Motor Cortex Stimulation for Intractable Pain:

Surgical Neurostimulation for Spinal Cord Injury

Traumatic spinal cord injury (SCI) is a devastating neurological condition characterized by a constellation of symptoms including paralysis, paraesthesia, pain, cardiovascular, bladder, bowel and sexual dysfunction. Current treatment for SCI involves acute resuscitation, aggressive rehabilitation and symptomatic treatment for complications. Despite the progress in scientific understanding, regenerative therapies are lacking. In this review, we outline the current state and future potential of invasive and non-invasive neuromodulation strategies including deep brain stimulation (DBS), spinal cord stimulation (SCS), motor cortex stimulation (MCS), transcutaneous direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) in the context of SCI. We consider the ability of these therapies to address pain, sensorimotor symptoms and autonomic dysregulation associated with SCI. In addition to the potential to make important contributions to SCI treatment, neuromodulation has the added ability to contribute to our understanding of spinal cord neurobiology and the pathophysiology of SCI.

ECoG factors underlying multimodal control of a brain-computer interface

Most current brain-computer interface (BCI) systems for humans use electroencephalographic activity recorded from the scalp, and may be limited in many ways. Electrocorticography (ECoG) is believed to be a minimally-invasive alternative to electroencephalogram (EEG) for BCI systems, yielding superior signal characteristics that could allow rapid user training and faster communication rates. In addition, our preliminary results suggest that brain regions other than the sensorimotor cortex, such as auditory cortex, may be trained to control a BCI system using similar methods as those used to train motor regions of the brain. This could prove to be vital for users who have neurological disease, head trauma, or other conditions precluding the use of sensorimotor cortex for BCI control.