57 research outputs found
Synthesizing Speech from Intracranial Depth Electrodes using an Encoder-Decoder Framework
Speech Neuroprostheses have the potential to enable communication for people
with dysarthria or anarthria. Recent advances have demonstrated high-quality
text decoding and speech synthesis from electrocorticographic grids placed on
the cortical surface. Here, we investigate a less invasive measurement modality
in three participants, namely stereotactic EEG (sEEG) that provides sparse
sampling from multiple brain regions, including subcortical regions. To
evaluate whether sEEG can also be used to synthesize high-quality audio from
neural recordings, we employ a recurrent encoder-decoder model based on modern
deep learning methods. We find that speech can indeed be reconstructed with
correlations up to 0.8 from these minimally invasive recordings, despite
limited amounts of training data
Decoding executed and imagined grasping movements from distributed non-motor brain areas using a Riemannian decoder
Using brain activity directly as input for assistive tool control can circumventmuscular dysfunction and increase functional independence for physically impaired people. The motor cortex is commonly targeted for recordings, while growing evidence shows that there exists decodable movement-related neural activity outside of the motor cortex. Several decoding studies demonstrated significant decoding from distributed areas separately. Here, we combine information from all recorded non-motor brain areas and decode executed and imagined movements using a Riemannian decoder. We recorded neural activity from 8 epilepsy patients implanted with stereotactic-electroencephalographic electrodes (sEEG), while they performed an executed and imagined grasping tasks. Before decoding, we excluded all contacts in or adjacent to the central sulcus. The decoder extracts a low-dimensional representation of varying number of components, and classified move/no-move using a minimum-distance-to-geometric-mean Riemannian classifier. We show that executed and imagined movements can be decoded from distributed non-motor brain areas using a Riemannian decoder, reaching an area under the receiver operator characteristic of 0.83 ± 0.11. Furthermore, we highlight the distributedness of the movement-related neural activity, as no single brain area is the main driver of performance. Our decoding results demonstrate a first application of a Riemannian decoder on sEEG data and show that it is able to decode from distributed brain-wide recordings outside of the motor cortex. This brief report highlights the perspective to explore motor-related neural activity beyond the motor cortex, as many areas contain decodable information.</p
Decoding executed and imagined grasping movements from distributed non-motor brain areas using a Riemannian decoder
Using brain activity directly as input for assistive tool control can circumventmuscular dysfunction and increase functional independence for physically impaired people. The motor cortex is commonly targeted for recordings, while growing evidence shows that there exists decodable movement-related neural activity outside of the motor cortex. Several decoding studies demonstrated significant decoding from distributed areas separately. Here, we combine information from all recorded non-motor brain areas and decode executed and imagined movements using a Riemannian decoder. We recorded neural activity from 8 epilepsy patients implanted with stereotactic-electroencephalographic electrodes (sEEG), while they performed an executed and imagined grasping tasks. Before decoding, we excluded all contacts in or adjacent to the central sulcus. The decoder extracts a low-dimensional representation of varying number of components, and classified move/no-move using a minimum-distance-to-geometric-mean Riemannian classifier. We show that executed and imagined movements can be decoded from distributed non-motor brain areas using a Riemannian decoder, reaching an area under the receiver operator characteristic of 0.83 ± 0.11. Furthermore, we highlight the distributedness of the movement-related neural activity, as no single brain area is the main driver of performance. Our decoding results demonstrate a first application of a Riemannian decoder on sEEG data and show that it is able to decode from distributed brain-wide recordings outside of the motor cortex. This brief report highlights the perspective to explore motor-related neural activity beyond the motor cortex, as many areas contain decodable information
Surgical and Hardware-Related Adverse Events of Deep Brain Stimulation:A Ten-Year Single-Center Experience
INTRODUCTION: Although deep brain stimulation (DBS) is effective for treating a number of neurological and psychiatric indications, surgical and hardware-related adverse events (AEs) can occur that affect quality of life. This study aimed to give an overview of the nature and frequency of those AEs in our center and to describe the way they were managed. Furthermore, an attempt was made at identifying possible risk factors for AEs to inform possible future preventive measures. MATERIALS AND METHODS: Patients undergoing DBS-related procedures between January 2011 and July 2020 were retrospectively analyzed to inventory AEs. The mean follow-up time was 43 ± 31 months. Univariate logistic regression analysis was used to assess the predictive value of selected demographic and clinical variables. RESULTS: From January 2011 to July 2020, 508 DBS-related procedures were performed including 201 implantations of brain electrodes in 200 patients and 307 implantable pulse generator (IPG) replacements in 142 patients. Surgical or hardware-related AEs following initial implantation affected 40 of 200 patients (20%) and resolved without permanent sequelae in all instances. The most frequent AEs were surgical site infections (SSIs) (9.95%, 20/201) and wire tethering (2.49%, 5/201), followed by hardware failure (1.99%, 4/201), skin erosion (1.0%, 2/201), pain (0.5%, 1/201), lead migration (0.52%, 2/386 electrode sites), and hematoma (0.52%, 2/386 electrode sites). The overall rate of AEs for IPG replacement was 5.6% (17/305). No surgical, ie, staged or nonstaged, electrode fixation, or patient-related risk factors were identified for SSI or wire tethering. CONCLUSIONS: Major AEs including intracranial surgery-related AEs or AEs requiring surgical removal or revision of hardware are rare. In particular, aggressive treatment is required in SSIs involving multiple sites or when Staphylococcus aureus is identified. For future benchmarking, the development of a uniform reporting system for surgical and hardware-related AEs in DBS surgery would be useful
Intraoperative magnetic resonance imaging versus standard neuronavigation for the neurosurgical treatment of glioblastoma: A randomized controlled trial.
BACKGROUND: Although the added value of increasing extent of glioblastoma resection
is still debated, multiple technologies can assist neurosurgeons in attempting to
achieve this goal. Intraoperative magnetic resonance imaging (iMRI) might be helpful
in this context, but to date only one randomized trial exists. METHODS: We included
14 adults with a supratentorial tumor suspect for glioblastoma and an indication for
gross total resection in this randomized controlled trial of which the interim
analysis is presented here. Participants were assigned to either ultra-low-field
strength iMRI-guided surgery (0.15 Tesla) or to conventional neuronavigation-guided
surgery (cNN). Primary endpoint was residual tumor volume (RTV) percentage.
Secondary endpoints were clinical performance, health-related quality of life
(HRQOL) and survival. RESULTS: Median RTV in the cNN group is 6.5% with an
interquartile range of 2.5-14.75%. Median RTV in the iMRI group is 13% with an
interquartile range of 3.75-27.75%. A Mann-Whitney test showed no statistically
significant difference between these groups (P =0.28). Median survival in the cNN
group is 472 days, with an interquartile range of 244-619 days. Median survival in
the iMRI group is 396 days, with an interquartile range of 191-599 days (P =0.81).
Clinical performance did not differ either. For HRQOL only descriptive statistics
were applied due to a limited sample size. CONCLUSION: This interim analysis of a
randomized trial on iMRI-guided glioblastoma resection compared with cNN-guided
glioblastoma resection does not show an advantage with respect to extent of
resection, clinical performance, and survival for the iMRI group. Ultra-low-field
strength iMRI does not seem to be cost-effective compared with cNN, although the
lack of a valid endpoint for neurosurgical studies evaluating extent of glioblastoma
resection is a limitation of our study and previous volumetry-based studies on this
topic.Peer reviewe
NeuroMind:Past, present, and future
This narrative report describes the underlying rationale and technical developments of NeuroMind, a mobile clinical decision support system for neurosurgery. From the perspective of a neurosurgeon - (app) developer it explains how technical progress has shaped the world's "most rated and highest rated" neurosurgical mobile application, with particular attention for operating system diversity on mobile hardware, cookbook medicine, regulatory affairs (in particular regarding software as a medical device), and new developments in the field of clinical data science, machine learning, and predictive analytics. Finally, the concept of "computational neurosurgery" is introduced as a vehicle to reach new horizons in neurosurgery
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