Integrated human-machine interface for closed-loop stimulation using implanted and wearable devices

Recent development in implantable devices for electrical brain stimulation includes sensing and embedded computing capabilities that enable adaptive stimulation strategies. Applications include stimulation triggered by pathologic brain activity and endogenous rhythms, such as circadian rhythms. We developed and tested a system that integrates an electrical brain stimulation & sensing implantable device with embedded computing and uses a distributed system with commercial electronics, smartphone and smartwatch for patient annotations, extensive behavioral testing, and adaptive stimulation in subjects in their natural environments. The system enables precise time synchronization of the external components with the brain stimulating device and is coupled with automated analysis of continuous streaming electrophysiology synchronized with patient reports. The system leverages a real-time bi-directional interface between devices and patients with epilepsy living in their natural environment

Distributed brain co-processor for tracking spikes, seizures and behaviour during electrical brain stimulation

Early implantable epilepsy therapy devices provided open-loop electrical stimulation without brain sensing, computing, or an interface for synchronized behavioural inputs from patients. Recent epilepsy stimulation devices provide brain sensing but have not yet developed analytics for accurately tracking and quantifying behaviour and seizures. Here we describe a distributed brain co-processor providing an intuitive bi-directional interface between patient, implanted neural stimulation and sensing device, and local and distributed computing resources. Automated analysis of continuous streaming electrophysiology is synchronized with patient reports using a handheld device and integrated with distributed cloud computing resources for quantifying seizures, interictal epileptiform spikes and patient symptoms during therapeutic electrical brain stimulation. The classification algorithms for interictal epileptiform spikes and seizures were developed and parameterized using long-term ambulatory data from nine humans and eight canines with epilepsy, and then implemented prospectively in out-of-sample testing in two pet canines and four humans with drug-resistant epilepsy living in their natural environments. Accurate seizure diaries are needed as the primary clinical outcome measure of epilepsy therapy and to guide brain-stimulation optimization. The brain co-processor system described here enables tracking interictal epileptiform spikes, seizures and correlation with patient behavioural reports. In the future, correlation of spikes and seizures with behaviour will allow more detailed investigation of the clinical impact of spikes and seizures on patients

Deep generative networks for algorithm development in implantable neural technology

Electrical stimulation of deep brain structures is an established therapy for drug-resistant focal epilepsy. The emerging implantable neural sensing and stimulating (INSS) technology enables simultaneous delivery of chronic deep brain stimulation (DBS) and recording of electrical brain activity from deep brain structures while patients live in their home environment. Long-term intracranial electroencephalography (iEEG) iEEG signals recorded by INSS devices represent an opportunity to investigate brain neurophysiology and how DBS affects neural circuits. However, novel algorithms and data processing pipelines need to be developed to facilitate research of these long-term iEEG signals. Early-stage analytical infrastructure development for INSS applications can be limited by lacking iEEG data that might not always be available. Here, we investigate the feasibility of utilizing the Deep Generative Adversarial Network (DCGAN) for synthetic iEEG data generation. We trained DCGAN using 3-second iEEG segments and validated synthetic iEEG usability by training a classification model, using synthetic iEEG only and providing a good classification performance on unseen real iEEG with an F1 score 0.849. Subsequently, we demonstrated the feasibility of utilizing the synthetic iEEG in the INSS application development by training a deep learning network for DBS artifact removal using synthetic data only and demonstrated the performance on real iEEG signals. The presented strategy of on-demand generating synthetic iEEG will benefit early-stage algorithm development for INSS applications