Patent Application
20210213279
The present application relates to electrophysiologic recording and/or stimulation of brain tissue using electrode arrays.
Several common disorders of the brain, spinal cord, and peripheral nervous system arise due to abnormal electrical activity in biological (neural) circuits. In general terms, these conditions may be classified into:
When the electrical lesion is focal and relatively discrete, as is very often the case, effective diagnosis and treatment of such conditions depends on precise localization of the lesion and, when possible, restoration of normal electrophysiologic function to the affected region.
A variety of well-established techniques exist for localizing electrical lesions in the brain, each of which has specific limitations.
While the foregoing list is not exhaustive, it provides a general overview of the range of techniques presently available for electrical recording and stimulation of the living human brain.
In practice, all neural recording and stimulation techniques involve design trade-offs among a number of primary factors:
In one aspect, an integrated circuit comprises a size and being configured according to a flexibility requirement for catheter-based delivery to electrophysiologically relevant anatomic targets.
In some examples, the electrophysiologically relevant anatomic targets comprise a brain. In some examples, the electrophysiologically relevant anatomic targets comprise an area of the nervous system. In some examples, the electrophysiologically relevant anatomic targets comprise a heart.
In some examples, the flexibility requirement of the integrated circuit has a tolerable bending radius of approximately 20 cm or less.
In some examples, a longest rectangular dimension of the size of the integrated circuit is approximately 2 mm or less.
In some examples, the integrated circuit has a multiplexer array. In some examples, the multiplexer array has an aspect ratio 1:r. In some examples, 1/r is less than 1. In some examples, r is determined based on a total electronics layout area divided by (2 mm)2.
In some examples, the integrated circuit is configured for use with flexible electrode arrays implanted in a human body. In some examples, the integrated circuit is configured for use in a neural interface or brain-machine interface. In some examples, the integrated circuit is configured for use in a signal conditioning unit for recording and processing individual-neuronal activity, neuronal population activity, local field activity, electrophysiologic signals in other bandwidth ranges, or some combination thereof. In some examples, the integrated circuit is configured for use in cardiac electrophysiology.
In one aspect, a microelectronic multiplexing unit includes one or more multiplexing elements comprising a size and being configured according to a flexibility requirement of catheter-based delivery to electrophysiologically relevant anatomic targets.
In some examples, the electrophysiologically relevant anatomic targets comprise a brain. In some examples, the electrophysiologically relevant anatomic targets comprise an area of the nervous system. In some examples, the electrophysiologically relevant anatomic targets comprise a heart.
In some examples, the one or more multiplexing elements have a total input channel count between approximately 2 and 100,000. In some examples, the one or more multiplexing elements have a total input channel count higher than 100,000.
In some examples, the one or more multiplexing elements have a multiplexing ratio of 1:n, wherein n is an integer. In some examples, n is a power of two. In some examples, n is selected from the group consisting of 2, 4, 8, 16, 32, 64, 128, 256, 512, and 1024.
In some examples, the one or more multiplexing elements have a tolerable bending radius of 20 cm or less.
In some examples, a longest rectangular dimension of the size of the microelectronic multiplexing unit is 2 mm or less.
In some examples, the one or more multiplexing elements are arranged in an array.
In some examples, the array of multiplexing elements has an aspect ratio 1:r. In some examples, 1/r is less than 1. In some examples, r is determined based on a total electronics layout area divided by (2 mm)2.
In some examples, the microelectronic multiplexing unit is configured for use with flexible electrode arrays implanted in a human body. In some examples, the microelectronic multiplexing unit is configured for use in a neural interface or brain-machine interface. In some examples, the microelectronic multiplexing unit is configured for use in a signal conditioning unit for recording and processing individual-neuronal activity, neuronal population activity, local field activity, electrophysiologic signals in other bandwidth ranges, or some combination thereof. In some examples, the microelectronic multiplexing unit is configured for use in cardiac electrophysiology.
In one aspect, a high-density connector system includes one or more multiplexing integrated circuits, wherein the one or more multiplexing integrated circuits are configured for catheter deployment, wherein power and data lines of the one or more multiplexing integrated circuits are disposed within a wall of the catheter.
In some examples, the catheter comprises a wired catheter, wherein the wall of the wired catheter contains individually insulated wires. In some examples, the individually insulated wires are exposed at a first end of the catheter and a second end of the wired catheter.
In some examples, the wired catheter is configured for use with an electrode array. In some examples, the electrode array comprises an endovascular electrode array. In some examples, the electrode array comprises an endoscopic electrode array. In some examples, the individually insulated wires are connected to a subset of electrodes of the electrode array. In some examples, the individually insulated wires run from an interface in a brain to amplification or recording electronics external to the brain. In some examples, the wired catheter is configured to test the electrode array. In some examples, the electrode array is an electrode array with one or more on-board multiplexers.
In some examples, the high-density connector system is configured to enable temporary electrical interfacing with a plurality of electrodes deployed in a body in minimally invasive fashion in proximity to electrophysiologically active tissue, while maintaining normal physiologic conditions in the tissue.
In some examples, the temporary electrical interfacing may last for one or more hours. In some examples, the temporary electrical interfacing may last for one or more days. In some examples, the plurality of electrodes comprises a massive number of electrodes. In some examples, the electrophysiologically active tissue comprises neural tissue. In some examples, the electrophysiologically active tissue comprises cardiac tissue. In some examples, the catheter is configured to deploy electrode interfaces into fluid-containing compartments where normal fluid flow will be constantly maintained. In some examples, the fluid-containing compartments comprise a ventricular system of a brain, a spinal subarachnoid space, or a venous or arterial system of the brain, or some combination thereof.
In some examples, a first end of the wired catheter is located outside a body, and a second end of the wired catheter is located inside the body in proximity to the electrode array. In some examples, the wired catheter is configured to conform anatomically to a trajectory or a compartment within a body. In some examples, the trajectory comprises vascular access from a femoral artery or a femoral vein to a deep venous system of a brain, transcortical insertion into a ventricular system of the brain, venous or arterial access to the brain, or stereotactic access to the ventricular system.
In some examples, the wired catheter establishes access to an anatomical target, and conformable, foldable, rollable, or otherwise collapsible electrode arrays may be deployed through the wired catheter to a location inside the anatomical target.
In some examples, the anatomical target comprises a brain. In some examples, the anatomical target comprises a heart. In some examples, the anatomical target comprises a gastrointestinal system. In some examples, the anatomical target comprises an urogenital system.
In some examples, the multiplexing integrated circuits comprise a multiplexer custom application specific integrated circuit (ASIC). In some examples, the catheter has a diameter of approximately 2 mm (6 French). In some examples, the catheter has a diameter of approximately less than 0.5 mm to approximately 4 mm. In some examples, the catheter is a wired catheter and the multiplexer ASIC is configured to increase a bandwidth of the wired catheter. In some examples, the multiplexer ASIC has one or more features of catheter compatibility, the features of catheter compatibility comprising narrow aspect ratio, thinness, or flexibility.
In some examples, the wired catheter incorporates multiple multiplexing elements. In some examples, the multiplexer ASIC conditions or controls a signal output from an implanted electrode array, and the multiplexing elements are connected to power and data leads located in a wall of the wired catheter.
In some examples, the power and data lines are separately insulated conductive traces. In some examples, the catheter has a bore of approximately 2 mm (6 French). In some examples, the catheter has a bore ranging in size from approximately less than 0.1 mm to approximately greater than 10 mm. In some examples, the separately insulated conductive traces comprise a large number of braided conductive traces. In some examples, a conductive surface of the conductive traces is exposed at a first end of the catheter and a second end of the catheter, so as to support one or more sensors containing a plurality of multiplexers.
In some examples, the catheter is created using wire braiding or polymer extrusion techniques.
In some examples, the catheter is integrated with a rotating hemostatic valve, so as to support deployment of electrode interfaces into fluid-containing compartments. In some examples, the fluid-containing compartments comprise a brain or a nervous system. In some examples, the fluid-containing compartments comprise blood vessels of the brain or the ventricular system of the brain. In some examples, the fluid-containing compartments comprise a heart, a gastrointestinal system, or a genitourinary system. In some examples, the rotating hemostatic valve is attached to an end of the catheter, with dual ports, allowing fluids to be flushed through the catheter during operation.
In one aspect, the present application discloses an implantable medical device with a flexible substrate, an array of electrodes mounted on the flexible substrate for recording and stimulating neurological activities within ventricles of a brain, and a conformal scaffolding supporting the flexible substrate.
In some embodiments, the array of electrodes can be periodic. In some embodiments, the conformal scaffolding can be continuous. In some embodiments, the conformal scaffolding can be a plurality of flat panels oriented parallel to each other, and a continuous loop of metal wire, wound in a helical pattern across the plurality of parallel panels and longitudinally along the length of the plurality of parallel panels. In some embodiments, the metal wire can be made of a shape memory alloy, such as nitinol. In some embodiments, the flexible substrate can be a flexible printed circuit board made of polyimide. In some embodiments, the plurality of electrodes can be made of platinum, iridium, or gold. In some embodiments, the implantable medical device further includes a power source and a microprocessor, each electrically coupled to the array of electrodes. In another aspect, the present application discloses a method for electrically interacting with a neural tissue using an electrode array located within a ventricular compartment of a brain, the method can include selecting a portion of neural tissue for electrical interaction, accessing previously stored registration information regarding a location of the electrode array within the ventricular compartment of the brain, selecting one or more electrodes in the electrode array for electrical interaction based on the registration information, and interacting with the neural tissue with the selected electrodes.
In some embodiments, the method can include stimulating neural activities of the neural tissue, or recording neural activities of the neural tissue, or simultaneously stimulating and recording neural activities of the neural tissue. In some embodiments, the method can include forming an electrical field beam distributed in a three-dimensional space using the selected electrodes. In some embodiments, the method can include localizing electrical activity in the brain using the selected electrode distributed in a three-dimensional space. In some embodiments, the method can include localizing electrical activities from epileptogenic foci within a hippocampus for the management of epilepsy. In some embodiments, the method can include stimulating the brain in response to epileptogenic activity within the hippocampus for the management of epilepsy. In some embodiments, the method can include interacting with motor pathways by an electrical field generated by the electrode array at a distance to assist in restoring mobility and limb control. In some embodiments, the method can include stimulating visual pathways to generate visual perception. In some embodiments, the method can include stimulating sensory cortex or sensory thalamus to deliver sensory stimulation to the brain for a neurosensory prosthesis or for the treatment of thalamic pain. In some embodiments, the method can include stimulating hypothalamic nuclei for the management of neuroendocrine disorders, circadian rhythm disorders, physiologic response to fever or hypothermia, or obesity. In some embodiments, the method can include registering the electrode array to obtain its orientation and position within the ventricular compartment of a brain via neuroimaging. In some embodiments, the method can include placing the electrode array into the ventricular compartment of a brain via a minimally invasive insertion technique, such as a cannula or catheter.
An ideal electrophysiologic neural probe should simultaneously provide optimal performance in all four of the above categories. Exemplary existing solutions for lesions of particular types, in particular brain regions are as follows:
Diagnosis and treatment of functional electrophysiologic lesions in brain regions remain challenging or intractable. In particular, deep brain regions are frequent sites of functional lesions, yet remain difficult to access systematically and minimally invasively. For example, the medical temporal lobe is a common site for seizure foci and the substantia nigra is the site of neuronal degeneration causing Parkinson's disease; both regions are several centimeters deep to the cortical surface.
The present application discloses an electrode array for neural recording and stimulation, which can be deployed using minimally invasive techniques, to electrophysiologically localize and stimulate targets within wide regions deep within the brain.
The present application also discloses integrated circuits and related techniques, including multiplexing elements, capable of bending to accommodate the contours of tissue interfaces or the requirements of minimally invasive delivery systems (e.g., such as catheters). Such integrated circuits are beneficial components of systems that serve, for example, large numbers of electrodes.
The present application also discloses integrated circuits, and related techniques, for catheters employing embedded integrated circuits to interface with electrode arrays comprising large numbers of electrodes.
The device described herein can be used with minimally invasive techniques for precise spatial and temporal localization of electrical activity within the brain, and for precise electrical stimulation of brain tissue, to diagnose and restore function in conditions caused by abnormal electrical activity in the brain.
An exemplary electrophysiologic neural probe provides maximal spatial and temporal resolution, enables three dimensional electrical recording and stimulation, and can be deployed noninvasively, without disrupting normal brain tissue.
In particular, the present disclosure describes a flexible and collapsible array of electrodes, and a minimally invasive method of delivering such an array into the cerebral ventricles, the fluid-filled cavities at the center of the brain. The walls of the cerebral ventricles are formed by the inner surfaces of several deep brain structures that are difficult to access from the cortical surface, including the hippocampus and medial temporal lobe (frequently involved in seizure disorders), the hypothalamus (which is involved in hormonal regulation, circadian rhythm, and the modulation of cravings related to a range of factors, including sleep, food, salt and water, warmth, and sex), the thalamus and basal ganglia (involved in movement disorders such as Parkinson's disease), and the internal capsule (frequently damaged in hemorrhagic stroke). By arraying electrodes along the inner walls of the cerebral ventricles, deep brain targets can be accessed electrically for precise electrical recording and stimulation.
In summary, electrode arrays positioned within the ventricles can interface with structures deep within the brain, without traumatizing brain tissue, in ways that conventional depth electrodes and surface electrodes cannot. The ability of these electrodes to more extensively interface with deep brain structures is due to two principal properties. First, during initial placement, ventricular arrays can be navigated within a purely fluidic compartment that provides extensive access to deep brain structures. By navigating within this fluidic compartment (the cerebral ventricular system), ventricular electrode arrays avoid traumatizing delicate brain tissue. Second, multiple neural structures that are difficult to access electrically using conventional techniques are situated in close proximity to the surface of the ventricular system. The ventricular system of the brain can be accessed and navigated using techniques of minimally invasive neurosurgery, including neuro-endoscopy.
Conformal electrode arrays can be clinically useful in mapping and targeted ablation of cardiac lesions causing heart arrhythmias. For example, conformal electrode arrays can be used for electrophysiologic mapping in real-time in the heart. Exemplary techniques for treating conditions such as atrial fibrillation can use conformal electrode arrays, delivered through the major blood vessels, to record from the electrical system of the heart (De Ponti et al. (2004) Europace 6:97-108); (Yamada (2007) Indian Pacing Electrophysiol. J. 7:97-109). However, there is extremely limited precedent for intraventricular electrode recording in the brain (Konrad et al. (2003) J. Neurol. Neurosurg. Psychiatry 74:561-565), and prior work has been conducted only with linear electrode configurations, not with conformal arrays. Additionally, there is limited precedent for stimulation of brain regions surrounding the ventricles from within the ventricles, (Benabid et al. (2016) Neurosurgery 79:806-815) and prior work has been limited to conventional deep brain stimulation electrodes, not conformal electrode arrays.
In some embodiments, array 200 can include a mechanism for expanding skeleton member 201 from the axial configuration used for initial implantation, to an expanded, deployed configuration that conforms (based on measurements obtained, for example, from patient-specific medical imaging) to the inner shape of the intracranial ventricular compartment. Certain general geometric characteristics are appropriate for implantation within the cerebral ventricles, but shape-memory materials permit skeleton member 201 to be sized and shaped in a patient-specific manner. Ovoid and cylindrical shapes provide useful approximations to the shapes of certain parts of the cerebral ventricular system.
A non-exclusive list of materials that can be used to make stiffener 204 includes polyimide, polyether ether ketone (PEEK), polycarbonates, polyamides, polyethylene, polypropylene, polyesters, and polyethersulfones. The stiffness of stiffener 204 can be controlled such that it is rigid enough to hold the array in place while it is being unsheathed from a cannula, while stiffener 204 can be flexible enough to conform in a gentle arc per the anatomy inside the cerebral ventricles.
In some embodiments of the present disclosure, stiffener 204 and center panel 203 can be bonded together with a biocompatible adhesive. Exemplary biocompatible adhesives can include, but not limited to, medical grade epoxies, including flexible and high-bond-strength cyanoacrylate epoxies. In some embodiments, stiffener 204 and center panel 203 can be bonded by heat curing under pressure. In some embodiments, stiffener can be molded or etched with trenches, which can be used to hold skeleton member 201 in place. In one embodiment of the present disclosure, the side panels do not have stiffeners, and can wrap upwards to conform to the anatomy. In some embodiments, each side panel 202 also can have a stiffener.
Flexible printed circuit board 207 can be a polymer substrate upon which a series of electronic devices, for example, electrodes 208, can be mounted. In some embodiments, flexible printed circuit board 207 can be polyimide, PEEK, polyacrylic, epoxy, fluoropolymers or a transparent conductive polyester film. Flexible circuit 207 can be mounted on top of skeleton member 201 (not shown in
In order to generate a strong and focused electrical field for stimulation and recording or neural activity, flexible printed circuit board 207 can have a periodic array of electrodes 208. For example, a total of 350 electrodes 208 are shown in
In some embodiments, electrodes 208 can be composed of a biocompatible and electrically conducting material. Electrodes can be made of materials including, but not limited to, platinum, iridium, or gold. Electrodes 208 also can be further coated with platinum-iridium or gold to improve conduction properties, biocompatibility, and radiopacity.
In some embodiments, the array of electrodes 208 supported on flexible printed circuit board 207 can be used for recording of electrical signals generated by the brain in the regions surrounding the cerebral ventricles, or for electrically stimulating regions of the brain surrounding the cerebral ventricles. In some embodiments, electrodes 208 in the array can be designed and arranged for recording, stimulation, or both.
Material and geometric considerations, as well as electrical impedance considerations, apply to optimizing for one mode of operation or the other. Arrays can be configured with recording electrodes alone, stimulation electrodes alone, a combination of types, or electrodes capable of operating in both modes. Electrode surfaces can be treated, for example through chemical etching or other roughening techniques, or through polymer coating, to optimize their effective surface area and modify their impedance for recording or stimulation.
In some embodiments, each electrode 208 can have an associated conductor trace 205. In some embodiments, conductor traces 205 can be used to connect electrodes 208 to recording, stimulation, and other computational apparatus outside the ventricular system. Conductor traces 205 can be aligned inside the loops of skeleton member 201, which can be threaded inside the loop and merge into a single signal cable 206. Cable 206 can exit the ventricular system and the skull along the insertion path of the endoscope used to implant the array, as discussed below. In some embodiments, conductor traces 205 can be composed of any suitable biocompatible conductor, for example, gold. In some embodiments, conductor traces 205 can be gold at nine micrometers thick, sandwiched inside flexible printed circuit board 207. Cable 206 can pass through a narrow-diameter tract through the cerebral cortex and cortical white matter, to exit through a small burr hole surgically drilled through the skull at the time of initial implantation. Accordingly, and as discussed in detail below, electrode array 200 can be connected to an implantable power source, implanted microcomputer, and implanted mechanism for data telemetry and communication with external devices. In some embodiments, the power source and microcomputer can be external to the body.
In some embodiments, a biocompatible coating can be conformal coated on to the entire assembly as a moisture barrier and lubricating coating. In some embodiments, the entire assembly can be conformally coated with Parylene C.
Corresponding to the perspective view in
The collapsed configuration of the electrode array 200, as shown in the perspective view in
In some embodiments, skeleton member 201 can be calibrated in a patient-specific manner to exert adequate pressure on the walls of the ventricular compartment to remain in fixed position and in contact with the inner ventricular surface, but without disrupting neurologic function and without significantly deforming the anatomic structures forming the boundaries of the ventricular compartment. In some embodiments, the contact pressure may be almost negligible, for example, just adequate to maintain the skeleton member 201 in the shape of the cavity, without exerting a physiologically significant pressure on the surrounding brain. The very minimal residual pressure can be accommodated over time by the brain with negligible clinical physiologic effect.
Prior neural electrical stimulation techniques have been one-dimensional or two-dimensional in nature. For example, some techniques for neural stimulation in the context of electrode arrays have been demonstrated in the context of interleaved stimulation and current steering techniques for cochlear implants (Rubenstein (2004) Curr. Opin. Otolaryngol. Head Neck Surg. 5:444-448); (Choi et al. (2012) Cochlear Implant Research Updates, Chapter 5). The electrode arrays and neural substrates of interest in cochlear implant applications, however, are essentially one-dimensional.
Recent developments in the context of deep brain stimulation (Timmermann et al. (2015) Lancet Neurol. 14:693-701) have demonstrated the value of current-steering techniques in deep brain stimulation, but those systems are also limited by being essentially one-dimensional as well. This revised approach to deep brain stimulation, using multiple current-sources, has recently been described and implemented (Timmermann et al. (2015) Lancet Neural. 14:693-701), but the approach, while effective, remains limited in the sense that the electrode array is effectively linear, and requires intraparenchymal placement. The volume of brain tissue accessible for neural stimulation using deep brain simulation electrodes is extremely limited as compared with the planar intraventricular electrode arrays described here, which can assume three-dimensional shapes.
Additionally, the deep brain stimulation electrodes must penetrate deep into the brain, damaging neural tissue along the insertion tract. The device disclosed herein relates to three-dimensional conformal electrode arrays, used to record from or stimulate three-dimensional volumes of neural tissue, which has not been accomplished by the prior art techniques.
An electrode array on a three-dimensional surface enables more versatile shaping of electric fields and more precise spatial targeting than conventional one-dimensional and two-dimensional electrode arrays. The ability to position arrays of many electrodes deep within the brain confers such arrays the further ability to generate tailored electrical fields, designed to stimulate an individual brain region with high spatial and temporal precision. In contrast to depth electrodes (such as those used in deep brain stimulation), for which intraparenchymal position is the primary determinant of the region stimulated, the regions accessible to stimulation by conformal arrays can be programmed with many degrees of freedom after deployment. Accordingly, stimulation by the described conformal electrode array does not require the direct proximity to the region of interest as does stimulation by linear depth electrodes such as those used in deep brain stimulation.
Because of the high volumetric density of neurons within the brain, focused electrical fields are required for effective and precise neural stimulation. In some embodiments, a beam-formed electrical field can be created by the stimulation device. This can require three-dimensional distribution of the electrode contacts inside the brain. The conformable array described in the present disclosure with three-dimensional distribution of electrodes enables beam forming of the electrical field. Beam formation enables a strong and focused stimulation of brain tissue, which is an advantage over existing technologies using one-dimensional electrodes. Further, the relatively large number of electrodes and the conformal design of the device enable a stimulation of three-dimensional volumes of neural tissue.
Several minimally invasive approaches can be used in contemporary neurosurgery for precise placement of devices within the cerebral ventricular system. (Mark M. Souweidane. Intraventricular Neuroendoscopy: A Practical Atlas. B. Braun, Aesculap Neurosurgery, Berlin) The conformal electrode array described herein is designed to integrate with several such techniques.
Following deployment, the conformal electrode array changes from a collapsed state (as shown in
Following array implantation is registration of the array 506. During this step, three-dimensional neuroimaging can be used to establish the final, deployed, spatial and anatomic orientation of an array within the ventricular system. In some embodiments, elements of the conformal electrode arrays are radio-opaque, enabling unambiguous localization of each electrode in three-dimensional space and with respect to neighboring neuroanatomic structures using conventional neuroimaging modalities, such as computed tomography (CT). Registration can allow for precise stimulation and recording of neural tissue.
After deployment, as particular electrodes transmit electrical signals reflecting neuronal activity within the brain, it may be important in many applications to correlate the precise positions of implanted electrodes with their positions in three-dimensional space and with respect to anatomic structures. Such correlations can be established using CT imaging of the brain, provided the position of each electrode can be identified on CT. For this reason, to ensure detectability via CT and fluoroscopic imaging, certain components of the electrodes and the device are radio-opaque. For example, in some embodiments, radio opaqueness can be achieved using platinum titanium alloys. Analysis of such imaging data (typically high-resolution computed tomography, CT) forms the basis of the following:
Following registration, conformal electrode array can operate in a plurality of modes. For example, the device can operate in a recording mode 508, a stimulation mode 512 and a feedback mode 510.
In some embodiments, the device can include a recording mode. In the recording mode, a method of correlating imaging determining the position of the array relative to anatomic structures, with electrophysiologic recording data from which particular neural signals arise, to determine the spatial and neuroanatomic origin of those signals can be performed.
In some embodiments, the method can include a stimulation mode. In the stimulation mode, a method of correlating imaging determining the position of the array relative to anatomic structures, with computationally determined electric field geometry, so as to achieve precise image-guided electrical stimulation of neural structures can be performed. In some embodiments, this method can include a method of shaping the electric fields generated by the electrodes, so as to stimulate precise anatomic regions surrounding the cerebral ventricle; this configuration may be programmed prior to or following array implantation (based on patient-specific imaging, electrode recordings, behavior, response to therapy, or other data). A set of computational models, taking into account patient-specific anatomy based on neuroimaging obtained with the array in place, can be used to compute the anatomic origin of particular electrical signals recorded by the array. Similarly, a related set of such models can be used to shape the electrical fields and steer the electrical currents collectively generated by the array within surrounding neural tissue, in order to stimulate with anatomic and functional precision.
In some embodiments, in a feedback mode, electrical stimulation and recording can be performed simultaneously (by designating certain electrodes for stimulation and others for recording) or in an interleaved manner, in order to confirm efficacy of electrical stimulation in real-time, and in order to adapt electrical stimulation programs to real-time electrophysiologic responses. In some embodiments, the device can switch between modes after implantation. Each individual electrode in the array can be independently controlled.
Once the electrode is implanted its geometric configuration and impedance are fixed. But any electrode can theoretically be used at any time for recording or stimulation. In practice, arrays can be fabricated with specific electrodes designed either for recording or for stimulation, and the mode will rarely be changed after implantation. However, the current or voltage settings at each stimulation electrode can be independently controlled, as can stimulation timing; frequency, amplitude, and pulse-width of stimulation; and stimulation pulse shape, among other parameters.
The described conformal electrode array positioned in the cerebral ventricles can be minimally disruptive to normal brain tissue but can have extensive access to deep brain nuclei and fiber tracts that are otherwise difficult to access. Accordingly, the conformal array of ventricular neural electrodes disclosed herein has several major advantages over existing technologies.
Array 200 assumes a narrow axial configuration when confined to the inner channel of the cannula 601, then expands when unsheathed from the cannula 601 in the temporal horn 104 of the lateral ventricle.
As the leads from the recording electrodes exit the brain, they form a bundle that is tunneled through a small-diameter hole surgically drilled in the skull. After exiting the skull, this bundle may be tunneled in a subcutaneous layer to a microcomputer or other device designed to power the electrodes, store recording data, store stimulation parameters, and coordinate wireless data telemetry with external devices. These active electronic components are contained within the hermetic package. In such a configuration, the conformal electrode array permits long-term electroencephalographic monitoring of patients in the ambulatory setting, as there is no fluidic communication between the brain and the outside world, and hence no major risk of intracranial infection. In this configuration, the monitoring capabilities of the conformal, minimally invasive system disclosed here offer an option not available using conventional grid and strip electrodes, which are implanted via craniotomy, tunneled through dura, skull, and skin, and permit leakage of cerebrospinal fluid and a conduit between the brain and the outside world. Epilepsy patients undergoing monitoring using such techniques, which represent the present state of the art, must be monitored in a hospital setting until the recording electrodes are removed. Furthermore, in the current state of the art, removal of the electrodes requires a second operation for electrode removal, repair of the dura membrane, and reaffixing of the removed portion of the skull.
On the other hand, the system disclosed herein does not preclude monitoring using such conventional techniques. Using the system disclosed herein, device leads may also, temporarily, be tunneled through the skin for patient monitoring in a conventional epilepsy monitoring unit.
Epilepsy often but not always arises due to lesions deep in the temporal lobe that are difficult to access electrically and surgically. Medically refractory epilepsy is a condition in which an individual is prone to recurrent seizures that cannot be controlled by antiseizure medications, though the individual may be otherwise neurologically normal between seizures. This class of seizure disorder is often caused by a lesion deep within the temporal lobe of the brain (the associated condition is often referred to as “mesial temporal lobe epilepsy”). Definitive treatment for such lesions has traditionally involved major brain surgery. In recent years, a variety of modern techniques have been developed for ablating such lesions in minimally invasive fashion, once a sufficiently high degree of diagnostic confidence is achieved with regard to lesion location. However, definitive diagnosis remains challenging for the reasons described in the previous section:
EEG, MEG, and ECoG provide limited spatial resolution when the lesions of interest are deep within the brain, and only a limited number of exploratory depth electrodes can safely be placed.
Traditional, contemporary approaches to localizing seizure foci within the medial temporal lobe and hippocampus approach these structures from the external cortical surface. However, the surface of the medial temporal lobe and hippocampus form the inner wall of the temporal horn of the lateral ventricle, and are therefore directly accessible to electrode arrays placed within the cerebral ventricles. The system disclosed here provides for highly spatially accurate localization of abnormal electrical activity in these deep structures, without requiring depth electrodes or a traditional craniotomy (a conformal ventricular electrode array can be introduced through a small burr hole, in stereotactic or endoscope-assisted fashion).
One principal application of the conformal intraventricular electrode array is in localization of seizure foci in patients having temporal lobe epilepsy. In such patients, the electrode array is deployed in recording mode, with electrodes arrayed along the ventricular surface of the temporal horn, which is defined by the structures of the medial temporal lobe, including the hippocampus. In this application, the goal is precise spatial and anatomic localization of epileptogenic foci within the hippocampus or medial temporal lobe. The array configuration of the electrodes permits patterns of electrical activity to be localized in three-dimensional space and correlated with three-dimensional anatomic neuroimaging.
Neurologic disorders such as Parkinson's disease and epilepsy can be treated using spatially targeted electrical recording and stimulation of specific neuroanatomic structures. Electrical stimulation of deep brain targets is an important modality in the treatment of Parkinson's disease, essential tremor, and certain (thalamic) pain syndromes. The efficacy of neurostimulation-based therapy is highly dependent on the ability to stimulate the correct target with precision. In certain cases, it is difficult or impossible to introduce a conventional intraparenchymal depth electrode into the target without simultaneously generating a lesion associated with electrode placement.
The conformal electrode array in the present disclosure can be used in deep brain stimulation for Parkinson's disease. A grid of intraventricular electrodes enables highly versatile shaping of electrical fields, with the ability to design and modify the electric field within and surrounding the traditional targets used during deep brain stimulation. In some embodiments, the aggregate electric field and current density function of the implanted array can be configured to stimulate deep brain nuclei associated with the treatment of Parkinson's disease and related movement disorders. These periventricular targets include the subthalamic nucleus, globus pallidus, specific thalamic nuclei, and substantia nigra.
Other applications of the described conformal electrode array can include minimally invasive stimulation of the optic radiations. This technique may provide an approach to delivering visual stimuli to the blind. Several approaches to electrical stimulation of the visual pathways have been experimentally demonstrated and reviewed (Pezaris et al. (2009) Neurosurg. Focus 27:E6), as potential approaches to developing a visual prosthesis for the blind. All such approaches, to date, have used intraparenchymal depth electrodes, which would require introducing lesions into the very tracts or grey matter structures that carry or process visual information, as the depth electrodes would need to penetrate the cortical regions or white matter tracts of interest.
Phosphenes, visual phenomena often described as transient “flashes of light” related to electrical stimulation, are common side effects of deep brain stimulation during initial intraoperative placement and testing of the electrodes, and subsequent programming. In the context of deep brain stimulation targeting the thalamus and subthalamic nucleus, for example, high-amplitude stimulation can give rise to fringe electrical fields that cause depolarization of axons in the optic tracts, giving rise to transient visual sensations. While these effects are unwanted in the context of deep brain stimulation, they confirm that it is possible to generate visual sensations in reproducible manner by controlling the electric field generated by electrodes placed at a distance from the optic pathway, rather than directly into the pathway itself (at the level of the optic tracts, lateral geniculate nuclei, optic radiations, or visual cortex, for example).
The conformal array of intraventricular electrodes disclosed herein enables highly versatile shaping of electrical fields, with the ability to target locations along the visual pathway, including the optic tracts, lateral geniculate nuclei, optic radiations, and visual cortex. An adaptive, computational approach to mapping the visual pathways using electrical stimulation and recording, with or without collaboration from the subject, holds promise for a prosthesis to restore vision to the visually impaired.
Targeted electrical stimulation of white matter tracts transected by hemorrhage or stroke has the potential to restore neurologic function. Several approaches to electrical stimulation of the motor pathways have been experimentally demonstrated and reviewed, as potential approaches to developing a neural prostheses for paralyzed individuals and amputees (Wolpaw et al. (2012) Mayo Clin. Proc. 87:268-279), and as approaches to restoring function in patients paralyzed or partially paralyzed due to stroke (Boyd et al. (2015) Front Neurol. 6:226). Some such major and promising approaches, to date, have used cortical surface electrodes or intraparenchymal depth electrodes, which can only be placed through conventional neurosurgical techniques, and which can require introducing lesions into the very tracts that carry motor information, as the electrodes need to penetrate the cortical regions or white matter tracts of interest.
Involuntary, stimulation-triggered muscular contractions are common side effects of deep brain stimulation during initial intraoperative placement and testing of the electrodes, and subsequent programming. In the context of deep brain stimulation targeting the thalamus or globus pallidus, for example, high-amplitude stimulation can give rise to fringe electrical fields that cause depolarization of axons in the internal capsule, giving rise to transient muscular contractions (often in the face). While these effects are unwanted in the context of deep brain stimulation, they confirm that it is possible to control motor function in reproducible ways by controlling the electric field generated by electrodes placed at a distance from the motor (corticospinal) tracts, rather than directly into the tracts themselves (at the level of the motor cortex or spinal cord). The internal capsule is of particular interest in the context of this disclosure. Fibers of the internal capsule carry neural signals regarding voluntary movement from the motor cortex to the spinal cord, from where they are transmitted to the skeletal muscles that generate such movement. The internal capsule is a common location for hemorrhagic strokes, particularly those related to high blood pressure; strokes of this type tend to disrupt or destroy some of the internal capsule fibers, leaving stroke victims permanently weak or paralyzed on the side of the body opposite the hemorrhage. Many of the internal capsule fibers travel within millimeters of the ventricular surface, and are therefore amenable to precise stimulation using precisely controlled electrical fields. This disclosure therefore has the potential to be used in the context of neural prosthetics for paralyzed and disabled individuals, as well as for individuals recovering from stroke. The conformal array of intraventricular electrodes disclosed herein can enable highly versatile shaping of electrical fields, with the ability to target locations along the motor pathway, including multiple targets within the internal capsule. An adaptive, computational approach to mapping the motor pathways using electrical stimulation and recording, with or without collaboration from the subject, holds promise for a prosthesis to assist in restoring mobility and limb control to the paralyzed and disabled.
The conformal electrode array in the present disclosure can be used in deep brain stimulation for thalamic pain syndrome. In some embodiments, the aggregate electric field and current density function of the implanted array is configured to stimulate targets within the thalamus associated with thalamic pain syndrome.
The conformal electrode array in the present disclosure can be used for stimulation of hypothalamic nuclei. In some embodiments, the aggregate electric field and current density function of the implanted array is configured to stimulate targets within specific nuclei of the hypothalamus, in the walls of the third ventricle. Such targeting may be useful in the management of neuroendocrine disorders, circadian rhythm disorders, physiologic responses to fever or hypothermia, and obesity, which are centrally physiologically regulated by specific nuclei in the hypothalamus.
The conformal electrode array in the present disclosure can be used in stimulation of subcortical white matter tracts and internal capsule for stroke rehabilitation and neuromotor prostheses. In some embodiments, the aggregate electric field and current density function of the implanted array can be configured to stimulate a set of targets within the motor pathways of the brain, including targets within the internal capsule or cerebral or elsewhere in the corticospinal tract. In these embodiments, the conformal electrode array can have clear advantages over traditional depth and microelectrode arrays, as the conformal array can be configured to simulate the fields and current densities generated by an array of electrodes implanted anywhere within large volumes of the brain, without damaging or displacing brain tissue, and the configuration can be changed. Implanted electrodes or microelectrode arrays, by contrast, cannot easily be moved after implantation without risk of significant brain injury. Furthermore, the set of targets stimulated can be chosen in a three-dimensional manner that would be difficult or impossible to achieve using any existing depth electrodes or microelectrode array. In some embodiments, feedback control based on sensed electrical activity within the sensory pathways, including neuronal activity within the sensory thalamus, may be used to modulate motor coordination.
The conformal electrode array in the present disclosure can be used in stimulation of the sensory thalamus for neurosensory prostheses. Most of the surface of the thalamus is accessible from the ventricular system. Most of the major sensory pathways of the nervous system ascend through the brainstem and relay within the thalamus before ascending to the cortex. In some embodiments, the aggregate electric field and current density function of the implanted array is configured to stimulate a set of targets within the sensory thalamus, for use in the context of a sensory neuroprosthetic device, delivering sensory stimulation to the brain (from modalities such as touch, pain, temperature, hearing, and vision) in a programmable manner, possibly based on data acquired by external sensors.
In some embodiments, the aggregate electric field and current density function of the implanted array is configured to stimulate a set of targets within the visual pathways of the brain, including targets within the optic tracts, lateral geniculate bodies, and optic radiations. In each of these targets, a topological representation of images projected on the retina is preserved in the organization of neuronal cell layers and corresponding axons, facilitating rational stimulation patterns intended to generate perception of meaningful images.
In these embodiments as well, the conformal array can be configured to simulate the fields and current densities generated by multiple arrays of electrodes implanted at many sites within the optic pathways, without damaging or displacing brain tissue in those pathways, and the configuration can be changed based on individual patient experience over time. Implanted electrodes or microelectrode arrays, by contrast, cannot easily be moved after implantation without risk of significant brain injury, and implantation would damage the optic pathways. Furthermore, the set of targets stimulated can be chosen in a three-dimensional manner that would be difficult or impossible to achieve using any existing depth electrodes or microelectrode array, and difficult-to-access parts of the visual pathways can be targeted noninvasively.
In such visual prosthetic applications, stimulation could be delivered in a programmed manner, based on data acquired by external sensors such as video cameras.
While the disclosure has been described in connection with certain embodiments, it is to be understood that the disclosure is not to be limited to the disclosed embodiments but, on the contrary, is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the disclosure, which scope is to be accorded the broadest interpretation so as to encompass all such modifications and equivalent structures as is permitted under the law.
Flexibility, the ability to conform to a curved surface, or to be bent or rolled, can be an important feature of minimally invasive electrode arrays. In particular, some uses relate to arrays that can be deployed into the cerebral ventricles, or into a blood vessel, through a small-diameter catheter. Delivery can be effectuated by having the electrode array assume a constrained configuration (for example, “rolled up”) while in the catheter, prior to being deployed in the brain or at other anatomic targets. Electronic components embedded in the arrays can also be flexible to withstand the rolling or bending of catheter-based delivery, sometimes along curved trajectories (for example, through the vascular system of the brain).
The dimensions and physical properties of conformable integrated circuits designed for catheter-based deployment are constrained by two factors: (1) the inner diameter of the deployment catheter, and (2) the minimum radius of curvature of the deployment trajectory. The integrated circuit must be able to fit within the deployment catheter, and must be able to bend to accommodate curved deployment trajectories. Integrated circuits fabricated using conventional silicon-based processes are typically stiff, and rectangular with aspect ratios (Length/Width) close to 1. For an integrated circuit whose components occupy total surface area A that must fit within a catheter of inner radius r, the circuit layout must conform to a rectangle with one side no longer than r. This means that the other side must be at least as long as A/r in order to provide the required surface area for all circuit elements. The aspect ratio must then be at least A/r2. In many applications this will result in a rectangular chip with one side much longer than the other, an aspect ratio significantly greater than 1.
Silicon-based integrated circuits are typically stiff, so designing flexible integrated circuits poses certain challenges. Catheter-based delivery systems may require that circuit elements bend without breaking. In order to accommodate this requirement, a circuit element can be designed to tolerate a certain minimum radius of curvature. Several techniques can be used, including thinning silicon chips (from the back side) in post-processing to reduce stiffness and increase flexibility.
In some embodiments, high-density electrode arrays can include on-board multiplexing and other signal conditioning. The techniques provide for specifications for a custom multiplexer and other circuit elements for use with catheter-based delivery. The specifications can include requirements of an aspect ratio for the multiplexer chips, which can permit the chips to align with the axis of a catheter, bending in only one direction, and being thin enough (e.g., possibly through back-surface etching in post-processing) to tolerate such bending along the long axis of the chip. The aspect ratio can be an unconventional, very long aspect ratio for the multiplexer chip (e.g., potentially thinned in post-processing). A long aspect ratio can enable the multiplexer ASIC and other circuit elements to be delivered into the brain through a narrow and potentially tortuous channel, as required for endoscopic use or for endovascular catheter delivery through blood vessels. It has been recognized and appreciated that array-based multiplexers can be critical to high-bandwidth neural recording beyond the limits of arrays currently being used (e.g., which, in practice, may mean scaling to record from tens of thousands of microelectrodes or more). On-array multiplexers are described, for example, in U.S. Pat. No. 8,934,965 “Conformable actively multiplexed high-density surface electrode array for brain interfacing,” the contents of which is hereby incorporated herein by reference in its entirety. Some embodiments include an on-array multiplexer, such as that described by the '965 Patent, because, for example, it may not be efficient, or perhaps even feasible, to design a one-wire-per-electrode system when scaling to tens of thousands of electrodes, so data to and from multiple electrodes must be multiplexed onto shared channels. Integrating multiplexing elements onto electrode arrays can add substantial complexity to such systems, as the multiplexers are active (powered) electronic elements, whereas the electrode arrays themselves would otherwise be only passive sensing elements.
In some embodiments, the multiplexing elements can be designed so that they are flexible, so that they can fit within the delivery catheters, and/or the like. According to some embodiments, the (e.g., unusual) size and aspect ratio of the multiplexer chips makes them compatible with deployment through even small (e.g., approximately 2 mm diameter, or 6 French) catheters, for use with flexible, rollable, conformable electrode arrays, deliverable in minimally invasive fashion to target areas (e.g., in the ventricular system or vascular system of the brain, and/or elsewhere). Existing multiplexers for neural interfaces could not have been deployed in this manner. In some embodiments, the techniques can be used to provide a practical, workable solution, particularly to delivering multiplexer elements through narrow catheters, and/or including along long (e.g., meter-long) and tortuous paths through blood vessels into the brain.
As shown in this example, the multiplexer 1004 has a number of inputs, including VCC 1008 (a connection of the multiplexer 1004 to power), GND 1010 (a connection of the multiplexer 1004 to ground), SEL 1012 (a line selection input to the multiplexer 1004), and OUT 1014 (digitized output from the multiplexer 1004). However, it should be appreciated the techniques are not so limited.
In some embodiments, the multiplexing elements described herein can be used outside the domain of neural interfaces. For example, other catheter-based electrode technologies could make use of these elements, including mapping electrodes for cardiac electrophysiology.
The techniques described herein relate to thin-film polymer-based surface electrode arrays, with electrode contacts that can be of various shapes and sizes, grouped into various configurations and with various spacings (e.g., ranging from 1 to 500 microns, typically 10 to 250 microns). The techniques can be used to maximize the spatial sampling density of neural electrode arrays.
The electrodes can support the potential to record individual-neuron activity as well as population activity, local field activity, electrophysiologic signals in other bandwith ranges, and/or the like.
High-density arrays can include on-board multiplexing and/or signal conditioning. It has been recognized and appreciated that array-based multiplexers can be critical to high-bandwidth neural recording beyond the limits of arrays currently being used (e.g., which, in practice, may mean scaling to record from tens of thousands of microelectrodes or more). The reason for this, for example, is because it may not be efficient, or perhaps even feasible, to design a one-wire-per-electrode system when scaling to tens of thousands of electrodes, so data to and from multiple electrodes must be multiplexed onto shared channels
In some embodiments, the techniques include a custom multiplexer to the specifications useful for catheter-based delivery. Among the specifications, some embodiments include specifications for a specific aspect ratio for the multiplexer chips, which would permit the chips to align with the axis of a catheter, bending in only one direction, and being thin enough (e.g., possibly through back-surface etching in post-processing) to tolerate such bending along the long axis of the chip.
In some embodiments, the design requirements can be specific to one or more applications. For example, for some applications the multiplexing elements need to be flexible, and/or they need to fit within the delivery catheters. Referring to
In some embodiments, the (e.g., unusual) size and aspect ratio of the multiplexer chips make them compatible with deployment through even small (e.g., approximately 2 mm diameter, or 6 French) catheters, for use with flexible, rollable, conformable electrode arrays, deliverable in minimally invasive fashion to target areas (e.g., in the ventricular system or vascular system of the brain, and/or elsewhere). Existing multiplexers for neural interfaces could not have been deployed in this manner. In some embodiments, the techniques can be used to provide a workable solution, particularly to delivering multiplexer elements through narrow catheters, and especially along long (e.g., meter-long) and tortuous paths through blood vessels into the brain. These vascular access routes are often important routes for minimally invasive brain-machine interfaces.
In some embodiments, the multiplexing elements described herein can be used outside the domain of neural interfaces. For example, other catheter-based electrode technologies could make use of these elements, including mapping electrodes for cardiac electrophysiology.
In some embodiments, the integrated circuit described herein, designed for use with flexible arrays, can enable substantial signal conditioning on-board the array. In particular, for example, the flexible arrays can be designed to support the potential to record individual-neuronal activity as well as neuronal population activity, local field activity, and/or electrophysiologic signals in other bandwidth ranges.
Generally, the techniques described herein provide for integration of multiplexing ASICs designed for catheter deployment with power and data lines in the catheter walls. The technique can enable interfacing with orders of magnitude more electrodes than would otherwise be possible.
Some embodiments relate to wired catheters, which contain individually insulated wires in the catheter walls, which could be exposed at either end of the catheter. These catheters can be used with, for example, endovascular and/or endoscopic electrode arrays, as they can permit direct wired connections to a limited number of electrodes on an array, with a wired connection that could run the length of a catheter, from the interface in the brain to amplification or recording electronics outside the head, and/or the like. The wired catheters can be used to test electrode arrays (e.g., including electrode arrays with on-board multiplexers).
The techniques described herein can enable temporary but potentially lengthy (e.g., hours to days) electrical interfacing (e.g., recording and/or stimulation) with massive numbers of electrodes deployed in the body, in minimally invasive fashion, in proximity to neural tissue (or any electrophysiologically active tissue, including but not limited to cardiac tissue), while maintaining the normal physiologic conditions in the tissue surrounding the electrodes. In some embodiments, the technology can be used for deployment of electrode interfaces into fluid-containing compartments or conduits, such as the ventricular system of the brain, the spinal subarachnoid space, or the venous or arterial systems of the brain, where normal fluid flow should ideally be constantly maintained. The high-density connectors described herein can be designed to enable a very high-bandwidth temporary connection with electrode interfaces containing massive numbers of electrodes.
Some embodiments provide for a connector scheme. The connector can include a catheter with a first end (e.g., referred to as a proximal end for ease of explanation) located outside the body, and a second end (e.g., referred to as a distal end for ease of explanation) located inside the body, near the location of the electrode array.
The catheter can be designed to conform anatomically to the trajectory and compartments it must occupy, such as for vascular access from femoral artery or femoral vein to deep venous system of the brain, or transcortical insertion into the ventricular system of the brain. Some of these anatomic constraints can include those related to venous or arterial access to the brain, and/or stereotactic access to the ventricular system.
Once catheter access to the brain (e.g., its vascular or ventricular system) has been established, then conformable, foldable, rollable, or otherwise collapsible electrode arrays may be deployed through the catheter to a distal site located inside the brain.
Similar schemes are envisioned for other organ systems and anatomic systems, specifically including the heart, gastrointestinal system, and urogenital system.
In some embodiments, the techniques include a multiplexer custom application specific integrated circuit (ASIC) designed for deployment through a catheter of diameter approximately 2 mm (6 French). Such wired catheters can be used in conjunction with such a multiplexer. Such multiplexers can have one or more features of catheter compatibility: narrow aspect ratio, thinness, and/or slight flexibility to accommodate deployment around bends when needed. Electrode interfaces deployed into the brain through the wired catheter can incorporate copies of such a multiplexing element. These multiplexers can control the output from the implanted array, and each array-mounted multiplexer can be connected to power and data leads located in the walls of the catheter, as described next.
Some embodiments relate to the design of a catheter containing separately insulated conductive traces in the catheter walls, which can be used as power and data connections to the multiplexer elements. Small-bore (e.g., approximately 2 mm or 6 French) catheters containing large numbers of braided, individually insulated (e.g., so as not to short one another along the catheter length) conductive traces, with conductive surfaces exposed distally and proximally so as to support a sensor containing a plurality of multiplexers (with data and power lines), can be provided using the techniques described herein.
In some embodiments, various materials for the catheters, as well as the manufacturing techniques of these catheters using wire braiding and polymer extrusion techniques, can be used to implement the techniques described herein.
Some embodiments relate to integration of a rotating hemostatic valve system into the catheter. Such a high-density connection scheme can be used to support deployment of electrode interfaces into fluid-containing compartments of the brain and nervous system, including the blood vessels of the brain and the ventricular system of the brain. Even temporary deployment of electrode arrays in such locations has the potential to disrupt normal physiologic fluid flow, so maintenance of normal fluid flow while these arrays are in place can be important. The wired catheters disclosed herein can include integrated rotating hemostatic valves attached to the proximal end, with dual ports, allowing fluids such as physiologic saline or heparinized saline to be flushed through the catheter during operation, to avoid stasis and abnormal blood clotting, even while the distal sensor elements are manipulated.
In some embodiments, the techniques include the integration of multiplexing ASICs designed for catheter deployment with power and data lines in the catheter walls, which can enable interfacing with orders of magnitude more electrodes than would otherwise be possible.
In some embodiments, the techniques can provide for the integration of separately insulated conductive traces for power and data within the walls of a small-bore catheter.
In some embodiments, the techniques can provide for a catheter-based delivery scheme and hemostatic valve system enabling concurrent maintenance of normal physiologic fluid flow and fluid environment (e.g., and avoiding blood clotting) during electrode recordings. In particular, the techniques can be used in the blood vessels of the brain and/or in the ventricular system of the brain.
Various aspects are described in this disclosure, which include, but are not limited to, the following aspects:
Various computer systems can be used to perform any of the aspects of the techniques and embodiments disclosed herein. The computer system may include one or more processors and one or more non-transitory computer-readable storage media (e.g., memory and/or one or more non-volatile storage media) and a display. The processor may control writing data to and reading data from the memory and the non-volatile storage device in any suitable manner, as the aspects of the invention described herein are not limited in this respect. To perform functionality and/or techniques described herein, the processor may execute one or more instructions stored in one or more computer-readable storage media (e.g., the memory, storage media, etc.), which may serve as non-transitory computer-readable storage media storing instructions for execution by the processor.
In connection with techniques described herein, code used to, for example, provide the techniques described herein may be stored on one or more computer-readable storage media of computer system. Processor may execute any such code to provide any techniques for planning an exercise as described herein. Any other software, programs or instructions described herein may also be stored and executed by computer system. It will be appreciated that computer code may be applied to any aspects of methods and techniques described herein. For example, computer code may be applied to interact with an operating system to plan exercises for diabetic users through conventional operating system processes.
The various methods or processes outlined herein may be coded as software that is executable on one or more processors that employ any one of a variety of operating systems or platforms. Additionally, such software may be written using any of numerous suitable programming languages and/or programming or scripting tools, and also may be compiled as executable machine language code or intermediate code that is executed on a virtual machine or a suitable framework.
In this respect, various inventive concepts may be embodied as at least one non-transitory computer readable storage medium (e.g., a computer memory, one or more floppy discs, compact discs, optical discs, magnetic tapes, flash memories, circuit configurations in Field Programmable Gate Arrays or other semiconductor devices, etc.) encoded with one or more programs that, when executed on one or more computers or other processors, implement the various embodiments of the present invention. The non-transitory computer-readable medium or media may be transportable, such that the program or programs stored thereon may be loaded onto any computer resource to implement various aspects of the present invention as discussed above.
The terms “program,” “software,” and/or “application” are used herein in a generic sense to refer to any type of computer code or set of computer-executable instructions that can be employed to program a computer or other processor to implement various aspects of embodiments as discussed above. Additionally, it should be appreciated that according to one aspect, one or more computer programs that when executed perform methods of the present invention need not reside on a single computer or processor, but may be distributed in a modular fashion among different computers or processors to implement various aspects of the present invention.
Computer-executable instructions may be in many forms, such as program modules, executed by one or more computers or other devices. Generally, program modules include routines, programs, objects, components, data structures, etc. that perform particular tasks or implement particular abstract data types. Typically, the functionality of the program modules may be combined or distributed as desired in various embodiments.
Also, data structures may be stored in non-transitory computer-readable storage media in any suitable form. Data structures may have fields that are related through location in the data structure. Such relationships may likewise be achieved by assigning storage for the fields with locations in a non-transitory computer-readable medium that convey relationship between the fields. However, any suitable mechanism may be used to establish relationships among information in fields of a data structure, including through the use of pointers, tags or other mechanisms that establish relationships among data elements.
Various inventive concepts may be embodied as one or more methods, of which examples have been provided. The acts performed as part of a method may be ordered in any suitable way. Accordingly, embodiments may be constructed in which acts are performed in an order different than illustrated, which may include performing some acts simultaneously, even though shown as sequential acts in illustrative embodiments.
The indefinite articles “a” and “an,” as used herein in the specification and in the claims, unless clearly indicated to the contrary, should be understood to mean “at least one.” As used herein in the specification and in the claims, the phrase “at least one,” in reference to a list of one or more elements, should be understood to mean at least one element selected from any one or more of the elements in the list of elements, but not necessarily including at least one of each and every element specifically listed within the list of elements and not excluding any combinations of elements in the list of elements. This allows elements to optionally be present other than the elements specifically identified within the list of elements to which the phrase “at least one” refers, whether related or unrelated to those elements specifically identified.
The phrase “and/or,” as used herein in the specification and in the claims, should be understood to mean “either or both” of the elements so conjoined, i.e., elements that are conjunctively present in some cases and disjunctively present in other cases. Multiple elements listed with “and/or” should be construed in the same fashion, i.e., “one or more” of the elements so conjoined. Other elements may optionally be present other than the elements specifically identified by the “and/or” clause, whether related or unrelated to those elements specifically identified. Thus, as a non-limiting example, a reference to “A and/or B”, when used in conjunction with open-ended language such as “comprising” can refer, in one embodiment, to A only (optionally including elements other than B); in another embodiment, to B only (optionally including elements other than A); in yet another embodiment, to both A and B (optionally including other elements); etc.
As used herein in the specification and in the claims, “or” should be understood to have the same meaning as “and/or” as defined above. For example, when separating items in a list, “or” or “and/or” shall be interpreted as being inclusive, i.e., the inclusion of at least one, but also including more than one, of a number or list of elements, and, optionally, additional unlisted items. Only terms clearly indicated to the contrary, such as “only one of” or “exactly one of,” or, when used in the claims, “consisting of,” will refer to the inclusion of exactly one element of a number or list of elements. In general, the term “or” as used herein shall only be interpreted as indicating exclusive alternatives (i.e. “one or the other but not both”) when preceded by terms of exclusivity, such as “either,” “one of,” “only one of,” or “exactly one of.” “Consisting essentially of,” when used in the claims, shall have its ordinary meaning as used in the field of patent law.
Use of ordinal terms such as “first,” “second,” “third,” etc., in the claims to modify a claim element does not by itself connote any priority, precedence, or order of one claim element over another or the temporal order in which acts of a method are performed. Such terms are used merely as labels to distinguish one claim element having a certain name from another element having a same name (but for use of the ordinal term).
The phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” “having,” “containing”, “involving”, and variations thereof, is meant to encompass the items listed thereafter and additional items.
Having described several embodiments of the invention in detail, various modifications and improvements will readily occur to those skilled in the art. Such modifications and improvements are intended to be within the spirit and scope of the invention. Accordingly, the foregoing description is by way of example only, and is not intended as limiting.
Various aspects are described in this disclosure, which include, but are not limited to, the above-described aspects.
This Application claims priority under 35 U.S.C. § 119(e) to U.S. Application Ser. No. 62/948,712, filed Dec. 16, 2019, entitled “CONFORMABLE INTEGRATED CIRCUITS FOR MINIMALLY INVASIVE BRAIN-MACHINE INTERFACES,” U.S. Application Ser. No. 62/948,723, filed Dec. 16, 2019, entitled “ELECTRODE ARRAY FOR BRAIN-MACHINE INTERFACE HAVING AN INTEGRATED MULTIPLEXER,” and U.S. Application Ser. No. 62/948,729, filed Dec. 16, 2019, entitled “HIGH-DENSITY CONNECTOR TECHNOLOGY FOR NEURAL INTERFACE DEVICES,” the entire contents of which are hereby incorporated by reference herein in their entirety. This Application is a Continuation-in-part of U.S. application Ser. No. 15/856,677, filed Dec. 28, 2017, entitled “CONFORMAL ELECTRODE ARRAYS FOR ELECTROPHYSIOLOGIC RECORDING AND NEURAL STIMULATION WITHIN THE CEREBRAL VENTRICLES,” which is a Continuation of U.S. application Ser. No. 15/585,917, filed May 3, 2017, entitled “CONFORMAL ELECTRODE ARRAYS FOR ELECTROPHYSIOLOGIC RECORDING AND NEURAL STIMULATION WITHIN THE CEREBRAL VENTRICLES,” which claims priority under 35 U.S.C. § 119(e) to U.S. Application Ser. No. 62/406,623, filed Oct. 11, 2016, entitled “VISUAL PROSTHESIS” and U.S. Application Ser. No. 62/395,672, filed Sep. 16, 2016, entitled “CONFORMAL ELECTRODE ARRAY FOR ELECTROPHYSIOLOGIC RECORDING AND NEURAL STIMULATION FROM WITHIN THE CEREBRAL VENTRICLES,” the entire contents of which are incorporated herein by reference in their entirety.
| Number | Date | Country | |
|---|---|---|---|
| 62948712 | Dec 2019 | US | |
| 62948723 | Dec 2019 | US | |
| 62948729 | Dec 2019 | US | |
| 62406623 | Oct 2016 | US | |
| 62395672 | Sep 2016 | US |
| Number | Date | Country | |
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| Parent | 15585917 | May 2017 | US |
| Child | 15856677 | US |
| Number | Date | Country | |
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| Parent | 15856677 | Dec 2017 | US |
| Child | 17124126 | US |
