Table of Contents
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The Response of the CNS to Injury
Ohio State University, Phil Popovich
The goal of this study was to improve our understanding of the cellular response to injury in the spinal cord or brain. When
a hemorrhage is introduced into the CNS there is resulting cell death and an inflammatory tissue response. The extent of this
neuroinflammation determines the ability of the nervous system to regenerate. The degree of neuroinflammation is directly
related to the extent of the vascular injury with injuries in the spinal cord resulting in greater damage than similar injuries
in the brain. It was suggested that the level of vascular damage introduced by insertion of the microelectrodes would result
in little if any neuroinflammation.
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Safe Stimulation of Neural Tissue
Huntington Med. Res. Inst., Doug McCreery, Al Lossinsky
Future neuroprosthetic devices propose the use of microelectrode arrays implanted in the CNS. This study addressed the effect
of different stimulus parameters on inducing neural damage as well as stimulation-induced depression of neural excitability
(SIDNE). The results suggest that stimulation with 6 nC/phase and 100% duty cycle does not generate neural damage, however
increased charge injections (20-40 nC/phase) were damaging but the damage could be alleviated with decreased duty cycles.
SIDNE became a factor when multiple contacts were used and interleaving the stimulation of the different contacts was not
able to decrease this effect. It was suggested that blunt tip (6 mm tip radius of curvature) electrodes were good for current-density
and microhemorrage considerations.
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Experiences with the Neurotrophic Electrode in Locked-in Humans
Neural Signals Inc., Phil Kennedy
Dr. Kennedy reported on the use of neurotrophic electrodes implanted in the motor cortex of a locked-in patient to control
a cursor based on the recorded neural activity. Dissociation of facial muscle EMG and cortex controlled cursor movement was
achieved with training. Phase of the neural signal was related to the direction of movement, whereas firing rate was not correlated
with directionality. It was concluded that the success of the system in humans will depend on technological advances that
make improvements to the signal to noise ratio. Rat and monkey histological studies indicate there is no neural damage resulting
from insertion of the electrodes. Use of neurotrophic factors in the electrode is being explored to optimize the number of
neurons residing inside the glass cone.
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A Tissue Engineering Approach To Understand Regeneration, Glial Scar and Interfaces
Case Western Reserve University, Ravi Bellamkonda
Recent work in neural regeneration has resulted in great advances toward bridging the gaps induced by injury and in understanding
the mechanisms involved in neuronal growth both in the peripheral and central nervous system. However, several issues remain
to be solved to promote neuronal growth into bridges and across glial scar tissue. Dr. Bellamkonda is studying the use of
tissue engineering to solve these issues and to gain a better understanding of the mechanisms involved. He has created 3D
gel matrices that incorporate haptotaxic and chemotaxic processes to promote neuronal cell growth and guided axonal extension.
He has used layers of these gels to model the glial scar and explore methods for dissolving the glial scar and allow axonal
growth.
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Brain Prostheses: Tissue Compatibility and Integration
Wadsworth Center, NY Dept. of Health, Bill Shain
The effect on tissue viability of single and multiple microelectrode devices inserted into the brain was evaluated using staining
techniques to identify individual cells or cell products attached to the microelectrodes. The results indicate there are two
distinct reactive responses: an early response characterized by inflammation and a prolonged response arising from cell interaction
(astrocytes, microglia, endothelial cells) around the device. The size of the probe has an effect on the early response (diminished
response with smaller probes), but the prolonged response is the same regardless of size. Understanding the mechanisms involved
in generating these responses will help explain why some of these devices fail and should suggest methods for regulating the
reactive response.
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Deep Brain Stimulation
University of Toronto, Andres Lozano
Deep brain stimulation (DBS) in structures of the thalamus is an effective treatment for a variety of movement disorders.
However, little is know about the long-term effects of stimulation on the efficacy of the treatment as well as the extent
of stimulation induced tissue damage. The results show little to no stimulation induced neural damage and for the majority
of the patients, DBS remained an effective treatment over a 5 year period. However, some patients no longer needed the device
after years of stimulation. Possible reasons for this phenomenon were a progressive thalamotomy from the stimulation, natural
progression of the disease, or permanent physiological changes induced by the stimulation.
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Panel Discussion - What are the risks associated with CNS implantation and stimulation? What additional work needs to be done
Terry Hambrecht, Moderator
Neural damage associated with implanted electrodes can be attributed to the insertion of the electrode, the presence and micromovement
of the electrode and stimulation through the electrode. The mechanisms involved in neural damage induced by electrical stimulation
are not clear and they are probably related to either cell activation, passage of current through surrounding tissue or induced
electric and magnetic fields or a combination of these events. Future work should examine new techniques to evaluate electrical
vs. mechanical damage to better guide the development of microelectrodes for implantation in the CNS. Such research will probably
lead to development of electrodes with materials that match the mechanical impedance of the brain and to treatments that can
counteract the reactive response induced by the electrodes.
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Cortical Control of Neural Prostheses
Arizona State University, Andy Schwartz, Daryl Kipke
This group has been successful in obtaining stable single unit recording of the rat barrel cortex for up to four weeks in
all the preparations and up to eight months in one preparation. Better results are expected with polyimide electrodes developed
at ASU which are flexible and can be filled with neurotrophic factors to promote neuronal growth into the device. Consistent
recordings were obtained from microwire electrode arrays implanted into the motor and pre-motor cortex of monkeys, allowing
classification of task-related and directional cells. Monkeys were trained to control a virtual target based on the population
vector obtained from the neuronal activity. Current work is exploring the feasibility of training to tune individual units
for a particular direction and allow three-dimensional control using three perfectly tuned cells in orthogonal directions.
Future work is aimed at controlling a robotic arm with the cortical signals.
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Cortical Control of Neural Prostheses
Brown University, John Donoghue, Kenji Nakata, Mijail Serruya
UTAH electrode arrays (100 channels, 74 active) were implanted into the arm area of the premotor cortex in monkeys. Neural
activity recordings have been stable for over two years in one animal, with a 40% yield from the electrode arrays. Recordings
made while the animal is performing two dimensional endpoint movements show that the neural units are directionally tuned.
Offline reconstruction of the kinematics can be obtained using a linear filter that relates neural firing rate to endpoint
position and velocity. The accuracy of the reconstruction depends on the length of the filter and the size of the neuronal
ensemble. This approach will be used in online experiments to control the movement of a robotic arm.
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Direct Brain Interface Based on Event Detection in ECoG
University of Michigan, Simon Levine
The goal of this work is to create an interface with all types of assistive technology based on electrocorticogram (ECoG)
recordings. Previous work has shown that ECoG recordings have better resolution than EEG, can be used in multi-channel control,
have less artifact and can be correlated to events. Preliminary work with subjects who had subdural electrodes implanted in
several different areas of the cortex has shown that high accuracy can be achieved even without training and that the ECoG
best correlated to the motor task was recorded from the motor areas of the cortex. Future research will investigate imagined
movements for control, correlation of brain activity with external measurements using fMRI and use of multiple channels to
take advantage of the redundancy for accuracy improvement.
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Chronic Microstimulation of the Lumbosacral Spinal Cord
Huntington Med. Res. Inst., Doug McCreery, Al Lossinsky
Microelectrodes were implanted into the S2 region of the spinal cord of cats with the goal of activating the motoneurons of
the urogenital system. Six working electrodes penetrated to the intermediate gray matter and two long stabilizer bars were
used to keep the electrode array in place. High charge/phase resulted in stimulation induced neural damage, but this could
be compensated for with low stimulation duty cycles. The use of microelectrode arrays is more difficult in the spinal cord
than in the brain due to the increased movement of the electrodes resulting from body movement and tissue differences, as
a result the stabilization bars are important. Spinal intact animals were used and these subjects showed no neurological deficits
as a result of the presence of the implanted electrode array.
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Microstimulation of the Lumbosacral Spinal Cord - Mapping
University of Pittsburgh, Jim Roppolo
The goal of this study was to provide information on the location and distribution of specific neuronal populations within
the spinal cord. Colon and anal sphincter pressures were measured as well as hind limb movements during microstimulation of
the cat spinal cord. Stimulation in the intermediate gray area of S2 was able to generate colon pressures greater than sphincter
pressures. Gait-like hind limb movements could be generated by stimulating in one spot in the lumbar region of the cord using
sinusoidal variation of the stimulus amplitude. Flexion/extension as well as adduction/abduction of the limb were dependent
on the electrode position and stimulus amplitude.
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Microstimulation of the Lumbosacral Spinal Cord - Mapping
Case Western Reserve University, Warren Grill, Michel Lemay, Ken Gustafson
This study focused on three areas important for the development of a neuroprosthesis based on microstimulation of spinal interneurons
to generate distributed outputs. First, anatomical mapping was done to identify inhibitory interneurons of the urethral sphincter.
Second, hindlimb motor responses were characterized by measuring hindlimb forces as a function of limb and electrode location
in attempts to utilize the equilibrium point hypothesis. And third, computer modeling and fMRI techniques are being employed
to develop methods to map the location of specific neuronal populations in the human spinal cord. It was suggested that one
would need to activate four different interneurons controlling four different equilibrium points (on each side of the spinal
cord) to generate robust controlled movement.
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Multichannel Stimulating and Intracortical Recording Electrodes
University of Michigan, Ken Wise
Thin film microprobes are commonly used for neuronal recording and stimulation. Unfortunately these probes suffer from a loss
of signal over time. Attempts are being made to improve this limitation with different contact sizes, shapes and polymer coatings.
"Puffer" probes are also being developed with flowmeters that allow for chemical delivery. However, the viscosity of the fluid
may become an issue with the micropores that follow the shank of the probe, but they may be able to overcome problem with
thermopneumatic pumps. One goal of the study is to develop fully functional active stimulating and recording arrays of up
to 256 channels with incorporation of telemetry interfaces allowing control of the stimulation contact and stimulus waveform
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Insulating Biomaterials
InnerSea Technologies, Dave Edell
Most of the work in the study has been concentrated on protecting the CMOS integrated circuits by development of coatings
and efficient cleaning of the substrates. Results suggest that substrates that are not clean lead to circuit failures. Fluorocarbon
and silicon films are used for coatings. Coating of flat surfaces and wires is easier than coating of three-dimensional structures.
Cleaning the substrates with CO2 has been found to be effective.
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Hermetic Packages and Feedthroughs.
The University of Michigan, Khalil Najafi
Any implantable neuroprosthetic device must have hermetic sealings that last for decades. The goal of this project was to
develop hermetic sealing techniques specifically designed for small implantable devices. A glass-silicon package was used
with a polysilicon binding layer. Testing with telemetry monitoring of the humidity inside the package suggests lifetimes
of several decades, however there may be a problem with polysilicon dissolution at high temperatures. Therefore, new directions
include using boron-doped coatings to protect the polysilicon from corrosion.
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Functional Neuromuscular Stimulation (FNS)
Case Western Reserve University, Pat Crago, Kevin Kilgore, Rich Lauer, Bob Kirsch
Biomechanical models of commonly performed tendon transfers in C5-C6 SCI individuals to restore voluntary or stimulated wrist
extension have been developed to simulate surgical strategies that overcome current limitations in the functional outcome
of the procedure. A study to evaluate the efficacy of command control algorithms for controlling the hand grasp system indicates
that variable gain and rectification based algorithms are most effective. Cortical control (EEG) of the hand neuroprosthesis
was evaluated in three subjects resulting in decreased performance in the GRT test as compared to other control methods, and
no difference in ADL tasks. New research directions in FNS of the upper extremity research will lead to expansion of this
technology to other SCI populations (C1-C4 and C7) as well as enhancement of the existing systems for the C5-C6 population.
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Neural Control Multichannel Implantable System
Case Western Reserve University, Hunter Peckham, Michael Keith
A second generation upper extremity neuroprosthesis is being developed that overcomes some of the limitations present in the
current systems and includes improvements in areas identified by neuroprosthesis users. Such improvements include simplified
donning of the controller, improved finger extension, overhead reach and bilateral function. Some of these issues have been
addressed with the development of an implantable wrist angle transducer, implanting electrodes in the intrinsic muscles of
the hand, implanting the triceps muscle and finally incorporating EMG of voluntary muscles as a control signal. These improvements
should also allow extension of the hand neuroprosthesis to the C7 population. The challenge in this research will be to develop
technology that is simple and thus less cumbersome for patients to use.
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Unassisted Standing by FNS
Case Western Reserve University, Ron Triolo
Currently, nine individuals with paraplegia have been implanted with the standing FNS system. The system allows subjects to
reach while standing, make transfers and introduces some mobility. Large variability in functional outcome across subjects
has been observed, attributed mostly to differences in subject size. Biomechanical modeling will be used in the future to
address this issue and also to design the sensor-based control for the system and provide the subjects with the ability to
control their posture. Previous work on adaptive recruitment mapping has used artificial neural networks to linearize the
input/output properties of the system to allow better control. Trunk/spine stability and current muscle stimulation methods
(reverse recruitment order) were identified as the main impediments to unassisted standing.
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Speech Processors for Auditory Prostheses
House Ear Institute, Bob Shannon
Auditory prostheses represent the most successful neuroprosthetic device to date, however the best patients still cannot perform
as well as normal hearing individuals. Therefore, the goal of this study was to compare different speech processing techniques.
The results suggest that there is no difference between the clarion and nucleus devices and that the optimal number of electrodes
is eight using matched frequency input (instead of frequency compression, which is normally used). The study also found that
one week of training, one hour/day, could significantly improve speech recognition.
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Speech Processors for Auditory Prostheses
Research Triangle Institute, Blake Wilson, Dewey Lawson
Possibilities for improvement in the functional outcome of auditory prosthesis include identification of the mechanisms underlying
the variability in the outcome and closing of the gaps between the physiology of normal hearing and the function that implants
can provide. The functional outcome of combined electric and acoustic stimulation (EAS) in a patient with low frequency residual
hearing resulted in as good or better speech recognition compared to electrical or acoustic stimulation alone. Issues with
tissue damage caused by the electrodes arise when these devices are implanted into individuals who have some residual hearing.
More research is needed to evaluate the effect of implant depth on the extent of hair cell damage. There may be a trade off
between lost hearing following deeper implants and improved long term hearing as the residual hearing diminishes with time.
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Neurophysiological Effects of Simulated Auditory Prosthesis Stimulation
University of Iowa, Paul Abbas, Charles Miller, Jay Rubinstein
This study is using both animal and computer models to better understand cochlear stimulation. In the animal studies single
fiber refractory studies were conducted to address the input / output function of high frequency stimulation used in auditory
prostheses. Measurements are also being made of the spatial extent of excitation using intraneural recordings, however this
has proved difficult to interpret due to vague tonotopic arrangement in the auditory nerve. Computer simulations of the response
of the auditory nerve to stimulation suggest that stochastic ion channel fluctuations can be important factors in matching
the models to experimental data.
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Feasibility of a Central Nervous System Auditory Prosthesis
Huntington Med. Res. Inst. - House Ear Institute, Doug McCreery, Bob Shannon
In a subset of patients the auditory nerve is no longer a possible site of stimulation and in turn the goal of this project
is to attempt to design an auditory prosthesis that stimulates the auditory nucleus. The proposed device uses both penetrating
microelectrodes and electrodes placed on the surface of the auditory nucleus. They have decided to place the microelectrodes
in the ventral nucleus based on innervations of the auditory nerve, however there are questions whether the total tonotopic
map of the auditory nucleus can be accessed due to anatomical and surgical considerations.
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Effects of Remaining Hair Cells on Cochlear Implant Function
University of Iowa, Paul Abbas, Charles Miller, Jay Rubinstein
Similar to the other work presented by this group a combination of computer modeling and animal experimentation were used
to explore the role of remaining hair cells on cochlear implant function. In the computer modeling section of the project
they explored the role of hair cell synaptic activity in combination with stochastic ion channel representations and found
that synaptic noise increased the dynamic range of the neuronal firing by desynchronization from the electrical sinusoidal
input. The compound action potential of the auditory nerve was also recorded in normal and deafened cats. Lower thresholds
were observed in the animals with remaining hair cells as well as improved temporal responses.
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Protective Effects of Patterned Electrical Stimulation
UCSF, Pat Leake
This study addressed the effects of electrical stimulation of the cochlea on neuronal survival in cats deafened at birth.
The results show ganglion cell density decrease as a function of the duration of deafness. However, electrical stimulation
caused in an increase in spiral ganglion cell survival compared to non-stimulated deafened animals, but the cell density was
less than that found in non-deafened animals. The results also suggest that the longer the stimulation is used the better
the cell survival, and that high frequency stimulation is beneficial.
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Protective Effects of Patterned Electrical Stimulation
University of Melbourne, Rob Shepherd
Previous research shows there is a direct relationship between spiral ganglion cell loss and duration of deafness. Experimental
results indicate there is extensive cell loss within the first 12 months and only 2% cell survival after eight years. Deafness
results in significant reduction of spontaneous cell activity, significant reduction in the size of the cochlear nucleus (50%),
rapid atrophy of the cells during the first week, particularly in the ventral cochlear nucleus, as well as significant reduction
of the synaptic density in the auditory midbrain. Function changes in cell activation following deafness includes little spontaneous
activity, increased refractoriness, activation threshold and latency, and changes in the tonotopic organization to a more
rudimentary representation. Future research will investigate application of electrical stimulation combined with neurotrophic
factors to maintain cell density and functionality.
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Multichannel Transcutaneous Cortical Stimulation System
Illinois Institute of Technology, Phil Troyk
256-channel transcutaneous stimulation systems for the visual cortex with magnetic coupling for power have been designed and
implemented. Each 256-channel module consists of four 64-channel submodules, each with its own power supply. The connector
shell and inserter have been redesigned for practical wire attachment. Development of the 5 MHz transmitter technology has
been completed and the transmitter is fully functional. The durability of the ceramic packaging has been tested in 90°C saline
for over two years without failures. Future work will make these devices available for various applications.
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Last updated February 09, 2005