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Motor BMIs Have Entered the Clinical Realm

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Handbook of Neuroengineering

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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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Authors and Affiliations

  1. Department of Bioengineering, University of Washington, Seattle, WA, USA

    David J. Caldwell

  2. Medical Scientist Training Program, University of Washington, Seattle, WA, USA

    David J. Caldwell

  3. Center for Neurotechnology, Seattle, WA, USA

    David J. Caldwell, Jeffrey A. Herron, Andrew L. Ko & Jeffrey G. Ojemann

  4. Department of Neurological Surgery, University of Washington, Seattle, WA, USA

    Jeffrey A. Herron, Andrew L. Ko & Jeffrey G. Ojemann

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  1. David J. Caldwell
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  2. Jeffrey A. Herron
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  3. Andrew L. Ko
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  4. Jeffrey G. Ojemann
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Correspondence to Jeffrey G. Ojemann .

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  1. Neuroengineering and Biomedical Instrumentation Laboratory Department of Biomedical Engineering and Department of Electrical and Computer Engineering, Neurology, Johns Hopkins University, Baltimore, MD, USA

    Nitish V. Thakor

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Caldwell, D.J., Herron, J.A., Ko, A.L., Ojemann, J.G. (2023). Motor BMIs Have Entered the Clinical Realm. In: Thakor, N.V. (eds) Handbook of Neuroengineering. Springer, Singapore. https://doi.org/10.1007/978-981-16-5540-1_108

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