Adaptive Deep Brain Stimulation: Investigational System Development at the Edge of Clinical Brain Computer Interfacing
Over the last few decades, the use of deep brain stimulation (DBS) to improve the treatment of those with neurological movement disorders represents a critical success story in the development of invasive neurotechnology and the promise of brain-computer interfaces (BCI) to improve the lives of those suffering from incurable neurological disorders. In the last decade, investigational devices capable of recording and streaming neural activity from chronically implanted therapeutic electrodes has supercharged research into clinical applications of BCI, enabling in-human studies investigating the use of adaptive stimulation algorithms to further enhance therapeutic outcomes and improve future device performance. In this talk, Dr. Herron will review ongoing clinical research efforts in the field of adaptive DBS systems and algorithms. This will include an overview of DBS in current clinical practice, the development of bidirectional clinical-use research platforms, ongoing algorithm evaluation efforts, a discussion of current adoption barriers to be addressed in future work.
Brain-Machine Interfaces: Beyond Decoding
A brain-machine interface (BMI) is a system that enables users to interact with computers and robots through the voluntary modulation of their brain activity. Such a BMI is particularly relevant as an aid for patients with severe neuromuscular disabilities, although it also opens up new possibilities in human-machine interaction for able-bodied people. Real-time signal processing and decoding of brain signals are certainly at the heart of a BMI. Yet, this does not suffice for subjects to operate a brain-controlled device. In the first part of my talk I will review some of our recent studies, most involving participants with severe motor disabilities, that illustrate additional principles of a reliable BMI that enable users to operate different devices. In particular, I will show how an exclusive focus on machine learning is not necessarily the solution as it may not promote subject learning. This highlights the need for a comprehensive mutual learning methodology that foster learning at the three critical levels of the machine, subject and application. To further illustrate that BMI is more than just decoding, I will discuss how to enhance subject learning and BMI performance through appropriate feedback modalities. Finally, I will show how these principles translate to motor rehabilitation, where in a controlled trial chronic stroke patients achieved a significant functional recovery after the intervention, which was retained 6-12 months after the end of therapy.