Development of an implantable flexible probe for simultaneous near-infrared spectroscopy and electrocorticography

Intraoperative Cerebral Measurements Using Implantable Cortical Multimodality Probe

In this study, a multimodality probe that simultaneously measures electroencephalograms, cerebral hemodynamics, and brain surface temperature was developed. This probe has six channels, and each channel has a platinum electrode for cortical electroencephalogram measurements, light emitting diodes, and photodiodes for hemodynamic measurements using near-infrared spectroscopy (NIRS), and a thermistor for measuring the cerebral surface temperature (BrT). A probe with a width of 8.0 mm and maximum total thickness of 0.7 mm was fabricated using flexible printed circuit board technology for chronic intracranial placement. Brain activity using the prototype probe at the resected site was measured and its function performance was evaluated. Characteristic epileptogenic abnormal electroencephalograms accompanied by polarity reversal between channels occurred at 16 min and 38 s. It was concluded that the brain cells consumed oxygen during the occurrence of abnormal electroencephalograms. At this time, no noticeable change in HbT values could be confirmed.

Non Invasive Brain Stimulation Study Based on Ischemic Stroke Patients

Non-invasive brain stimulation (NIBS) methods are progressively used as neuromodulator and showing optimistic potential for medical practice. In present study experimental NIRS-tDCS raw dataset of twenty-two sub-acute ischemic stroke patients has been used to explore the significant variation in measured NIRS signal namely cerebral oxygenation, oxy-hemoglobin and deoxy-hemoglobin before and after tDCS. Pearson correlation statistical method is used to determine the strength and relationship between hemodynamic responses. The negative correlation has been shown between oxy-hemoglobin and deoxy-hemoglobin before and after tDCS at 99% confidence interval (P<; 0.01). One sample t-test is used to determine the pre to post tDCS significant change in regional cerebral oxygenation, oxy-hemoglobin and deoxy-hemoglobin independently at 99% confidence interval (P<; 0.01). On the basis of significant change in the NIRS measurement parameters (HbO₂, Hb and rSO₂) the healthy and lesioned hemisphere of patients suffering from sub-acute ischemic stroke have been classified. A significant increase in pre to post rSO₂ has been found in the healthy hemispheres of patients. For the lesioned hemisphere, the two cases were found. One is due to the decrease in rSO₂ after tDCS and significant change from pre to post rSO₂. The second is negligible pre to post change in the rSO₂ and insignificant variation in rSO₂.

Implantable Multi-Modality Probe for Subdural Simultaneous Measurement of Electrophysiology, Hemodynamics, and Temperature Distribution

OBJECTIVE

The purpose of this paper is to demonstrate how the integration of the multi-channel measurement capabilities of near-infrared spectroscopy (NIRS), electrocorticography (ECoG), and negative temperature coefficient thermistor sensors into a single device compact enough for subdural implantation can provide beneficial information on various aspects of brain cortical activity and prove a powerful medical modality for pre-, intra-, and post-operative diagnoses in neurosurgery.

METHODS

The development of a flexible multi-modal multi-channel probe for the simultaneous measurement of the NIRS, ECoG, and surficial temperature obtained from the cerebral cortex was carried out. Photoelectric bare chips for NIRS channels, miniature temperature-coefficient thermistors for measuring localized temperature variation, and 3-mm-diameter platinum plates for ECoG recording were assembled on a polyimide-based flexible printed circuit to create six channels for each modality. A conformal coating of Parylene-C was applied on all the channels except the ECoG to make the probe surface biocompatible.

RESULTS

As a first-in-human study, the simultaneous measurement capability of the multi-modality probe, with sufficient signal-to-noise ratio and accuracy, to observe pathological neural activities in subjects during surgery and post-operative monitoring, with no complications two weeks since the implantation, was confirmed.

CONCLUSION

The feasibility of using a single device to assess the dynamic pathological activity from three different aspects was determined for human patients.

SIGNIFICANCE

The simultaneous and accurate multi-channel recording of electrical, hemodynamic, and thermographic cortical activities in a single device small enough for subdural implantation is likely to have major implications in neurosurgery and neuroscience.

The design, fabrication, and applications of flexible biosensing devices

Flexible biosensors form part of a rapidly growing research field that take advantage of a multidisciplinary approach involving materials, fabrication and design strategies to be able to function at biological interfaces that may be soft, intrinsically curvy, irregular, or elastic. Numerous exciting advancements are being proposed and developed each year towards applications in healthcare, fundamental biomedical research, food safety and environmental monitoring. In order to place these developments in perspective, this review is intended to present an overview on field of flexible biosensor development. We endeavor to show how this subset of the broader field of flexible and wearable devices presents unique characteristics inherent in their design. Initially, a discussion on the structure of flexible biosensors is presented to address the critical issues specific to their design. We then summarize the different materials as substrates that can resist mechanical deformation while retaining their function of the bioreceptors and active elements. Several examples of flexible biosensors are presented based on the different environments in which they may be deployed or on the basis of targeted biological analytes. Challenges and future perspectives pertinent to the current and future stages of development are presented. Through these summaries and discussion, this review is expected to provide insights towards a systematic and fundamental understanding for the fabrication and utilization of flexible biosensors, as well as inspire and improve designs for smart and effective devices in the future.

Epileptic Seizure Suppression by Focal Brain Cooling With Recirculating Coolant Cooling System: Modeling and Simulation

A focal brain cooling system for treatment of refractory epilepsy that is implantable and wearable may permit patients with this condition to lead normal daily lives. We have developed such a system for cooling of the epileptic focus by delivery of cold saline to a cooling device that is implanted cranially. The outflow is pumped for circulation and cooled by a Peltier device. Here, we describe the design of the system and evaluate its feasibility by simulation. Mathematical models were constructed based on equations of fluid dynamics and data from a cat model. Computational fluid dynamics simulations gave the following results: 1) a cooling device with a complex channel structure gives a more uniform temperature in the brain; 2) a cooling period of <10 min is required to reach an average temperature of 25.0°Cat 2 mm below the brain surface, which is the target temperature for seizure suppression. This time is short enough for cooling of the brain before seizure onset after seizure prediction by an intracranial electroencephalogram-based algorithm; and 3) battery charging would be required once every several days for most patients. These results suggest that the focal brain cooling system may be clinically applicable.

Design of focal brain cooling system for suppressing epileptic seizures

Epilepsy is a group of diseases caused by excessive neuronal activities, and one-quarter of the patients do not become seizure-free by the existing treatments. The potential treatments include focal brain cooling, which aims to cool the region where the excessive neuronal activities begin. We are developing a focal brain cooling system. The system delivers cold saline to a cranially implanted cooling device. The outflow is cooled by a Peltier device and pumped for circulation. The Peltier device and the pump are activated only when a seizure is predicted. In this research, the length of time for cooling the brain was calculated with a computational fluid dynamics (CFD)-based model of the focal brain cooling system. As a result, it takes less than 10 minutes for the average temperature 2 mm below the cooling device to reach 25.0 °C. It is much shorter than the time from seizure prediction to seizure onset when an existing algorithm for prediction is used.

Development of NIRS probe based on LED sensing that enables multimodal integration

We propose LED sensing which provides the miniaturization and symmetrization for NIRS sensor system. In order to make it into practical application, the spectral responses of LEDs were investigated and then formula for calculating changes in hemoglobin concentrations were established. In blood phantom experiment, temporal changes in hemoglobin concentration were observed by CW-NIRS using LED sensing.

Cortico-cortical activity between the primary and supplementary motor cortex: An intraoperative near-infrared spectroscopy study

Background:

The supplementary motor area (SMA) makes multiple reciprocal connections to many areas of the cerebral cortices, such as the primary motor cortex (PMC), anterior cingulate cortex, and various regions in the parietal somatosensory cortex. In patients with SMA seizures, epileptic discharges from the SMA rapidly propagate to the PMC. We sought to determine whether near-infrared spectroscopy (NIRS) is able to intraoperatively display hemodynamic changes in epileptic network activities between the SMA and the PMC.

Case Descriptions:

In a 60-year-old male with SMA seizures, we intraoperatively delivered a 500 Hz, 5-train stimulation to the medial cortical surface and measured the resulting hemodynamic changes in the PMC by calculating the oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR) concentration changes during stimulation. No hemodynamic changes in the lateral cortex were observed during stimulation of the medial surface corresponding to the foot motor areas. In contrast, both HbO2 and HbR increased in the lateral cortex corresponding to the hand motor areas when the seizure onset zone was stimulated. In the premotor cortex and the lateral cortex corresponding to the trunk motor areas, hemodynamic changes showed a pattern of increased HbO2 with decreased HbR.

Conclusions:

This is the first reported study using intraoperative NIRS to characterize the epileptic network activities between the SMA and PMC. Our intraoperative NIRS procedure may thus be useful in monitoring the activities of cortico-cortical neural pathways such as the language system.

Determination of detection depth of optical probe in pedicle screw measurement device

BACKGROUND

There is a high probability of accidental perforation of the vertebral pedicle wall in pedicle screw insertion surgery. A pedicle screw (PS) measurement device with an optical probe has been reported to send out a warning signal before the PS tip breaking the vertebral pedicle wall.

METHODS

In this study, we explored the detection depth of optical probe in this measurement device, which was closely related to the effective alarm distance. In the boundary, the vertebrae tissues could be treated as 2-layer models including spongy bones and compact bones. The Monte Carlo simulation and phantom models were performed to analyse and define the detection depth. Then the porcine vertebrae models were performed to obtain optical spectrum and reduced scattering coefficient, based on which the detection depths were deduced. Moreover, a comparison was made to explore the most significant pattern factor from the experiment results.

RESULTS

According to the pattern factor, an alarm threshold was successfully deduced to define the alarm distance during pedicle screw monitoring.

CONCLUSIONS

Thus, the proposed alarm standard based on detection depth provides a potential for guiding pedicle screw in surgery.

Direct cortical hemodynamic mapping of somatotopy of pig nostril sensation by functional near-infrared cortical imaging (fNCI)

Functional near-infrared spectroscopy (fNIRS) is a neuroimaging technique for the noninvasive monitoring of human brain activation states utilizing the coupling between neural activity and regional cerebral hemodynamics. Illuminators and detectors, together constituting optodes, are placed on the scalp, but due to the presence of head tissues, an inter-optode distance of more than 2.5cm is necessary to detect cortical signals. Although direct cortical monitoring with fNIRS has been pursued, a high-resolution visualization of hemodynamic changes associated with sensory, motor and cognitive neural responses directly from the cortical surface has yet to be realized. To acquire robust information on the hemodynamics of the cortex, devoid of signal complications in transcranial measurement, we devised a functional near-infrared cortical imaging (fNCI) technique. Here we demonstrate the first direct functional measurement of temporal and spatial patterns of cortical hemodynamics using the fNCI technique. For fNCI, inter-optode distance was set at 5mm, and light leakage from illuminators was prevented by a special optode holder made of a light-shielding rubber sheet. fNCI successfully detected the somatotopy of pig nostril sensation, as assessed in comparison with concurrent and sequential somatosensory-evoked potential (SEP) measurements on the same stimulation sites. Accordingly, the fNCI system realized a direct cortical hemodynamic measurement with a spatial resolution comparable to that of SEP mapping on the rostral region of the pig brain. This study provides an important initial step toward realizing functional cortical hemodynamic monitoring during neurosurgery of human brains.