The present disclosure relates to detection of neural activity, specifically through the receiving of electrical signals from the nervous system using electrodes.
Electroceutical devices are medical devices which treat ailments using electrical impulses. Such devices may utilise bioelectric neuromodulation to treat a range of diseases or medical conditions.
One advantage of bioelectric neuromodulation devices, compared to pharmaceutical or biological treatments, is that the level of stimulation may be rapidly adjusted to respond to changing patient needs. This is known as closed-loop control. However, true closed-loop bioelectric neuromodulation requires the ability to chronically stimulate or activate neural activity, inhibit or suppress neural activity, and sense ongoing spontaneous or naturally evoked neural activity.
Any discussion of documents, acts, materials, devices, articles or the like which has been included in the present specification is not to be taken as an admission that any or all of these matters form part of the prior art base or were common general knowledge in the field relevant to the present disclosure as it existed before the priority date of each of the appended claims.
According to one aspect of the present disclosure there is provided a method of detecting neural activity in a nerve, the method comprising:
receiving a first electrical signal from a first pair of electrodes, the first pair of electrodes comprising two first electrodes located proximate each other along the nerve;
receiving a second electrical signal from a second pair of electrodes, the second pair of electrodes comprising two second electrodes located proximate each other along the nerve, wherein the second pair of electrodes is spaced from the first pair of electrodes along the nerve;
applying a correlation analysis between the first and second electrical signals, including for at least one non-zero lag time, to obtain correlation data; and
detecting, from the correlation data, at least one neural signal indicative of neural activity in the nerve, the neural signal corresponding to increased correlation between the first and second signals at the at least one non-zero lag time.
In some embodiments, the first and/or second electrical signal may have a negative signal-to-noise ratio (SNR). That is, a power of a neural signal component may be smaller than a power of a noise signal component of the first and/or second electrical signal. Conventional recording apparatus, suitable for recording evoked neural activity in response to artificial stimulation, is typically unable to record ongoing spontaneous or natural neural activity due to excessive noise in the signal. The disclosed method may provide the ability to sense and extract neural signals which would otherwise be hidden in background noise.
In some embodiments, each of the first and second pairs of electrodes may be located outside a perineurium (nerve sheath) of the nerve. Since a high signal-to noise ratio is not necessarily required, the method may detect spontaneous or natural neural activity without requiring breach or penetration of the perineurium. As such, methods according to the present disclosure may be considered minimally invasive. The electrodes being located outside the perineurium may increase the longevity of devices employing the method, and their suitability for chronic implantation.
Lag time may be understood as a time offset, conduction delay or latency between the first and second electrical signals. In some embodiments, the at least one non-zero lag time may be preselected based on a distance between the first pair of electrodes and the second pair of electrodes. Alternatively, or additionally, the at least one non-zero lag time may be preselected based on a fibre type of the nerve. The lag time may be preselected to substantially coincide with a neural signal conduction time between the first and second pairs of electrodes. For example, for a given distance between the electrode pairs, the lag time may be selected based on an anticipated conduction speed of a fibre type of interest.
An absolute value of the non-zero lag time may be selected to be greater than a threshold value. The threshold value may be set to be sufficient to distinguish signals detected at the non-zero lag time from signals detected at zero lag time. For example, the absolute value of the non-zero lag time may be above 0.1 ms, 0.2 ms, 0.3 ms or otherwise.
In some embodiments, the correlation analysis may be applied for a single non-zero lag time. In other embodiments, the correlation analysis may be applied for a plurality of non-zero lag times. The plurality of non-zero lag times may span a range of lag times. For example, the plurality of non-zero lag times may be set at increments between a maximum and minimum lag time. The plurality of non-zero lag times may include negative and positive sign lag times.
The method may further comprise categorising the neural signal as afferent or efferent based on the sign of the lag time at which the neural signal is detected. That is, the direction of travel of the neural signal in the nerve may be indicated by whether the neural signal is detected at a positive lag time or a negative lag time, depending on which pair of electrodes is first reached by the signal. For example, an neural signal may reach the first pair of electrodes before the second pair of electrodes resulting in the signal being detected at a positive lag time. The neural signal may then be categorised as afferent or efferent depending on the relative positioning of the first and second electrodes along the nerve.
Further, the method may comprise categorising a fibre type of the nerve based on a magnitude of a non-zero lag time at which the neural signal is detected. For example, for a known distance between the first and second pairs of electrodes, the non-zero lag time can be indicative of a conduction speed of the nerve. The conduction speed may then be used to categorise the nerve fibre type based on known characteristics of neural fibres.
In some embodiments, the method may also comprise applying the correlation analysis for a zero lag time to obtain the correlation data. Signals which are received at both electrodes simultaneously will generally correspond to increased correlation in the correlated data at a substantially zero lag time. The method may further comprise detecting, from the correlation data, at least one alternative signal indicative of electrical activity, the alternative signal corresponding to increased correlation between the first and second signals for a substantially zero lag time. The alternative signals may be indicative of movement or evoked neural responses to stimulation.
In some embodiments, the neural signal may correspond to one or more regions of increased correlation between the first and second signals at the at least one non-zero lag time. Similarly, in some embodiments, the alternative signal may correspond to one or more regions of increased correlation between the first and second signals at zero lag time.
In some embodiments, the one or more regions of increased correlation in the correlation data at the at least one non-zero lag time (corresponding to the neural signal) may include one or more peaks in correlation between the first and second signals, the peaks being centred at the at least one non-zero lag time. Similarly, in some embodiments, the one or more regions of increased correlation in the correlation data at the at zero lag time (corresponding to an alternative signal) may include one or more peaks in correlation between the first and second signals, the peaks being centred at zero lag time.
In some embodiments, the nerve may be a peripheral nerve. In other embodiments, the nerve may be a central nervous system nerve. In some embodiments, the nerve may be an autonomic nervous system nerve. The ability to detect, monitor and/or record neural activity in the autonomic nervous system may be advantageous, as stimulation of autonomic nerves typically does not produce a conscious percept. In other embodiments, the nerve may be a nerve of the somatic nervous system, for example, a mixed somatosensory nerve. In some embodiments, the nerve may be myelinated. In other embodiments, the nerve may be non-myelinated.
As examples, the nerve may be the pelvic nerve, vagus nerve or sciatic nerve. However, the disclosed method is not limited to these nerves.
The ability to detect or sense neural activity, particularly ongoing spontaneous or natural neural activity may be useful for neuromodulation of peripheral nerves. In particular, the ability to detect or sense ongoing spontaneous neural activity may enable the validation of a number of potential biomarkers useful for closed-loop control of electroceutical devices. For example, the method may be useful for detection of neural activity such as afferent signalling of increasing inflammation in inflammatory bowel disease (IBD), wherein optionally therapeutic treatment is initiated or adapted in response to the detected neural activity. As IBD is a remitting/relapsing condition, there will often be periods where no therapeutic treatment is required. By monitoring afferent activity in the vagus nerve using the presently disclosed method, it may be possible to detect an increase in afferent neural activity associated with a flare (that is, an increase in inflammation) before the patient experiences symptoms of the flare. In such cases, it may be possible to initiate or increase therapeutic treatment (for example, by stimulation of the vagus nerve using an electroceutical device) in direct response to the detected increase in afferent neural activity. Continued monitoring of subsequent afferent activity may then detect a resultant decrease in afferent activity associated with a decrease in inflammation, providing an indication for cessation or reduction of the therapeutic treatment. Adaptation (e.g. initiation, cessation, increase or decrease) of therapeutic treatment in response to detected neural activity may allow for ongoing closed-loop treatment of IBD, without the patient experiencing symptoms of the disease. Such closed-loop treatment may ensure that therapeutic treatment is only applied when required or only applied to a degree that is necessary. This has potential benefits for electroceutical devices in terms of reduced power consumption and/or improved battery life and minimisation of any off-target effects or safety issues.
In other examples, the method may be useful for detection of neural activity such as bladder volume afferent signalling, for example, for closed loop control of bladder prostheses.
According to another aspect of the present disclosure, there is provided processing apparatus configured to carry out the above described method. In some embodiments, the processing apparatus may be at least partially implantable. In some embodiments, the processing apparatus may be wholly implantable.
In any embodiments, the received first and second electrical signals may be amplified, filtered or otherwise processed prior to applying the correlation analysis. Accordingly, the processing apparatus may comprise a signal amplifier, signal filter and/or other types of signal processors. In some embodiments, the processing apparatus may comprise at least two recording inputs (or channels) for receiving the first and second electrical signals. The processing apparatus may be configured to receive (and optionally record) the first and second electrical signals at a sample rate of about 10 kHz or more, for example, a sample rate of at least 10 kHz, 20 kHz, 30 kHz, 40 kHz, 50 kHz or more. In one embodiment, the processing apparatus may be configured to amplify received signals. For example, the processing apparatus may be configured to provide at least 100 times gain to the first and/second electrical signals. The processing apparatus may be configured to provide a band pass filter, for example, at least a 10−5 kHz band pass filter.
According to another aspect of the present disclosure, there is provided a non-transitory computer-readable memory medium comprising instructions to cause a processing apparatus to perform the above described method.
According to another aspect of the present disclosure, there is provided a system for detecting neural activity in a nerve, the system comprising:
a first pair of electrodes, the first pair of electrodes comprising two first electrodes positionable proximate each other along the nerve; and
a second pair of electrodes, the second pair of electrodes comprising two second electrodes positionable proximate each other along the nerve,
wherein the second pair of electrodes is configured to be spaced from the first pair of electrodes along the nerve; and
processing apparatus configured to:
The provision of first and second pairs of electrodes does not preclude the provision of third, fourth, fifth or yet further electrode pairs, whether for the purposes of monitoring or applying electrical signals.
In some embodiments, at least one of the first and second electrode pairs may be comprised in an electrode mounting device adapted to mount to the nerve to electrically interface the first and second electrode pairs with the nerve. The first and second pairs of electrodes may be in a substantially fixed relationship. For example, the electrode mounting device may comprise a support which substantially maintains the relative locations and orientations of the electrodes.
In some embodiments, the electrode mounting device may comprise an electrode array, the electrode array comprising the first pair of electrodes and the second pair of electrodes. In this embodiment, the two first electrodes may be positioned proximate each other along the electrode array and the two second electrodes may be positioned proximate each other along the electrode array. The first pair of electrodes may be spaced from the second pair of electrodes along the electrode array. For example, the first and second electrode pairs may be comprised in an electrode array such as that disclosed in PCT application no. PCT/AU2018/051240, the entire contents of which PCT application is incorporated herein by reference.
The two first electrodes may be spaced from each other by a distance a1 and the two second electrodes may be spaced from each other by a distance a2. The first and second pairs of electrodes may be spaced from each other by a distance b1. The distances a1 and a2 may be substantially equal, i.e. it may be that a1=a2 or they may be different. In general, the distance b1 may be greater than the distances a1 and a2. For example, the ratio between the distance a1 or distance a2 and the distance b1 may be between 1:1.5 and 1:4, between 1:1.5 and 1:3 or about 1:2.5. In another example, the ratio may be about 1:5 or more. For example, the ratio between the distance a1 or distance a2 and the distance b1, may be about 1:5, about 1:6, about 1:7, about 1:8, about 1:9, about 1:10, about 1:11, about 1:12, about 1:13, about 1:14, about 1:15, about 1:16, about 1:17, about 1:18, about 1:19, about 1:20, or more.
Alternatively, or additionally, the distance b1 may be selected based on a type, or property, of fibre of the nerve in which detection of neural activity is desired. As an example, for a known nerve fibre conduction velocity (V, e.g., 1 m/s), the distance b1 may be selected to give increased correlation (or, in some embodiments, a region and/or peak in correlation) at a specific latency (L, e.g., 2 ms), for example, using the formula b1=VL (e.g., 2 mm). The magnitude of the specific latency may be selected to be large enough that the increased correlation is adequately distinguishable from background noise present at or around 0 ms, and/or selected to be small enough to minimise any signal temporal dispersion effects.
Throughout this specification the word “comprise”, or variations such as “comprises” or “comprising”, will be understood to imply the inclusion of a stated element, integer or step, or group of elements, integers or steps, but not the exclusion of any other element, integer or step, or group of elements, integers or steps.
By way of example only, embodiments of the present disclosure are now described with reference to the accompanying Figures in which:
A method of detecting neural activity in a nerve according to an embodiment of the present disclosure is described with reference to flowchart 100 of
Referring again to the flowchart 100 of
At 140, at least one neural signal indicative of neural activity in the nerve is detected from the correlation data, the neural signal corresponding to increased correlation between the first and second electrical signals at a non-zero lag time.
In this example, a correlation analysis was applied between the model first and second electrical signals Rec1 and Rec2 to obtain correlation data, according to the disclosed method, as shown in the lower portion of
The correlation data is presented graphically in the form of an activity ‘heat map’, in which darker areas indicate increased correlation between the first and second electrical signals and more power for a given time and conduction delay (lag time) combination. The ‘heat map’ was produced by repeating the correlation on blocks of the recorded signal data. The afferent neural signal (Aff), slow and fast efferent neural signals (Eff) and electromyographic signals (EMG) are each apparent in the correlation data as shown in
Each neural signal may appear in the graphical correlation data as a region of increased correlation between the first and second signals, indicated by a darkened band (or ‘hot spot’) having a central portion and flanking side portions. The central and side portions represent three peaks in correlation between the first and second electrical signals, for a given time value but corresponding to various lag times. The signal type may be categorised based on the sign of the lag time at which the band is centred. For example, referring to
Signals in the graphical correlation data detected as the dark band 304 centred at substantially 0 ms (i.e. at zero lag time) are those which are received at both the first and second pair of electrodes substantially simultaneously. Such alternative signals may not be representative of signals conducting up or down the nerve fibre. For example, EMG activity (indicative of muscle activity) is substantially simultaneously recorded on both electrode pairs and appears as a dark band centred at substantially 0 ms lag time.
With reference to
Trace P of
Other embodiments may apply a correlation analysis over a narrower or wider range of lag times. Alternatively or additionally, a correlation analysis may be applied between the first and second signals for a single lag time of interest (or multiple discrete lag times of interest), for example, to isolate neural responses of one or more conduction speeds of interest.
In this example, the applying a correlation analysis between the first and second electrical signals according to the method enabled the detection of neural signals which would otherwise be hidden in background noise due to a negative signal-to-noise ratio. Further, in this example, the application of the correlation analysis for a non-zero lag time according to the method provided the ability to distinguish between and categorise the detected neural signals.
With reference to
A system for detecting neural activity in a nerve according to an embodiment of the present disclosure is illustrated by system diagram 200 in
The processing apparatus 300 may be configured to perform the method disclosed above with reference to
The electrode pairs 210′, 220′ are embedded or otherwise located in an electrode mounting device 410 of the array, which is adapted to electrically interface the first and second electrode pairs 210′, 220′ with the nerve. The electrode mounting device 410 comprises a support 411 that substantially maintains the relative orientation and location of the pairs of electrodes 210′, 220′ with respect to each other. As such, in this embodiment, the spacing between the electrodes 211′, 212′, 221′, 222′ is substantially pre-defined and fixed.
An alternative embodiment is illustrated in
It will be appreciated that other embodiments may have four, five or more pairs of electrodes provided for various purposes. Additionally, the first and second pair of electrodes need not be adjacent each other on the array, and may be separated by one or more other pairs of electrodes.
As represented in
For example, when detecting activity in the rat pelvic nerve in the examples discussed above, the electrode pairs were spaced along the nerve with a distance b1 of approximately 2 mm from each other, resulting in the slow afferent and slow efferent neural signals being detectable at lag times of approximately +/−1 ms. However, in other embodiments, (e.g., when detecting signals travelling along myelinated nerve fibres) the conduction of signals between the electrode pairs may be much faster. As a result, the lag time across small distances may be very low, such that neural signals are obscured by the background noise present at and around Oms lag time. In such embodiments, the distance b1 between the electrode pairs may be increased accordingly, thereby to increase the lag time, such that the neural signal is more clearly distinguishable from the background noise present at Oms lag time. For example, when detecting fast afferent activity in the rat sciatic nerve (as shown in
In some embodiments, detecting or sensing of neural activity, e.g. in accordance with methods and apparatus described above, particularly ongoing spontaneous or natural neural activity, may be used in conjunction with neuromodulation of peripheral nerves, e.g. as part of closed-loop control of electroceutical devices. Referring for example to
The apparatus described with reference to
In other examples, the apparatus of
Methods and apparatus according to embodiments of the present disclosure may use non-transitory computer-readable memory medium comprising instructions to cause processing apparatus to perform the specified steps.
In general processing apparatus used in the present disclosure may comprise one or more processors and/or data storage devices. The one or more processors may each comprise one or more processing modules and the one or more storage devices may each comprise one or more storage elements. The modules and storage elements may be at one site, e.g. in a single hand-held device, or distributed across multiple sites and interconnected by a communications network such as the internet.
The processing modules can be implemented by a computer program or program code comprising program instructions. The computer program instructions can include source code, object code, machine code or any other stored data that is operable to cause a processor to perform the methods described. The computer program can be written in any form of programming language, including compiled or interpreted languages and can be deployed in any form, including as a stand-alone program or as a module, component, subroutine or other unit suitable for use in a computing environment. The data storage device may include non-transitory computer-readable memory or otherwise.
It will be appreciated by persons skilled in the art that numerous variations and/or modifications may be made to the above-described embodiments, without departing from the broad general scope of the present disclosure. The present embodiments are, therefore, to be considered in all respects as illustrative and not restrictive.
Number | Date | Country | Kind |
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2019901989 | Jun 2019 | AU | national |
The present application is a U.S. national phase of International Application No. PCT/AU2020/050570, filed Jun. 5, 2020, which claims priority to Australian provisional patent application no. 2019901989, filed 7 Jun. 2019, the entire content of which being hereby incorporated by reference.
Filing Document | Filing Date | Country | Kind |
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PCT/AU2020/050570 | 6/5/2020 | WO |