Monday, March 15, 2010

Medtronic's DBS Therapy for Epilepsy May Yet Get FDA Approval

An FDA advisory panel has voted 7 to 5 in favor of approval of Medtronic's deep brain stimulation (DBS) device, probably the Soletra, as a treatment option for medically refractory epilepsy in certain patients. The device, already approved for Parkinson's, was only days earlier reported to have failed an important study goal. Now it is seeing new life, and potential approval, due to a kink in the latest study.

Jennifer Corbett Dooren at the Wall Street Journal explains:

A study of the device was conducted in 110 patients, but it failed to meet a study goal that looked at a reduction in the seizure rate over a three-month period.

However, the FDA said that when looking at just the third month of treatment, patients being treated with the deep-brain-stimulation device had a greater reduction in seizures compared with patients whose device was not activated.

The missed study goal was influenced by one patient who developed a different type of seizure after the device was turned on, both the FDA and Medtronic said. When the device's power was lowered, the seizures stopped.

Medtronic asked the FDA and the panel to consider the data without the one patient, which would result in the study meeting the three-month goal, or to consider the last month of the three-month period. But the panel was divided on whether the patient should be removed from the analysis of the study.

Wall Street Journal from March 10: Medtronic Brain Stimulator Missed Study Goal

Wall Street Journal from March 12: FDA Panel Backs Device For Epilepsy

Medtronic press release: FDA Panel Recommends Approval with Conditions of Medtronic Deep Brain Stimulation Therapy for Patients with Refractory Epilepsy ...

Flashback: Medtronic's Deep Brain Stimulation Devices Approved for Parkinson's and Essential Tremor

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Thursday, March 11, 2010

fMRI Now Used as Rudimentary Memory Reading Device

At University College London, scientists are using an fMRI machine to identify the memories that people are bringing up. By first playing three different videos to human subjects and then asking them to recall them in turn while inside an fMRI, the researchers were able to use a computer algorithm to identify which video was being recalled.

Professor Eleanor Maguire led this Wellcome Trust-funded study, an extension of work published last year which showed how spatial memories – in that case, where a volunteer was standing in a virtual reality room – are recorded in regular patterns of activity in the hippocampus, the area of the brain responsible for learning and memory.

“In our previous experiment, we were looking at basic memories, at someone’s location in an environment,” said Professor Maguire. “What is more interesting is to look at ‘episodic’ memories – the complex, everyday memories that include much more information on where we are, what we are doing and how we feel.”

Although a whole network of brain areas support memory, the researchers focused their study on the medial temporal lobe, an area deep within the brain believed to be most heavily involved in episodic memory. It includes the hippocampus – an area which Professor Maguire and colleagues have studied extensively in the past.

They found that the key areas involved in recording the memories were the hippocampus and its immediate neighbours. However, the computer algorithm performed best when analysing activity in the hippocampus itself, suggesting that this is the most important region for recording episodic memories. In particular, three areas of the hippocampus – the rear right and the front left and front right areas – seemed to be involved consistently across all participants. The rear right area had been implicated in the earlier study, further enforcing the idea that this is where spatial information is recorded. However, it is still not clear what role the front two regions play.

Here are the three videos study participants were asked to memorize:

Full story: Traces of the past: computer algorithm 'reads' memories ...

Abstract in Current Biology: Decoding Individual Episodic Memory Traces in the Human Hippocampus...

Image: Siemens Magnetom Verio 3T open bore MRI

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Wednesday, March 10, 2010

intendiX Brain-Computer Interface Might Be Available Soon

Three years ago we wrote about an EEG brain-computer interface that was going to be available to consumers. Well, it turns out, there's been a slight delay and g.tec Guger Technologies from Graz, Austria has only just launched a marketing campaign for its technology. The intendiX system supposedly uses visually evoked EEG potentials to detect which on-screen option a user wants to select. The EEG triggers can be letters, words, actions, or just about anything that can be programmed into a computer.

Here's a mysterious ad that g.tec put out to launch intendiX:

Here's a video of a person typing using the G-Tec:

Product page: intendiX ...

Flashback: The First Commercially Available Brain Computer Interface...

(hat tip: Engadget)

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Monday, March 8, 2010

sterEOS 2D|3D Workstation Images Spines With Significant Radiation Reduction

Biospace Med, maker of X-ray imaging systems out of Paris, France, just received FDA approval to use the firm's sterEOS 2D|3D workstation on pediatric patients to image the spine. The company claims that the system provides imagery competitive to that of CT scanners, but with only .1% of the radiation dose. Patients remain standing while the system simultaneously takes an X-ray from the front and laterally, after which a computer reconstructs the two frames into a three dimensional representation of the spine. This allows for quick imaging of patients in a weight bearing position while significantly reducing their radiation exposure compared with CT.

From the press announcement:

“FDA clearance for sterEOS pediatric use in spine will have a significant impact on demand for EOS as it will allow for the first time to visualize in 3D the spine deformations in the standing, weigh bearing position and retrieve fundamental clinical parameters for surgical planning. This is all done at a drastically reduced radiation exposure, and enables to repeat exams for a better follow up from childhood to adulthood,” said Peter Newton, M.D., Rady Children’s Hospital, San Diego, Ca. “Reduction of radiation exposure is especially important for children and adolescents who have scoliosis or other types of musculoskeletal disorders that are being followed on a frequent basis and therefore need to have regular x-rays over a long period of time to watch the progression of their condition and treatment. A technology that can reduce radiation exposure up to 10 times compared to a conventional x-ray and up to 100 or more times compared to a CT scan is a major breakthrough for orthopedic imaging, especially for the pediatric population.”

Press release: FDA clears Biospace med's sterEOS 2D|3D workstation for pediatric use in spine...

Biospace Med homepage...

(hat tip: MassDevice)

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Tuesday, March 2, 2010

fMRI Can Visualize Dopamine Activity Directly in the Brain

Functional MRI has become a standard tool to peer into the physiologic processes happening within the brain. Though revolutionary for what it can achieve, traditional fMRI only displays the dynamics of hemoglobin molecules. (Hemoglobin is diamagnetic when oxygenated but becomes paramagnetic when deoxygenated. Hence fMRI detects regions of the brain where oxygen transfer from blood to tissues takes place.) This is an indirect approach that doesn't provide enough functional resolution and which also results in delayed readings that can mask the nature of underlying neural processes. Now researchers at Caltech and MIT have come up with a way to monitor the activity of dopamine within the brain, greatly expanding the ability of fMRI to help understand how brain functions.

From an MIT press statement:

To build the new sensors, the MIT team worked with chemical engineers at Caltech, using an approach called “directed evolution.” They started with a protein called cytochrome P450, an enzyme found in most organisms that is paramagnetic (meaning it can become weakly magnetic when exposed to a magnetic field). Using a technique called error-prone PCR, which is a faulty version of the way cells naturally replicate their genes, they generated a large collection of different mutated forms of the gene.

Each mutated gene was placed into an E. coli bacterium, which produced the mutated protein. The researchers then tested each protein for its ability to bind dopamine. At the end of each round, they took the best candidate and mutated it again for a new round of improvement. At the end of five rounds, they had two sensors that would bind strongly to dopamine but not to other neurotransmitters.

In studies of rats, the researchers showed that the sensor can effectively detect dopamine in the brain. However, in its current form, the dopamine probe must be injected into the brain, and the imaging is limited to the site of injection.

Bruce Jenkins, director of neurochemical imaging at the Martinos Center for Biomedical Imaging at MGH, says the new probe is “very cleverly designed,” but points out that an important challenge is yet to come: getting the molecule to cross the layer of cells that separates the brain from circulating blood. “Trying to get a charged protein across the blood-brain barrier is very tricky,” he says.

The MIT team hopes to overcome that obstacle by applying barrier disruption techniques used historically to deliver chemotherapeutic agents to the brain. They will also try to genetically program brain cells to express the sensor, so it doesn’t have to be injected.

Abstract in Nature Biotechnology: Directed evolution of a magnetic resonance imaging contrast agent for noninvasive imaging of dopamine

MIT press release: New technique offers a more detailed view of brain activity ...

Image credit: Wellcome images: MRI scan showing the regions of the brain involved in recognising familiar faces....

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Urgent PC Neuromodulation System Stimulates Leg Nerve, Aims to Quell Overactive Bladder

Clinicians recently concluded a multicenter study of the Urgent PC Neuromodulation System for urinary urgency, urinary frequency and urge incontinence. The device, made by Uroplasty of Minnetonka, MN, is a neurostimulator that acts on the tibial nerve through the ankle via which it sends a signal to the sacral nerve plexus that regulates urinary function. The advantage of the system lies in its indirect, minimally invasive action.

Here's from the study abstract's results and conclusions:

The 13-week subject global response assessment for overall bladder symptoms demonstrated that percutaneous tibial nerve stimulation subjects achieved statistically significant improvement in bladder symptoms with 54.5% reporting moderately or markedly improved responses compared to 20.9% of sham subjects from baseline (p <0.001). All individual global response assessment subset symptom components demonstrated statistically significant improvement from baseline to 13 weeks for percutaneous tibial nerve stimulation compared to sham. Voiding diary parameters after 12 weeks of therapy showed percutaneous tibial nerve stimulation subjects had statistically significant improvements in frequency, nighttime voids, voids with moderate to severe urgency and urinary urge incontinence episodes compared to sham. No serious device related adverse events or malfunctions were reported.

This pivotal multicenter, double-blind, randomized, sham controlled trial provides level I evidence that percutaneous tibial nerve stimulation therapy is safe and effective in treating overactive bladder symptoms. The compelling efficacy of percutaneous tibial nerve stimulation demonstrated in this trial is consistent with other recently published reports and supports the use of peripheral neuromodulation therapy for overactive bladder.

Abstract in The Journal of Urology: Randomized Trial of Percutaneous Tibial Nerve Stimulation Versus Sham Efficacy in the Treatment of Overactive Bladder Syndrome: Results From the SUmiT Trial

Press release: SUmiT TRIAL RESULTS CLEARLY DEMONSTRATE THERAPEUTIC EFFECT OF PERCUTANEOUS TIBIAL NERVE STIMULATION...

Product page: Urgent® PC ...

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Wednesday, February 17, 2010

A Simple Test for Concussion Diagnosis

A group of neurologists from the University of Michigan have developed a simple test to diagnose mild concussions in athletes. The original idea for the test was conceived by Michigan high school student Ian Richardson, whose father James K. Richardson, M.D. is an Associate Professor at the Department of Physical Medicine and Rehabilitation.

According to American Academy of Neurology, this reaction test has now undergone a preliminary clinical trial with encouraging early results for diagnosis of concussion:

“Research has shown that reaction time is slower after a concussion—even as long as several days after other symptoms are gone,” said study author James T. Eckner, MD, of the University of Michigan Department of Physical Medicine and Rehabilitation in Ann Arbor. “But the tests currently used to measure reaction time require computers and special software.”

Eckner and his colleagues developed a simple, inexpensive device to measure reaction time: a cylinder attached to a weighted disk. The examiner releases the device and the athlete catches it as soon as possible.

For the study, the researchers gave the test to 209 Division I college football, wrestling and women’s soccer athletes during their preseason physicals. Then any athlete who had a concussion diagnosed by a physician during the season took the test again within three days of the concussion.

Eight athletes had concussions during the study. Of those, seven of the athletes had a prolonged reaction time after the concussion compared to the preseason time. Catching the object took about 15 percent longer.

“Because of its simplicity and low cost, this test may work well with youth athletes, where there is limited access to computerized testing of reaction time,” Eckner said.

Press release: Simple Test May Help Judge Concussion in Athletes ...

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Tuesday, February 2, 2010

EEG to Play a Role at Next Week's Olympic Festivities

The Winter Olympics in Vancouver are fast approaching and InteraXon, a Toronto based company, has been hired to help bring the rest of Canada into the spirit. InteraXon has developed its own consumer grade electroencephalograph (EEG) brain to computer interface and has been searching for applications where it can be useful. So, in the traditional Olympic spirit of national pride and technological gimmickry, the Ontario Ministry of Tourism asked the firm to control the light on three major landmarks in the province using pure thought from a group of people streaming from the West.

The Globe and Mail explains in an article from last week:

When visitors to the Ontario Pavilion next month put on the headphone-like brainwave sensors, their mental activity will be communicated to control systems that light up each of the sites. Slow your mind and the lights dim as the brain starts producing lower-frequency alpha waves. Higher-frequency beta waves of an alert mind make the lights come to life – comet trails stream down the shaft of the CN Tower; backlit Niagara Falls starts to glow in shades of purple and red; Parliament Hill springs out of the shadows.

Here's an interview with COO of InteraXon on Canada's Business News Network:

More at Globe and Mail...

Link: InteraXon...

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Tuesday, January 26, 2010

SUMAVEL DosePro Migraine Treatment Injection System Going on Sale in US

Having received FDA approval last July, Zogenix out of San Diego, California is bringing to market its SUMAVEL DosePro sumatriptan delivery system for the treatment of oncoming migraines and cluster headaches. The needle-free device delivers the drug subcutaneously, bringing both speed and efficacy when oral pills are a poor option.

From the press release:

SUMAVEL DosePro delivers subcutaneous sumatriptan, a treatment that provides migraine relief starting within 10 minutes for some patients*, in a first-of-its-kind needle-free delivery system. SUMAVEL DosePro is expected to be available at most retail pharmacy outlets this month.

SUMAVEL DosePro offers other practical benefits. Approximately 30 percent of patients report vomiting as a symptom of migraine attacks, and the vast majority of attacks are also accompanied by nausea. During these episodes, oral therapies may be an impractical treatment option. Further, while most forms of triptans can be effective when taken early in a migraine attack, patients who experience rapid onset of migraines, or those that occur upon waking may not always achieve the fast relief they would like from tablet and nasal forms. Quickly absorbed subcutaneous sumatriptan may offer an alternative for these patients, although until now, it was only available in a needle-based system. New SUMAVEL DosePro delivers sumatriptan subcutaneously (under the skin) without a needle, which can offer fast relief in a patient-friendly delivery system.

*In two well-controlled clinical trials (N=1104) with patients experiencing moderate or severe pain and one or more migraine symptoms, the efficacy of subcutaneous sumatriptan versus placebo was evaluated. In these clinical trials, 16 percent of patients achieved relief within 10 minutes versus 4 percent for placebo; 70 percent of patients achieved relief at one hour versus 22 percent for placebo (P<.001); and 82 percent of patients achieved relief at two hours versus 39 percent for placebo (P<.05)

Product page: SUMAVEL DosePro...

Press release: SUMAVEL DosePro Available in the United States to Treat Acute Migraine and Cluster Headaches...

Flashback: Migraines Be Gone: Sumatriptan Needle Free DosePro Injector Gets OK In US

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Tuesday, January 12, 2010

Rehab Gaming System Helps Kids With Cerebral Palsy

Researchers from Indiana University and Rutgers have been testing whether a specially designed video gaming system can help children with hemiplegic cerebral palsy improve their hand coordination. The results are promising, and underscore the value of modifying underlying technologies to suit the needs of the patients.

The three study participants were asked to exercise the affected hand about 30 minutes a day, five days a week using a specially fitted sensor glove linked to a remotely monitored videogame console installed in their home. Games, such as one making images appear ("sliders") were custom-developed at Rutgers, calibrated to the individual teen's hand functionality, included a screen avatar of the hand, and focused on improvement of whole hand function.

"Popular off-the-shelf games are targeted to people with normal hand and arm function and coordination. These games don't work for or benefit those with moderate-severe hemiplegic cerebral palsy and many other disorders that affect movement. They just aren't made to be used by or improve hands that can't pinch or grasp" said Golomb [Dr. Meredith R. Golomb, Indiana University School of Medicine associate professor of neurology].

In the future, physical therapists could remotely monitor patients' progress and make adjustments to the intensity of game play to allow progressive work on affected muscles.

Press release: Virtual reality tele-rehab improves hand function

Abstract in Archives of Physical Medicine and Rehabilitation: In-Home Virtual Reality Videogame Telerehabilitation in Adolescents With Hemiplegic Cerebral Palsy

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Thursday, January 7, 2010

MRI Diffusion Tensor Imaging May Predict Onset of Alzheimer's

Scientists have been looking for years into methods that can distinguish a healthy brain from one that is in early stages of Alzheimer's. Traditional MRI doesn't reveal how water moves within the white matter, but diffusion tensor imaging (DTI), a method where specific radio frequencies and magnetic field pulses are applied in a predefined manner, can reveal the direction of water diffusion to uncover some of the physical processes within the brain. Now researchers from Tor Vergata University and Santa Lucia Foundation, both in Rome, have shown that diffusion tensor imaging is a better predictor of oncoming memory loss when compared to traditional MRI measurement of hippocampus volume.

Basic methods used in the study from the published abstract:

In this cross-sectional study, 76 healthy individuals (44 male and 32 female), ranging in age from 20 to 80 years, were recruited from universities, community recreational centers, hospital personnel, and patients' relatives from 2005 to 2008. These individuals were submitted to a 3-T MRI protocol with a whole-brain T1-weighted and diffusion-weighted scanning and a neuropsychological assessment. For each subject, we calculated the volumes of the total brain (gray + white matter) and hippocampi. The segmented hippocampi defined the binary masks where mean values of mean diffusivity (MD) and fractional anisotropy (FA) were calculated. Neuropsychological evaluation included tests of verbal memory (15 minutes delayed recall of a 15-word list) and visuospatial memory (20 minutes delayed reproduction of Rey complex figure).

A short audio report on the findings from MedPage Today:

More details expounding on the findings atMedPage Today: New Scan May Distinguish Early Alzheimer's from Normal Aging...

Abstract in Neurology: Hippocampal mean diffusivity and memory in healthy elderly individuals. A cross-sectional study

Image source: Wikimedia...

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Wednesday, January 6, 2010

Genetic Engineering and Light Team Up to Control Neuron Activity

Scientists at MIT have discovered a method to shutdown specific neurons with different colors of light. The scientists isolated two genes from bacteria and fungi that are light-sensitive. They then used a virus to insert these genes into neurons. When these genetically engineered neurons were exposed to light, the light-activated proteins lowered the neurons' voltage, preventing them from activating. One of the genes responds to yellow light, and the other responds to blue.

Current methods to directly control neuronal activity rely on over-stimulating neurons (e.g: DBS), rather than inhibiting their activity. While similar methods of light-sensitive gene delivery have been used in the past, this new method allows specific control with different colors of light.

Here's more from the press release:

“Silencing different sets of neurons with different colors of light allows us to understand how they work together to implement brain functions,” explains Ed Boyden, senior author of the study, to be published in the Jan. 7 issue of Nature. “Using these new tools, we can look at two neural pathways and study how they compute together. These tools will help us understand how to control neural circuits, leading to new understandings and treatments for brain disorders — some of the biggest unmet medical needs in the world.” Boyden is the Benesse Career Development Professor in the MIT Media Lab and an associate member of the McGovern Institute for Brain Research at MIT.

Read more from MIT: Neuroengineers silence brain cells with multiple colors of light

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Wednesday, December 23, 2009

Welcome Again to The 21st Century: Electroencephalography for At Home Entertainment

Emotiv Systems is finally releasing the much awaited Epoc headset brainwave controller. The available games and applications that the device can interface with are still scarce, so it seems to be geared toward developers and researchers that are thinking up new ways to utilize EEG. With a $300 starting price tag, this bodes well for a future where we'll be able to chow down on cheeseburgers while blowing up virtual goblins in Halo 12.

EEG display:
* 5 second rolling time window (chart recorder mode)
* ALL or selected channels can be displayed
* Automatic or manual scaling (individual channel display mode)
* Adjustable channel offset (multi-channel display mode)
* Synchronized marker window

FFT display:
* Selected channel only
* ALL or selected channels can be displayed
* Adjustable sampling window size (in samples)
* Adjustable update rate (in samples)
* dB mode – power or amplitude calculations
* dB scale
* FFT window methods: Hanning, Hamming, Hann, Blackman, Rectangle
* Predefined and custom sub-band histogram display – Delta, Theta, Alpha, Beta, custom bands

Gyro display:
* 5 second rolling time window (chart recorder mode)
* X and Y deflection

Data Packet display:
* 5 second rolling graph of Packet Counter output
* Packet loss – integrated count of missing data packets
* Verify data integrity for wireless transmission link

Data Recording and Playback:
* Fully adjustable slider, play/pause/exit controls.
* Subject and record ID, date, start time recorded in file naming convention.

Product page: EPOC Headset...

Flashbacks: Telekinetic Video Games; New Gaming Input Device Reads Your Mind; Mind Games

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Monday, December 14, 2009

Promising Results Released in Controlling Epilepsy via Deep Brain Stimulation

Last week at the American Epilepsy Society Meeting in Boston, Medtronic and NeuroPace released results of clinical trials studying the benefits of the firms' competing Deep Brain Stimulation (DBS) systems to control symptoms in patients suffering from severe epilepsy. The findings seem to foreshadow the future in which the technology might become a standard treatment option for patients who continue to develop seizures despite adequate medication regiments, and in some cases, vagus nerve stimulation or even ablative surgery.

From Medtronic's announcement:

The results of the study show improvement over time with median (mid-point) reduction in seizure frequency of 41 percent at one year, 56 percent at two years, and 68 percent at three years of DBS therapy, in conjunction with antiepileptic medications, compared to baseline. Of the original 110 patients who received DBS implants in the trial, 91 remain active in the study, including some who have received DBS therapy for more than five years. At the time of this data analysis, 102 patients had completed two years and 57 had completed three years of therapy. In addition, 14 patients (13 percent) experienced seizure free intervals ranging from six months to more than four years.

The study, known as SANTE® (Stimulation of the Anterior Nucleus of the Thalamus in Epilepsy), is a prospective, randomized, double-blind pivotal study to evaluate the use of DBS therapy for patients with medically refractory epilepsy with partial-onset seizures, a form of epilepsy that does not respond well to antiepileptic drugs.

The types of adverse events reported in the study were consistent with known adverse events associated with epilepsy and implanted DBS systems. There were no serious unanticipated device-related adverse events. At the conclusion of the unblinded phase of the study (first 13 months), 4.2 percent of adverse events (a total of 34 events) were serious and device-related. That rate declined over time. Of the 34 events, the most frequent serious device-related events were lead(s) not within the target (nine events) and implant site infection (eight events). Depression and memory impairment were reported more frequently in active stimulation patients compared to no stimulation (controls) although objective neuropsychological assessment did not show any statistical differences between active or no stimulation (control) groups.

The SANTE study involves stimulating the left and right anterior nucleus of the thalamus – the brain’s central message and relay station – with Medtronic DBS Therapy for Epilepsy in conjunction with epilepsy medications. Patients in the study have had epilepsy for an average of 22 years and 54 percent of the 110 implanted patients had previously undergone resective surgery and/or vagal nerve stimulation therapy. Benefit was seen in patients with prior history of vagal nerve stimulation or previous epilepsy surgery as well as patients without such history.

From a statement by NeuroPace:

The trial demonstrated a statistically significant reduction in seizure frequency in the treatment group (responsive stimulation active) as compared to the sham stimulation group (responsive stimulation inactive). During the last two months of the three month blinded evaluation period of the study, people in the treatment group experienced a mean percentage reduction of 29 percent in their disabling seizures compared to 14 percent reduction for those in the sham stimulation group. In the long term, open label period of the trial, at least 12 weeks of data were available for 171 study participants; 47 percent of these subjects experienced a 50 percent or greater reduction in their seizure frequency based on their most recent 12 weeks of data, as compared to their baseline.

The trial also demonstrated a serious adverse event rate less than comparative surgical procedures. There were no serious unanticipated device related adverse events reported in the trial. There was no difference between the treatment and sham stimulation groups when comparing the rate of adverse events, including depression, memory impairment and anxiety.

Press releases: Pivotal Study of Medtronic Deep Brain Stimulation Therapy Shows Long-Term Reduction in Seizure Rate in Patients with Severe Epilepsy; Pivotal Trial Data Demonstrate NeuroPace RNS System Reduced Seizures in People with Epilepsy...

Product pages: Medtronic DBS...; NeuroPace RNS System...

Flashbacks: Medtronic to Seek FDA Approval of Brain Stimulation Device for Epilepsy; Neuropace Implantable Epilepsy Device Showing Positive Signs in Initial Clinical Study

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Friday, December 11, 2009

Vocalizations Return to Paralyzed Man, Via Wireless Brain-Computer Interface

Locked-In Syndrome is one of the most terrifying brain lesions -- leaving patients aware but almost entirely without the power to move. Now, a collaboration of American academic researchers has implanted a wireless brain-machine interface, developed by Neural Signals of Duluth Georgia, into a locked-in subject who is almost completely paralyzed.

The system uses brain electrodes to read signals meant for jaw and mouth muscles. An FM radio is used to transmit these brain signals to a computer, which transforms them into recognizable sounds. Currently the system is only able to produce vowels, but with more electrodes and more powerful algorithms it should be able to scale up to fully vocalized words.

From the article abstract in PLoS ONE:

Background

Brain-machine interfaces (BMIs) involving electrodes implanted into the human cerebral cortex have recently been developed in an attempt to restore function to profoundly paralyzed individuals. Current BMIs for restoring communication can provide important capabilities via a typing process, but unfortunately they are only capable of slow communication rates. In the current study we use a novel approach to speech restoration in which we decode continuous auditory parameters for a real-time speech synthesizer from neuronal activity in motor cortex during attempted speech.

Methodology/Principal Findings

Neural signals recorded by a Neurotrophic Electrode implanted in a speech-related region of the left precentral gyrus of a human volunteer suffering from locked-in syndrome, characterized by near-total paralysis with spared cognition, were transmitted wirelessly across the scalp and used to drive a speech synthesizer. A Kalman filter-based decoder translated the neural signals generated during attempted speech into continuous parameters for controlling a synthesizer that provided immediate (within 50 ms) auditory feedback of the decoded sound. Accuracy of the volunteer's vowel productions with the synthesizer improved quickly with practice, with a 25% improvement in average hit rate (from 45% to 70%) and 46% decrease in average endpoint error from the first to the last block of a three-vowel task.

Conclusions/Significance

Our results support the feasibility of neural prostheses that may have the potential to provide near-conversational synthetic speech output for individuals with severely impaired speech motor control. They also provide an initial glimpse into the functional properties of neurons in speech motor cortical areas.

Here's the visual and audio feedback as presented to the locked-in man during tests:

Side image: (A) Left panels: Axial (top) and sagittal (bottom) slices showing brain activity along the precentral gyrus during a word generation fMRI task prior to implantation. Red lines denote pre-central sulcus; yellow lines denote central sulcus. Right panels: Corresponding images from a post-implant CT scan showing location of electrode. (B) 3D CT image showing electrode wire entering dura mater. Subcutaneous electronics are visible above the electrode wire, on top of the skull.

More at Wired: Wireless Brain-to-Computer Connection Synthesizes Speech

Article in PLoS ONE: A Wireless Brain-Machine Interface for Real-Time Speech Synthesis

Link: Neural Signals homepage...

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Wednesday, December 9, 2009

Getting Closer to Decoding Brain Activity from EEG

Admit it: In medical school, you never really understood what makes an alpha wave an alpha wave, or why it's different than a delta wave. You thought maybe some hardcore neurologists knew, but it turns out that was probably wishful thinking.

The truth is, Electroencephalogram (EEG) readings taken from the scalp are substantially modulated from their original source, but clinicians never knew exactly how the signal changes when it passes through that thick skull of ours. Now researchers from Max Planck Institute for Biological Cybernetics in Tübingen, Germany have a better handle on how EEG waveforms from the scalp relate to what the brain is producing.

By combining recordings of both EEG and individual neurons in trained monkeys, [Kevin] Whittingstall and [Nikos] Logothetis found that a combination of specific waves in the EEG could indeed reliably predict the activity of cells in the brain. They presented different movie clips consisting of everyday natural scenes to trained monkeys. While the monkeys watched, their brain activity was recorded via EEG and via electrodes that were placed directly on the neurons, thus allowing for a direct comparison between data sets. Specifically, they observed that the firing pattern of cells was highest during periods where bursts of ‘fast’ EEG activity were embedded within the slow-wave EEG. As the degree of this so-called ‘frequency band coupling’ changed, so also did the cells firing rate.

"We succeeded in identifying which aspects of the EEG best represent changes in the activity from a population of neurons in the brain", explains Kevin Whittingstall. "With this information, we can now move to better understand the cause of abnormal EEG waveforms in patients with certain neurological disorders."

It's about time! And all it took were some skull-less monkeys.

Press release: How to read brain activity?

Abstract in Neuron: Frequency-Band Coupling in Surface EEG Reflects Spiking Activity in Monkey Visual Cortex

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Tuesday, December 8, 2009

Stroke Patients Overcome Foot Drop with Video Game Exercise

Kinetic Muscles out of Tempe, Arizona has released a foot training device to help stroke sufferers regain precision of movement. The Foot Mentor Pro engages patients to move their feet in a coordinated fashion through video games, thereby repeatedly activating the brain to relearn how to engage muscles correctly.

From MTB Europe:

KMI's robotic technology, along with the proprietary patient interface and data communications module, promotes neuromuscular re-education through the clinically studied Active Repetitive Motion therapy that underlies KMI's product platform.

The Foot Mentor Pro can be deployed in both the clinic and home settings. The device provides records of patient time spent on the device and progress against established clinical measures, thereby reducing costs by eliminating paper records and facilitating filing for reimbursement.

More from MTB Europe...

Product page: Foot Mentor Pro

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Thursday, December 3, 2009

GE Releases Software to Aid in Image Guided Interventional Procedures

Interventional radiologists, radiation oncologists, neurosurgeons and others now have a new tool to help them target tumors, AVMs, and other hot spots using visual data from multiple sources.GE has just released the VolumeShare 4 multi-modality volume viewer for its Advantage Workstation software suite. The system brings together imaging data from various diagnostic modalities to aid in planning and during interventional procedures.

The VolumeShare 4 multi-modality volume viewer software integrates 3D images from GE’s Innova® interventional imaging system, as well as CT, MR, PET and PET/CT datasets to support new interventional visualization functions and analysis that are targeted for planning and navigation during image-guided interventional therapies, as well as monitoring the procedure results.

It is now possible to use the multi-modality images not just for diagnosis, but to steer the interventional gantry to different angles around the patient. An image that has already been acquired can be used to guide the gantry to the appropriate position for acquiring the real time image. Additionally, Advantage Workstation VolumeShare 4:

Provides images to show needle entry point and the final target, and allows the clinician to see all the anatomy in between to plan the best possible pathway.

Combines images from other 3D modalities, such as CT and MR, to show things that X-ray may not reveal, allowing for more effective guidance.

Enables "before" and "after" comparisons, i.e., comparing an X-ray image to either an MR image with physiology, or comparing a CT image with anatomy, or comparing the uptake of a radioactive PET tracer to blood flow in a region.

Press release: GE Healthcare Targets Interventional Visualization with 3D Multi-Modality Advantage Workstation with VolumeShare 4 At RSNA 2009...

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Tuesday, November 17, 2009

Myoguide EMG Amplifier/Stimulator from Intronix Tech

This week at Medica 2009 in Düsseldorf, a Canadian firm Intronix Technologies Corp is unveiling a new electrophysiological amplifier designed to identify where to place neuromodulator injections for muscle disorders, pain management, and cosmetic applications. The Myoguide is essentially a single-channel EMG amplifier with stimulator that sports a signal display with analysis and EMG audio, so a clinician can locate areas of hyperactive muscle fibers for treatment.

Published features of the product:

Ability to see and hear EMG signals, display real time analyzed EMG, and stimulation location capability. There are numerous advantages to embracing Myoguide for EMG guidance:

Conveniently integrated into one handheld package

Helps identify involved muscles i.e. pre-injection physiopathological evaluation, or pre-intervention evaluation. (Either by EMG or stimulation location)

pre-injection evaluation in cases where the site may be surrounded by essential nerves and blood vessels

pre-injection evaluation can lead to reduced drug dose and volume, thereby reducing the incidence of drug resistance, and limiting drug diffusion into adjacent areas.

Provides confirmation of treatment effects

Press release: ESTABLISHED CANADIAN COMPANY INTRODUCES HANDHELD NEEDLE-EMG GUIDED INJECTION SYSTEM... (.pdf)

Product page: Intronix Model 8008 Myoguide System ...

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