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.
Towards a Translational Neuroscience of Consciousness
The cognitive neuroscience of conscious perception has seen considerable growth over the past few decades. Confirming an influential hypothesis driven by earlier studies of neuropsychological patients, we have found that the lateral and polar prefrontal cortices play important causal roles in the generation of subjective experiences. However, this basic empirical finding has been hotly contested by researchers with different theoretical commitments, and the differences are at times difficult to resolve. To address the controversies, I suggest one alternative venue may be to look for clinical applications derived from current theories. I outline an example in which we used closed-loop fMRI combined with machine learning to nonconsciously manipulate the physiological responses to threatening stimuli, such as spiders or snakes. A clinical trial involving patients with phobia is currently taking place. I also outline how this theoretical framework may be extended to other diseases. Ultimately, a truly meaningful understanding of the fundamental nature of our mental existence should lead to useful insights for our colleagues on the clinical frontlines. If we use this as a yardstick, whoever loses the esoteric theoretical debates, both science and the patients will always win.