Mind Neuromodulation Interface for accelerated research and discovery

Electrical neuromodulation is an approved therapy for a number of neurologic disease states, including Parkinson's disease (PD), Obsessive Compulsive Disorder, Essential Tremor, epilepsy and neuropathic pain. Neuromodulatory strategies are also being piloted for an increasing number of additional indications, including Major Depressive Disorder, Dystonia, and addiction. The development of implantable devices capable of both neural sensing and adaptive stimulation may prove essential for both improving therapeutic outcomes and expanding the neuromodulation indication space. Nevertheless, an increasingly fragmented device ecosystem forces researchers and therapy developers to customize and reinvent data visualization, clinician engagement, and device control software to support individual clinical studies. Each hardware platform provides a unique software interface to the implanted neurostimulator, making pre-existing code from prior studies difficult to leverage for future work - a hindrance that will expand as device technology diversifies. Here, we envision, detail, and demonstrate the use of a novel software architecture, OMNI, that accelerates neuromodulation research by providing a flexible, platform- and device-agnostic interface for clinical research and therapy development

Embedded adaptive deep brain stimulation for cervical dystonia controlled by motor cortex theta oscillations

Dystonia is a disabling movement disorder characterized by excessive muscle contraction for which the underlying pathophysiology is incompletely understood and treatment interventions limited in efficacy. Here we utilize a novel, sensing-enabled, deep brain stimulator device, implanted in a patient with cervical dystonia, to record local field potentials from chronically implanted electrodes in the sensorimotor cortex and subthalamic nuclei bilaterally. This rechargeable device was able to record large volumes of neural data at home, in the naturalistic environment, during unconstrained activity. We confirmed the presence of theta (3–7 Hz) oscillatory activity, which was coherent throughout the cortico-subthalamic circuit and specifically suppressed by high-frequency stimulation. Stimulation also reduced the duration, rate and height of theta bursts. These findings motivated a proof-of-principle trial of a new form of adaptive deep brain stimulation - triggered by theta-burst activity recorded from the motor cortex. This facilitated increased peak stimulation amplitudes without induction of dyskinesias and demonstrated improved blinded clinical ratings compared to continuous DBS, despite reduced total electrical energy delivered. These results further strengthen the pathophysiological role of low frequency (theta) oscillations in dystonia and demonstrate the potential for novel adaptive stimulation strategies linked to cortico-basal theta bursts

Long-term wireless streaming of neural recordings for circuit discovery and adaptive stimulation in individuals with Parkinson's disease.

Neural recordings using invasive devices in humans can elucidate the circuits underlying brain disorders, but have so far been limited to short recordings from externalized brain leads in a hospital setting or from implanted sensing devices that provide only intermittent, brief streaming of time series data. Here, we report the use of an implantable two-way neural interface for wireless, multichannel streaming of field potentials in five individuals with Parkinson's disease (PD) for up to 15 months after implantation. Bilateral four-channel motor cortex and basal ganglia field potentials streamed at home for over 2,600 h were paired with behavioral data from wearable monitors for the neural decoding of states of inadequate or excessive movement. We validated individual-specific neurophysiological biomarkers during normal daily activities and used those patterns for adaptive deep brain stimulation (DBS). This technological approach may be widely applicable to brain disorders treatable by invasive neuromodulation