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Oxley TJ. The Promise of Endovascular Neurotechnology: A Brain-Computer Interface to Restore Autonomy to People With Motor Impairment. Am J Phys Med Rehabil 2024; 103:465-470. [PMID: 38377064 DOI: 10.1097/phm.0000000000002463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
ABSTRACT This Joel A. DeLisa Lecture on endovascular brain-computer interfaces was presented by Dr Thomas Oxley on February 23, 2023, at the Association of Academic Physiatrists Annual Scientific Meeting. The lecture described how brain-computer interfaces replace lost physiological function to enable direct communication between the brain and external digital devices, such as computers, smartphones, and robotic limbs. Specifically, the potential of a novel endovascular brain-computer interface technology was discussed. The brain-computer interface uses a stent-electrode array delivered via the jugular vein and is permanently implanted in a vein adjacent to the motor cortex. In a first-in-human clinical trial, participants with upper limb paralysis who received the endovascular brain-computer interface could use the system independently and at home to operate laptop computers for various instrumental activities of daily living. A Food and Drug Administration-approved trial of the endovascular brain-computer interface in the United States is in progress. Future development of the system will provide recipients with continuous autonomy through digital access with minimal caregiver assistance. Physiatrists and occupational therapists will have a vital role in helping people with paralysis achieve the potential of implantable brain-computer interfaces.
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Affiliation(s)
- Thomas J Oxley
- From the Vascular Bionics Laboratory, Department of Medicine, The University of Melbourne, Melbourne, Australia
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Brannigan JFM, Fry A, Opie NL, Campbell BCV, Mitchell PJ, Oxley TJ. Endovascular Brain-Computer Interfaces in Poststroke Paralysis. Stroke 2024; 55:474-483. [PMID: 38018832 DOI: 10.1161/strokeaha.123.037719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Stroke is a leading cause of paralysis, most frequently affecting the upper limbs and vocal folds. Despite recent advances in care, stroke recovery invariably reaches a plateau, after which there are permanent neurological impairments. Implantable brain-computer interface devices offer the potential to bypass permanent neurological lesions. They function by (1) recording neural activity, (2) decoding the neural signal occurring in response to volitional motor intentions, and (3) generating digital control signals that may be used to control external devices. While brain-computer interface technology has the potential to revolutionize neurological care, clinical translation has been limited. Endovascular arrays present a novel form of minimally invasive brain-computer interface devices that have been deployed in human subjects during early feasibility studies. This article provides an overview of endovascular brain-computer interface devices and critically evaluates the patient with stroke as an implant candidate. Future opportunities are mapped, along with the challenges arising when decoding neural activity following infarction. Limitations arise when considering intracerebral hemorrhage and motor cortex lesions; however, future directions are outlined that aim to address these challenges.
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Affiliation(s)
- Jamie F M Brannigan
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (J.F.M.B.)
| | - Adam Fry
- Synchron, Inc, New York, NY (A.F., N.L.O., T.J.O.)
| | - Nicholas L Opie
- Synchron, Inc, New York, NY (A.F., N.L.O., T.J.O.)
- Vascular Bionics Laboratory, Department of Medicine, The University of Melbourne, Victoria, Australia (N.L.O., T.J.O.)
| | - Bruce C V Campbell
- Department of Neurology (B.C.V.C.), The Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia
- Melbourne Brain Centre (B.C.V.C.), The Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia
| | - Peter J Mitchell
- Department of Radiology (P.J.M.), The Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia
| | - Thomas J Oxley
- Synchron, Inc, New York, NY (A.F., N.L.O., T.J.O.)
- Vascular Bionics Laboratory, Department of Medicine, The University of Melbourne, Victoria, Australia (N.L.O., T.J.O.)
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