Abstract
Brain-machine interfaces (BMI) are now entering the clinical realm, where signals measured from the human brain are utilized to provide innovative therapies and enhance quality of life for individuals affected by neurological diseases and injury. Motor BMIs describe devices driven by signals from the motor system, which includes regions both on the surface and in deeper portions of the brain. These devices can be used to restore or enhance function for those with deficits in motor output as well as to provide therapy for individuals with deficits in part of the motor circuit function. Implanted motor BMIs, particularly those based on electrocorticography (ECoG) and deep brain stimulation (DBS) technologies, are burgeoning as a result of advances in wireless, implanted technologies in humans, and are based on foundational advances developed in research laboratories. Motor BMIs have now enabled an individual with amyotrophic lateral sclerosis (ALS) to communicate with the external world in a novel manner, and are being explored for closed-loop, adaptive deep brain stimulation therapies. In these therapies, electrical stimulation of deep brain structures used to treat movement disorders such as Parkinson’s disease and essential tremor is modulated in real time to provide more efficient stimulation with potentially fewer side effects. Future advances will be based upon further hardware and algorithmic developments, co-adaptive strategies that utilize learning both by the human brain and the implanted device, and integration with stimulation to provide more effective therapy for an expanding repertoire of movement disorders, restore sensation, and modulate cortical activity.
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Abbreviations
- ALS:
-
Amyotrophic lateral sclerosis
- BMI:
-
Brain-machine interface
- CM:
-
Centromedian region of thalamus
- CM-PF:
-
Centromedian-parafascicular complex
- CT:
-
Computed tomography
- DBS:
-
Deep brain stimulation
- ECoG:
-
Electrocorticography
- EEG:
-
Electroencephalography
- ERP:
-
Event related potential
- ET:
-
Essential tremor
- FDA:
-
Food and Drug Administration
- FES:
-
Functional electrical stimulation
- fMRI:
-
Functional magnetic resonance imaging
- fNIRS:
-
Functional near-infrared spectroscopy
- GPe:
-
Globus pallidus externus
- GPi:
-
Globus pallidus internus
- Hz:
-
Hertz
- IDE:
-
Investigational device exemption
- iEEG:
-
Intracranial electroencephalography
- LFP:
-
Local field potential
- MEG:
-
Magnetoencephalography
- MRI:
-
Magnetic resonance imaging
- NHP:
-
Nonhuman primate
- OCD:
-
Obsessive compulsive disorder
- PAC:
-
Phase amplitude coupling
- PD:
-
Parkinson’s disease
- SCI:
-
Spinal cord injury
- sEEG:
-
Stereoelectroencephalography
- STN:
-
Subthalamic nucleus
- Vim:
-
Ventral intermediate nucleus of thalamus
- VNS:
-
Vagus nerve stimulation
- VTA:
-
Volume of tissue activated
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Caldwell, D.J., Herron, J.A., Ko, A.L., Ojemann, J.G. (2022). Motor BMIs Have Entered the Clinical Realm. In: Thakor, N.V. (eds) Handbook of Neuroengineering. Springer, Singapore. https://doi.org/10.1007/978-981-15-2848-4_108-1
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