1
|
Barra B, Kumar R, Gopinath C, Mirzakhalili E, Lempka SF, Gaunt RA, Fisher LE. High-frequency amplitude-modulated sinusoidal stimulation induces desynchronized yet controllable neural firing. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.14.580219. [PMID: 38405798 PMCID: PMC10888888 DOI: 10.1101/2024.02.14.580219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Regaining sensory feedback is pivotal for people living with limb amputation. Electrical stimulation of sensory fibers in peripheral nerves has been shown to restore focal percepts in the missing limb. However, conventional rectangular current pulses induce sensations often described as unnatural. This is likely due to the synchronous and periodic nature of activity evoked by these pulses. Here we introduce a fast-oscillating amplitude-modulated sinusoidal (FAMS) stimulation waveform that desynchronizes evoked neural activity. We used a computational model to show that sinusoidal waveforms evoke asynchronous and irregular firing and that firing patterns are frequency dependent. We designed the FAMS waveform to leverage both low- and high-frequency effects and found that membrane non-linearities enhance neuron-specific differences when exposed to FAMS. We implemented this waveform in a feline model of peripheral nerve stimulation and demonstrated that FAMS-evoked activity is more asynchronous than activity evoked by rectangular pulses, while being easily controllable with simple stimulation parameters. These results represent an important step towards biomimetic stimulation strategies useful for clinical applications to restore sensory feedback.
Collapse
Affiliation(s)
- Beatrice Barra
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Neuroscience Institute, New York University Langone Health, New York, USA
| | - Ritesh Kumar
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, USA
| | - Chaitanya Gopinath
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ehsan Mirzakhalili
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, USA
| | - Scott F. Lempka
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Robert A. Gaunt
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, USA
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, USA
| | - Lee E Fisher
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, USA
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, USA
| |
Collapse
|
2
|
Lamorie-Foote K, Kramer DR, Sundaram S, Cavaleri J, Gilbert ZD, Tang AM, Bashford L, Liu CY, Kellis S, Lee B. Primary somatosensory cortex organization for engineering artificial somatosensation. Neurosci Res 2024:S0168-0102(24)00009-9. [PMID: 38278220 DOI: 10.1016/j.neures.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 01/28/2024]
Abstract
Somatosensory deficits from stroke, spinal cord injury, or other neurologic damage can lead to a significant degree of functional impairment. The primary (SI) and secondary (SII) somatosensory cortices encode information in a medial to lateral organization. SI is generally organized topographically, with more discrete cortical representations of specific body regions. SII regions corresponding to anatomical areas are less discrete and may represent a more functional rather than topographic organization. Human somatosensory research continues to map cortical areas of sensory processing with efforts primarily focused on hand and upper extremity information in SI. However, research into SII and other body regions is lacking. In this review, we synthesize the current state of knowledge regarding the cortical organization of human somatosensation and discuss potential applications for brain computer interface. In addition to accurate individualized mapping of cortical somatosensation, further research is required to uncover the neurophysiological mechanisms of how somatosensory information is encoded in the cortex.
Collapse
Affiliation(s)
- Krista Lamorie-Foote
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Daniel R Kramer
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States; Department of Neurological Surgery, University of Colorado School of Medicine, Denver, CO, United States
| | - Shivani Sundaram
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States.
| | - Jonathon Cavaleri
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Zachary D Gilbert
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Austin M Tang
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States; Department of Neurological Surgery, University of Texas at Houston, Houston, TX, United States
| | - Luke Bashford
- Department of Biology and Biological Engineering, T&C Chen Institute for Neuroscience, California Institute of Technology, Pasadena, CA, United States; Department of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Charles Y Liu
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States; USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, United States
| | - Spencer Kellis
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States; USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, United States
| | - Brian Lee
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States; USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, United States
| |
Collapse
|
3
|
Fisher LE, Gaunt RA, Huang H. Sensory Restoration for Improved Motor Control of Prostheses. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2023; 28:100498. [PMID: 37860289 PMCID: PMC10583965 DOI: 10.1016/j.cobme.2023.100498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Somatosensory neuroprostheses are devices with the potential to restore the senses of touch and movement from prosthetic limbs for people with limb amputation or paralysis. By electrically stimulating the peripheral or central nervous system, these devices evoke sensations that appear to emanate from the missing or insensate limb, and when paired with sensors on the prosthesis, they can improve the functionality and embodiment of the prosthesis. There have been major advances in the design of these systems over the past decade, although several important steps remain before they can achieve widespread clinical adoption outside the lab setting. Here, we provide a brief overview of somatosensory neuroprostheses and explores these hurdles and potential next steps towards clinical translation.
Collapse
Affiliation(s)
- Lee E. Fisher
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Center for Neural Basis of Cognition, Pittsburgh, PA 15213, USA
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Robert A. Gaunt
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Center for Neural Basis of Cognition, Pittsburgh, PA 15213, USA
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - He Huang
- UNC/NC State Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695, USA
- UNC/NC State Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| |
Collapse
|
4
|
Arya R, Frink C, Kargol C, Byars AW, Huddleston D, Diedenhofer DB, Aungaroon G, Ervin B, Horn PS, Ihnen SKZ, Tenney JR, Kremer K, Fong S, Lin N, Liu W, Arthur TM, Skoch J, Leach JL, Mangano FT, Glauser TA, Greiner HM, Holland KD. Neuropsychological outcomes after epilepsy surgery: A comparison of stereo electroencephalography and subdural electrodes. Eur J Neurol 2023; 30:2986-2998. [PMID: 37329329 PMCID: PMC10529267 DOI: 10.1111/ene.15929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND AND PURPOSE We analyzed the association of neuropsychological outcomes after epilepsy surgery with the intracranial electrode type (stereo electroencephalography [SEEG] and subdural electrodes [SDE]), and electrical stimulation mapping (ESM) of speech/language. METHODS Drug-resistant epilepsy patients who underwent comprehensive neuropsychological evaluation before and 1 year after epilepsy surgery were included. SEEG and SDE subgroups were matched by age, handedness, operated hemisphere, and seizure freedom. Postsurgical neuropsychological outcomes (adjusted for presurgical scores) and reliable change indices were analyzed as functions of electrode type and ESM. RESULTS Ninety-nine patients aged 6-29 years were included with similar surgical resection/ablation volumes in the SEEG and SDE subgroups. Most of the neuropsychological outcomes were comparable between SEEG and SDE subgroups; however, Working Memory and Processing Speed were significantly improved in the SEEG subgroup. Undergoing language ESM was associated with significant improvements in Spelling, Letter-Word Identification, Vocabulary, Verbal Comprehension, Verbal Learning, and Story Memory scores, but a decline in Calculation scores. CONCLUSIONS Intracranial evaluations with SEEG and SDE are comparable in terms of long-term postsurgical neuropsychological outcomes. Our data suggest that SEEG may be associated with improvements in working memory and processing speed, representing cognitive domains served by spatially distributed networks. Our study also supports wider use of language ESM before epilepsy surgery, preferably using other language tasks in addition to visual naming. Rather than the type of electrode, postsurgical neuropsychological outcomes are driven by whether language ESM was performed or not, with beneficial effects of language mapping.
Collapse
Affiliation(s)
- Ravindra Arya
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Electrical Engineering and Computer Science, University of Cincinnati, Cincinnati, Ohio, USA
| | - Clayton Frink
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Christina Kargol
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Anna W Byars
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - David Huddleston
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Donna B Diedenhofer
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Gewalin Aungaroon
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Brian Ervin
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Electrical Engineering and Computer Science, University of Cincinnati, Cincinnati, Ohio, USA
| | - Paul S Horn
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - S K Z Ihnen
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Jeffrey R Tenney
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kelly Kremer
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Susan Fong
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Nan Lin
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Wei Liu
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Todd M Arthur
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Jesse Skoch
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - James L Leach
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Pediatric Neuroradiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Francesco T Mangano
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Tracy A Glauser
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Hansel M Greiner
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Katherine D Holland
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| |
Collapse
|
5
|
Chandrasekaran S, Bhagat NA, Ramdeo R, Ebrahimi S, Sharma PD, Griffin DG, Stein A, Harkema SJ, Bouton CE. Targeted transcutaneous spinal cord stimulation promotes persistent recovery of upper limb strength and tactile sensation in spinal cord injury: a pilot study. Front Neurosci 2023; 17:1210328. [PMID: 37483349 PMCID: PMC10360050 DOI: 10.3389/fnins.2023.1210328] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/15/2023] [Indexed: 07/25/2023] Open
Abstract
Long-term recovery of limb function is a significant unmet need in people with paralysis. Neuromodulation of the spinal cord through epidural stimulation, when paired with intense activity-based training, has shown promising results toward restoring volitional limb control in people with spinal cord injury. Non-invasive neuromodulation of the cervical spinal cord using transcutaneous spinal cord stimulation (tSCS) has shown similar improvements in upper-limb motor control rehabilitation. However, the motor and sensory rehabilitative effects of activating specific cervical spinal segments using tSCS have largely remained unexplored. We show in two individuals with motor-complete SCI that targeted stimulation of the cervical spinal cord resulted in up to a 1,136% increase in exerted force, with weekly activity-based training. Furthermore, this is the first study to document up to a 2-point improvement in clinical assessment of tactile sensation in SCI after receiving tSCS. Lastly, participant gains persisted after a one-month period void of stimulation, suggesting that targeted tSCS may lead to persistent recovery of motor and sensory function.
Collapse
Affiliation(s)
- Santosh Chandrasekaran
- Neural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Nikunj A. Bhagat
- Neural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center, Houston, TX, United States
| | - Richard Ramdeo
- Neural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Sadegh Ebrahimi
- Neural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Pawan D. Sharma
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United States
| | - Doug G. Griffin
- Northwell Health STARS Rehabilitation, East Meadow, NY, United States
| | - Adam Stein
- Department of Physical Medicine and Rehabilitation, Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Manhasset, NY, United States
| | - Susan J. Harkema
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United States
- Department of Bioengineering, University of Louisville, Louisville, KY, United States
- Frazier Rehabilitation Institute, University of Louisville Health, Louisville, KY, United States
- Department of Neurological Surgery, University of Louisville, Louisville, KY, United States
| | - Chad E. Bouton
- Neural Bypass and Brain Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, United States
| |
Collapse
|
6
|
Zhang S, Yu Y, Xu P, Shen X, Fang C, Wu X, Qu P, Wu T, Wang QM, Luo X, Hong Y. Mechanical digit sensory stimulation: a randomized control trial on neurological and motor recovery in acute stroke. Front Neurosci 2023; 17:1134904. [PMID: 37287803 PMCID: PMC10242038 DOI: 10.3389/fnins.2023.1134904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 05/10/2023] [Indexed: 06/09/2023] Open
Abstract
Background Mechanical digit sensory stimulation (MDSS) is a novel therapy designed to accelerate the recovery of upper limb (including hand) function in patients with hemiplegia following a stroke. The primary goal of this study was to investigate the effect of MDSS on patients with acute ischemic stroke (AIS). Methods Sixty-one inpatients with AIS were randomly divided into conventional rehabilitation group (RG) and stimulation group (SG), and the latter group received MDSS therapy. A healthy group consisting of 30 healthy adults was also included. The interleukin-17A (IL-17A), vascular endothelial growth factor A (VEGF-A), and tumor necrosis factor-alpha (TNF-α) plasma levels were measured in all subjects. The neurological and motor functions of patients were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Mini-Mental State Examination (MMSE), Fugel-Meyer Assessment (FMA), and Modified Barthel Index (MBI). Results After 12 days of intervention, the IL-17A, TNF-α, and NIHSS levels were significantly decreased, while the VEGF-A, MMSE, FMA, and MBI levels were significantly increased in both disease groups. No significant difference was observed between both disease groups after intervention. The levels of IL-17A and TNF-α were positively correlated with NIHSS but negatively correlated with MMSE, FMA, and MBI. The VEGF-A levels were negatively correlated with NIHSS but positively correlated with MMSE, FMA, and MBI. Conclusion Both MDSS and conventional rehabilitation significantly reduce the production of IL-17A and TNF-α, increase the VEGF-A levels, and effectively improve cognition and motor function of hemiplegic patients with AIS, and the effects of MDSS and conventional rehabilitation are comparable.
Collapse
Affiliation(s)
- Shuting Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Yang Yu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Panpan Xu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Xianshan Shen
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Chuanqin Fang
- Department of Neurology, The Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Xiaosan Wu
- Department of Neurology, The Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Ping Qu
- Department of Neurology, The Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Tingting Wu
- Key Laboratory of Oral Disease Research of Anhui Province, Stomatologic Hospital and College, Anhui Medical University, Hefei, Anhui Province, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Xun Luo
- School of Medicine, Shenzhen University, Shenzhen, Guangdong Province, China
| | - Yongfeng Hong
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| |
Collapse
|
7
|
Zuccaroli I, Lucke-Wold B, Palla A, Eremiev A, Sorrentino Z, Zakare-Fagbamila R, McNulty J, Christie C, Chandra V, Mampre D. Neural Bypasses: Literature Review and Future Directions in Developing Artificial Neural Connections. OBM NEUROBIOLOGY 2023; 7:158. [PMID: 36908763 PMCID: PMC9997488 DOI: 10.21926/obm.neurobiol.2301158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Reported neuro-modulation schemes in the literature are typically classified as closed-loop or open-loop. A novel group of recently developed neuro-modulation devices may be better described as a neural bypass, which attempts to transmit neural data from one location of the nervous system to another. The most common form of neural bypasses in the literature utilize EEG recordings of cortical information paired with functional electrical stimulation for effector muscle output, most commonly for assistive applications and rehabilitation in spinal cord injury or stroke. Other neural bypass locations that have also been described, or may soon be in development, include cortical-spinal bypasses, cortical-cortical bypasses, autonomic bypasses, peripheral-central bypasses, and inter-subject bypasses. The most common recording devices include EEG, ECoG, and microelectrode arrays, while stimulation devices include both invasive and noninvasive electrodes. Several devices are in development to improve the temporal and spatial resolution and biocompatibility for neuronal recording and stimulation. A major barrier to entry includes neuroplasticity and current decoding mechanisms that regularly require retraining. Neural bypasses are a unique class of neuro-modulation. Continued advancement of neural recording and stimulating devices with high spatial and temporal resolution, combined with decoding mechanisms uninhibited by neuroplasticity, can expand the therapeutic capability of neural bypassing. Overall, neural bypasses are a promising modality to improve the treatment of common neurologic disorders, including stroke, spinal cord injury, peripheral nerve injury, brain injury and more.
Collapse
Affiliation(s)
| | | | | | - Alexander Eremiev
- Department of Neurosurgery, New York University School of Medicine, New York, USA
| | | | | | - Jack McNulty
- Department of Neurosurgery, University of Iowa, Iowa City, IA, USA
| | - Carlton Christie
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Vyshak Chandra
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - David Mampre
- Johns Hopkins University, Baltimore, USA
- Department of Neurosurgery, University of Florida, Gainesville, USA
| |
Collapse
|
8
|
Sombeck J, Heye J, Kumaravelu K, Goetz S, Peterchev AV, Grill WM, Bensmaia SJ, Miller LE. Characterizing the short-latency evoked response to intracortical microstimulation across a multi-electrode array. J Neural Eng 2022; 19. [PMID: 35378515 PMCID: PMC9142773 DOI: 10.1088/1741-2552/ac63e8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 04/04/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Persons with tetraplegia can use brain-machine interfaces to make visually guided reaches with robotic arms. Without somatosensory feedback, these movements will likely be slow and imprecise, like those of persons who retain movement but have lost proprioception. Intracortical microstimulation (ICMS) has promise for providing artificial somatosensory feedback. If ICMS can mimic naturally occurring neural activity, afferent interfaces may be more informative and easier to learn than interfaces that evoke unnaturalistic activity. To develop such biomimetic stimulation patterns, it is important to characterize the responses of neurons to ICMS. APPROACH Using a Utah multi-electrode array, we recorded activity evoked by single pulses and trains of ICMS at a wide range of amplitudes and frequencies in two rhesus macaques. As the electrical artifact caused by ICMS typically prevents recording for many milliseconds, we deployed a custom rapid-recovery amplifier with nonlinear gain to limit signal saturation on the stimulated electrode. Across all electrodes after stimulation, we removed the remaining slow return to baseline with acausal high-pass filtering of time-reversed recordings. MAIN RESULTS After single pulses of stimulation, we recorded what was likely transsynaptically-evoked activity even on the stimulated electrode as early as ~0.7 ms. This was immediately followed by suppressed neural activity lasting 10-150 ms. After trains, this long-lasting inhibition was replaced by increased firing rates for ~100 ms. During long trains, the evoked response on the stimulated electrode decayed rapidly while the response was maintained on non-stimulated channels. SIGNIFICANCE The detailed description of the spatial and temporal response to ICMS can be used to better interpret results from experiments that probe circuit connectivity or function of cortical areas. These results can also contribute to the design of stimulation patterns to improve afferent interfaces for artificial sensory feedback.
Collapse
Affiliation(s)
- Joseph Sombeck
- Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Road, Evanston, Illinois, 60208, UNITED STATES
| | - Juliet Heye
- Department of Neuroscience, Northwestern University, 310 E. Superior St, Chicago, Illinois, 60202, UNITED STATES
| | - Karthik Kumaravelu
- Biomedical Engineering, Duke University, 2080 Duke University Road, Durham, North Carolina, 27708-0187, UNITED STATES
| | - Stefan Goetz
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2080 Duke University Road, Durham, North Carolina, 27708, UNITED STATES
| | - Angel V Peterchev
- Psychiatry & Behavioral Sciences, Duke University School of Medicine, 40 Duke Medicine Circle, Durham, North Carolina, 27710, UNITED STATES
| | - Warren M Grill
- Department of Biomedical Engineering, Duke University, Hudson Hall 136, Box 90281, Durham, North Carolina, 27708-0281, UNITED STATES
| | - Sliman J Bensmaia
- Organismal Biology and Anatomy, University of Chicago, 1027 E 57th St, Chicago, IL 60637, USA, Chicago, Illinois, 60637, UNITED STATES
| | - Lee E Miller
- Neuroscience, Northwestern University Feinberg School of Medicine, 303 East Chicago Ave, Chicago, Illinois, 60611-3008, UNITED STATES
| |
Collapse
|
9
|
Muret D, Root V, Kieliba P, Clode D, Makin TR. Beyond body maps: Information content of specific body parts is distributed across the somatosensory homunculus. Cell Rep 2022; 38:110523. [PMID: 35294887 PMCID: PMC8938902 DOI: 10.1016/j.celrep.2022.110523] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/10/2021] [Accepted: 02/21/2022] [Indexed: 11/23/2022] Open
Abstract
The homunculus in primary somatosensory cortex (S1) is famous for its body part selectivity, but this dominant feature may eclipse other representational features, e.g., information content, also relevant for S1 organization. Using multivariate fMRI analysis, we ask whether body part information content can be identified in S1 beyond its primary region. Throughout S1, we identify significant representational dissimilarities between body parts but also subparts in distant non-primary regions (e.g., between the hand and the lips in the foot region and between different face parts in the foot region). Two movements performed by one body part (e.g., the hand) could also be dissociated well beyond its primary region (e.g., in the foot and face regions), even within Brodmann area 3b. Our results demonstrate that information content is more distributed across S1 than selectivity maps suggest. This finding reveals underlying information contents in S1 that could be harnessed for rehabilitation and brain-machine interfaces. We replicate the high univariate selectivity profile of the somatosensory homunculus We use multivariate fMRI analysis to identify information content beyond selectivity Significant body part and action-related content are found throughout the homunculus Functional information is available, even in regions selective to other body parts
Collapse
Affiliation(s)
- Dollyane Muret
- Institute of Cognitive Neuroscience, University College London, 17 Queen Square, London WC1N 3AZ, UK.
| | - Victoria Root
- Institute of Cognitive Neuroscience, University College London, 17 Queen Square, London WC1N 3AZ, UK; Wellcome Centre of Integrative Neuroimaging, University of Oxford, Oxford OX3 9DU, UK
| | - Paulina Kieliba
- Institute of Cognitive Neuroscience, University College London, 17 Queen Square, London WC1N 3AZ, UK
| | - Danielle Clode
- Institute of Cognitive Neuroscience, University College London, 17 Queen Square, London WC1N 3AZ, UK; Dani Clode Design, 40 Hillside Road, London SW2 3HW, UK
| | - Tamar R Makin
- Institute of Cognitive Neuroscience, University College London, 17 Queen Square, London WC1N 3AZ, UK; Wellcome Trust Centre for Neuroimaging, University College London, London WC1N 3AR, UK
| |
Collapse
|
10
|
Elam JS, Glasser MF, Harms MP, Sotiropoulos SN, Andersson JLR, Burgess GC, Curtiss SW, Oostenveld R, Larson-Prior LJ, Schoffelen JM, Hodge MR, Cler EA, Marcus DM, Barch DM, Yacoub E, Smith SM, Ugurbil K, Van Essen DC. The Human Connectome Project: A retrospective. Neuroimage 2021; 244:118543. [PMID: 34508893 PMCID: PMC9387634 DOI: 10.1016/j.neuroimage.2021.118543] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/13/2021] [Accepted: 08/30/2021] [Indexed: 01/21/2023] Open
Abstract
The Human Connectome Project (HCP) was launched in 2010 as an ambitious effort to accelerate advances in human neuroimaging, particularly for measures of brain connectivity; apply these advances to study a large number of healthy young adults; and freely share the data and tools with the scientific community. NIH awarded grants to two consortia; this retrospective focuses on the "WU-Minn-Ox" HCP consortium centered at Washington University, the University of Minnesota, and University of Oxford. In just over 6 years, the WU-Minn-Ox consortium succeeded in its core objectives by: 1) improving MR scanner hardware, pulse sequence design, and image reconstruction methods, 2) acquiring and analyzing multimodal MRI and MEG data of unprecedented quality together with behavioral measures from more than 1100 HCP participants, and 3) freely sharing the data (via the ConnectomeDB database) and associated analysis and visualization tools. To date, more than 27 Petabytes of data have been shared, and 1538 papers acknowledging HCP data use have been published. The "HCP-style" neuroimaging paradigm has emerged as a set of best-practice strategies for optimizing data acquisition and analysis. This article reviews the history of the HCP, including comments on key events and decisions associated with major project components. We discuss several scientific advances using HCP data, including improved cortical parcellations, analyses of connectivity based on functional and diffusion MRI, and analyses of brain-behavior relationships. We also touch upon our efforts to develop and share a variety of associated data processing and analysis tools along with detailed documentation, tutorials, and an educational course to train the next generation of neuroimagers. We conclude with a look forward at opportunities and challenges facing the human neuroimaging field from the perspective of the HCP consortium.
Collapse
Affiliation(s)
| | | | - Michael P Harms
- Washington University School of Medicine, St. Louis, MO, USA
| | - Stamatios N Sotiropoulos
- Sir Peter Mansfield Imaging Centre & NIHR Nottingham Biomedical Research Centre, Queen's Medical Centre, School of Medicine, University of Nottingham, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | | | | | | | - Robert Oostenveld
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, the Netherlands
| | | | - Jan-Mathijs Schoffelen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, the Netherlands
| | - Michael R Hodge
- Washington University School of Medicine, St. Louis, MO, USA
| | - Eileen A Cler
- Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel M Marcus
- Washington University School of Medicine, St. Louis, MO, USA
| | - Deanna M Barch
- Washington University School of Medicine, St. Louis, MO, USA
| | - Essa Yacoub
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Stephen M Smith
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Kamil Ugurbil
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | | |
Collapse
|
11
|
Foldes ST, Chandrasekaran S, Camerone J, Lowe J, Ramdeo R, Ebersole J, Bouton CE. Case Study: Mapping Evoked Fields in Primary Motor and Sensory Areas via Magnetoencephalography in Tetraplegia. Front Neurol 2021; 12:739693. [PMID: 34630308 PMCID: PMC8497881 DOI: 10.3389/fneur.2021.739693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/13/2021] [Indexed: 12/02/2022] Open
Abstract
Devices interfacing with the brain through implantation in cortical or subcortical structures have great potential for restoration and rehabilitation in patients with sensory or motor dysfunction. Typical implantation surgeries are planned based on maps of brain activity generated from intact function. However, mapping brain activity for planning implantation surgeries is challenging in the target population due to abnormal residual function and, increasingly often, existing MRI-incompatible implanted hardware. Here, we present methods and results for mapping impaired somatosensory and motor function in an individual with paralysis and an existing brain–computer interface (BCI) device. Magnetoencephalography (MEG) was used to directly map the neural activity evoked during transcutaneous electrical stimulation and attempted movement of the impaired hand. Evoked fields were found to align with the expected anatomy and somatotopic organization. This approach may be valuable for guiding implants in other applications, such as cortical stimulation for pain and to improve implant targeting to help reduce the craniotomy size.
Collapse
Affiliation(s)
- Stephen T Foldes
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Santosh Chandrasekaran
- Neural Bypass and Brain-Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research at Northwell Health, New York, NY, United States
| | - Joseph Camerone
- MEG Center, Overlook Medical Center, Atlantic Health, Summit, NJ, United States
| | - James Lowe
- MEG Center, Overlook Medical Center, Atlantic Health, Summit, NJ, United States
| | - Richard Ramdeo
- Neural Bypass and Brain-Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research at Northwell Health, New York, NY, United States
| | - John Ebersole
- MEG Center, Overlook Medical Center, Atlantic Health, Summit, NJ, United States
| | - Chad E Bouton
- Neural Bypass and Brain-Computer Interface Laboratory, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research at Northwell Health, New York, NY, United States.,Department of Molecular Medicine, Hofstra-Northwell Medical School, New York, NY, United States
| |
Collapse
|
12
|
Chandrasekaran S, Fifer M, Bickel S, Osborn L, Herrero J, Christie B, Xu J, Murphy RKJ, Singh S, Glasser MF, Collinger JL, Gaunt R, Mehta AD, Schwartz A, Bouton CE. Historical perspectives, challenges, and future directions of implantable brain-computer interfaces for sensorimotor applications. Bioelectron Med 2021; 7:14. [PMID: 34548098 PMCID: PMC8456563 DOI: 10.1186/s42234-021-00076-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
Almost 100 years ago experiments involving electrically stimulating and recording from the brain and the body launched new discoveries and debates on how electricity, movement, and thoughts are related. Decades later the development of brain-computer interface technology began, which now targets a wide range of applications. Potential uses include augmentative communication for locked-in patients and restoring sensorimotor function in those who are battling disease or have suffered traumatic injury. Technical and surgical challenges still surround the development of brain-computer technology, however, before it can be widely deployed. In this review we explore these challenges, historical perspectives, and the remarkable achievements of clinical study participants who have bravely forged new paths for future beneficiaries.
Collapse
Affiliation(s)
- Santosh Chandrasekaran
- Neural Bypass and Brain Computer Interface Laboratory, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Matthew Fifer
- Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - Stephan Bickel
- The Human Brain Mapping Laboratory, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
- Department of Neurosurgery, Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
- Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Luke Osborn
- Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - Jose Herrero
- The Human Brain Mapping Laboratory, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Breanne Christie
- Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - Junqian Xu
- Departments of Radiology and Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Rory K J Murphy
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Sandeep Singh
- Good Shepherd Rehabilitation Hospital, Allentown, PA, USA
| | - Matthew F Glasser
- Departments of Radiology and Neuroscience, Washington University in St Louis, Saint Louis, MO, USA
| | - Jennifer L Collinger
- Rehabilitation Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert Gaunt
- Rehabilitation Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ashesh D Mehta
- The Human Brain Mapping Laboratory, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
- Department of Neurosurgery, Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Andrew Schwartz
- McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chad E Bouton
- Neural Bypass and Brain Computer Interface Laboratory, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA.
- Department of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA.
| |
Collapse
|
13
|
Bouton C, Bhagat N, Chandrasekaran S, Herrero J, Markowitz N, Espinal E, Kim JW, Ramdeo R, Xu J, Glasser MF, Bickel S, Mehta A. Decoding Neural Activity in Sulcal and White Matter Areas of the Brain to Accurately Predict Individual Finger Movement and Tactile Stimuli of the Human Hand. Front Neurosci 2021; 15:699631. [PMID: 34483823 PMCID: PMC8415782 DOI: 10.3389/fnins.2021.699631] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/22/2021] [Indexed: 01/01/2023] Open
Abstract
Millions of people worldwide suffer motor or sensory impairment due to stroke, spinal cord injury, multiple sclerosis, traumatic brain injury, diabetes, and motor neuron diseases such as ALS (amyotrophic lateral sclerosis). A brain-computer interface (BCI), which links the brain directly to a computer, offers a new way to study the brain and potentially restore impairments in patients living with these debilitating conditions. One of the challenges currently facing BCI technology, however, is to minimize surgical risk while maintaining efficacy. Minimally invasive techniques, such as stereoelectroencephalography (SEEG) have become more widely used in clinical applications in epilepsy patients since they can lead to fewer complications. SEEG depth electrodes also give access to sulcal and white matter areas of the brain but have not been widely studied in brain-computer interfaces. Here we show the first demonstration of decoding sulcal and subcortical activity related to both movement and tactile sensation in the human hand. Furthermore, we have compared decoding performance in SEEG-based depth recordings versus those obtained with electrocorticography electrodes (ECoG) placed on gyri. Initial poor decoding performance and the observation that most neural modulation patterns varied in amplitude trial-to-trial and were transient (significantly shorter than the sustained finger movements studied), led to the development of a feature selection method based on a repeatability metric using temporal correlation. An algorithm based on temporal correlation was developed to isolate features that consistently repeated (required for accurate decoding) and possessed information content related to movement or touch-related stimuli. We subsequently used these features, along with deep learning methods, to automatically classify various motor and sensory events for individual fingers with high accuracy. Repeating features were found in sulcal, gyral, and white matter areas and were predominantly phasic or phasic-tonic across a wide frequency range for both HD (high density) ECoG and SEEG recordings. These findings motivated the use of long short-term memory (LSTM) recurrent neural networks (RNNs) which are well-suited to handling transient input features. Combining temporal correlation-based feature selection with LSTM yielded decoding accuracies of up to 92.04 ± 1.51% for hand movements, up to 91.69 ± 0.49% for individual finger movements, and up to 83.49 ± 0.72% for focal tactile stimuli to individual finger pads while using a relatively small number of SEEG electrodes. These findings may lead to a new class of minimally invasive brain-computer interface systems in the future, increasing its applicability to a wide variety of conditions.
Collapse
Affiliation(s)
- Chad Bouton
- Feinstein Institutes for Medical Research at Northwell Health, New York, NY, United States.,Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, New York, NY, United States.,Hofstra-Northwell Medical School, New York, NY, United States
| | - Nikunj Bhagat
- Feinstein Institutes for Medical Research at Northwell Health, New York, NY, United States.,Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, New York, NY, United States
| | - Santosh Chandrasekaran
- Feinstein Institutes for Medical Research at Northwell Health, New York, NY, United States.,Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, New York, NY, United States
| | - Jose Herrero
- Feinstein Institutes for Medical Research at Northwell Health, New York, NY, United States.,Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, New York, NY, United States.,Department of Neurosurgery, Northwell Health, New York, NY, United States
| | - Noah Markowitz
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, New York, NY, United States
| | - Elizabeth Espinal
- Feinstein Institutes for Medical Research at Northwell Health, New York, NY, United States.,Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, New York, NY, United States
| | - Joo-Won Kim
- Department of Radiology and Psychiatry, Baylor College of Medicine, Houston, TX, United States
| | - Richard Ramdeo
- Feinstein Institutes for Medical Research at Northwell Health, New York, NY, United States.,Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, New York, NY, United States
| | - Junqian Xu
- Department of Radiology and Psychiatry, Baylor College of Medicine, Houston, TX, United States
| | - Matthew F Glasser
- Department of Radiology and Neuroscience, Washington University in St. Louis, St. Louis, MO, United States
| | - Stephan Bickel
- Feinstein Institutes for Medical Research at Northwell Health, New York, NY, United States.,Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, New York, NY, United States.,Hofstra-Northwell Medical School, New York, NY, United States.,Department of Neurosurgery, Northwell Health, New York, NY, United States.,Department of Neurology, Northwell Health, New York, NY, United States
| | - Ashesh Mehta
- Feinstein Institutes for Medical Research at Northwell Health, New York, NY, United States.,Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, New York, NY, United States.,Hofstra-Northwell Medical School, New York, NY, United States.,Department of Neurosurgery, Northwell Health, New York, NY, United States
| |
Collapse
|