Distributed brain co-processor for tracking spikes, seizures and behaviour during electrical brain stimulation

Early implantable epilepsy therapy devices provided open-loop electrical stimulation without brain sensing, computing, or an interface for synchronized behavioural inputs from patients. Recent epilepsy stimulation devices provide brain sensing but have not yet developed analytics for accurately trac...

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Main Authors: Sladky, V, Nejedly, P, Mivalt, F, Brinkmann, BH, Kim, I, St Louis, EK, Gregg, NM, Lundstrom, BN, Crowe, CM, Attia, TP, Crepeau, D, Balzekas, I, Marks, VS, Wheeler, LP, Cimbalnik, J, Cook, M, Janca, R, Sturges, BK, Leyde, K, Miller, KJ, Van Gompel, JJ, Denison, T, Worrell, GA, Kremen, V
Format: Journal article
Language:English
Published: Oxford University Press 2022
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author Sladky, V
Nejedly, P
Mivalt, F
Brinkmann, BH
Kim, I
St Louis, EK
Gregg, NM
Lundstrom, BN
Crowe, CM
Attia, TP
Crepeau, D
Balzekas, I
Marks, VS
Wheeler, LP
Cimbalnik, J
Cook, M
Janca, R
Sturges, BK
Leyde, K
Miller, KJ
Van Gompel, JJ
Denison, T
Worrell, GA
Kremen, V
author_facet Sladky, V
Nejedly, P
Mivalt, F
Brinkmann, BH
Kim, I
St Louis, EK
Gregg, NM
Lundstrom, BN
Crowe, CM
Attia, TP
Crepeau, D
Balzekas, I
Marks, VS
Wheeler, LP
Cimbalnik, J
Cook, M
Janca, R
Sturges, BK
Leyde, K
Miller, KJ
Van Gompel, JJ
Denison, T
Worrell, GA
Kremen, V
author_sort Sladky, V
collection OXFORD
description Early implantable epilepsy therapy devices provided open-loop electrical stimulation without brain sensing, computing, or an interface for synchronized behavioural inputs from patients. Recent epilepsy stimulation devices provide brain sensing but have not yet developed analytics for accurately tracking and quantifying behaviour and seizures. Here we describe a distributed brain co-processor providing an intuitive bi-directional interface between patient, implanted neural stimulation and sensing device, and local and distributed computing resources. Automated analysis of continuous streaming electrophysiology is synchronized with patient reports using a handheld device and integrated with distributed cloud computing resources for quantifying seizures, interictal epileptiform spikes and patient symptoms during therapeutic electrical brain stimulation. The classification algorithms for interictal epileptiform spikes and seizures were developed and parameterized using long-term ambulatory data from nine humans and eight canines with epilepsy, and then implemented prospectively in out-of-sample testing in two pet canines and four humans with drug-resistant epilepsy living in their natural environments. Accurate seizure diaries are needed as the primary clinical outcome measure of epilepsy therapy and to guide brain-stimulation optimization. The brain co-processor system described here enables tracking interictal epileptiform spikes, seizures and correlation with patient behavioural reports. In the future, correlation of spikes and seizures with behaviour will allow more detailed investigation of the clinical impact of spikes and seizures on patients.
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spelling oxford-uuid:6754d8d8-bf03-4ff8-85a8-74b9320251302023-05-05T12:32:14ZDistributed brain co-processor for tracking spikes, seizures and behaviour during electrical brain stimulationJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6754d8d8-bf03-4ff8-85a8-74b932025130EnglishSymplectic ElementsOxford University Press2022Sladky, VNejedly, PMivalt, FBrinkmann, BHKim, ISt Louis, EKGregg, NMLundstrom, BNCrowe, CMAttia, TPCrepeau, DBalzekas, IMarks, VSWheeler, LPCimbalnik, JCook, MJanca, RSturges, BKLeyde, KMiller, KJVan Gompel, JJDenison, TWorrell, GAKremen, VEarly implantable epilepsy therapy devices provided open-loop electrical stimulation without brain sensing, computing, or an interface for synchronized behavioural inputs from patients. Recent epilepsy stimulation devices provide brain sensing but have not yet developed analytics for accurately tracking and quantifying behaviour and seizures. Here we describe a distributed brain co-processor providing an intuitive bi-directional interface between patient, implanted neural stimulation and sensing device, and local and distributed computing resources. Automated analysis of continuous streaming electrophysiology is synchronized with patient reports using a handheld device and integrated with distributed cloud computing resources for quantifying seizures, interictal epileptiform spikes and patient symptoms during therapeutic electrical brain stimulation. The classification algorithms for interictal epileptiform spikes and seizures were developed and parameterized using long-term ambulatory data from nine humans and eight canines with epilepsy, and then implemented prospectively in out-of-sample testing in two pet canines and four humans with drug-resistant epilepsy living in their natural environments. Accurate seizure diaries are needed as the primary clinical outcome measure of epilepsy therapy and to guide brain-stimulation optimization. The brain co-processor system described here enables tracking interictal epileptiform spikes, seizures and correlation with patient behavioural reports. In the future, correlation of spikes and seizures with behaviour will allow more detailed investigation of the clinical impact of spikes and seizures on patients.
spellingShingle Sladky, V
Nejedly, P
Mivalt, F
Brinkmann, BH
Kim, I
St Louis, EK
Gregg, NM
Lundstrom, BN
Crowe, CM
Attia, TP
Crepeau, D
Balzekas, I
Marks, VS
Wheeler, LP
Cimbalnik, J
Cook, M
Janca, R
Sturges, BK
Leyde, K
Miller, KJ
Van Gompel, JJ
Denison, T
Worrell, GA
Kremen, V
Distributed brain co-processor for tracking spikes, seizures and behaviour during electrical brain stimulation
title Distributed brain co-processor for tracking spikes, seizures and behaviour during electrical brain stimulation
title_full Distributed brain co-processor for tracking spikes, seizures and behaviour during electrical brain stimulation
title_fullStr Distributed brain co-processor for tracking spikes, seizures and behaviour during electrical brain stimulation
title_full_unstemmed Distributed brain co-processor for tracking spikes, seizures and behaviour during electrical brain stimulation
title_short Distributed brain co-processor for tracking spikes, seizures and behaviour during electrical brain stimulation
title_sort distributed brain co processor for tracking spikes seizures and behaviour during electrical brain stimulation
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