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Kremen, V.

Publications and source records attributed to Kremen, V..

13 recordsLinked to original sources

A Translational Platform for Brain-Computer Interfaces and Adaptive Neuromodulation: Technical Characterization, Long-Term Validation, and Implementation of the CorTec Brain Interchange--BCI2000 Ecosystem

Objective: Adaptive neuromodulation systems and implantable brain-computer interfaces (BCIs) are promising therapies for neurological and psychiatric disorders. However, their broader translation into research and clinical practice remains limited by technological complexity, restricted access to implantable research platforms, and the lack of standardized, reproducible experimental workflows. We therefore aimed to develop and validate an open, general-purpose translational ecosystem that enables rapid development, evaluation, and dissemination of novel neuromodulation and implantable BCI paradigms. Approach: The CorTec Brain Interchange (BIC) implantable neural sensing and stimulation device was integrated with the open-source BCI2000 platform to create a modular, extensible neuromodulation ecosystem. We established a standardized battery of quantitative assessments to characterize implantable neuromodulation systems to comprehensively evaluate the CorTec BIC device through benchtop characterization, long-term preclinical in vitro and in vivo validation, and a human proof-of-concept demonstration. Results: Benchtop and saline testing provided a comprehensive technical ex vivo characterization of the BIC device, independently validating previously reported performance while extending its characterization through quantification of the recording noise floor, stimulation and acquisition latencies and impedance measurement accuracy. Long-term in vivo validation in five canines, with the longest implantation exceeding three years, demonstrated stable chronic recordings while capturing progressive channel deterioration and its underlying mechanical causes. The ecosystem enabled active functional decoding more than two years after implantation, implementation of closed-loop stimulation using arbitrary spectral biomarkers, detection and modulation of epilepsy-associated biomarkers, and brain stimulation evoked potential recordings. In addition, we translated an established one-dimensional BCI cursor control paradigm to the BIC benchtop evaluation kit and demonstrated its feasibility in a human participant. Finally, we openly provide standardized surgical, imaging, and analysis pipelines together with datasets and software to facilitate reproducible neuromodulation research. Significance: We present a versatile, open-source translational ecosystem that supports a wide range of neuromodulation and implantable BCI applications with minimal modification. This battery of quantitative assessments can be applied generally as a blueprint for systematic characterization of implantable neuromodulation systems. By combining comprehensive hardware characterization with standardized software tools and experimental workflows, this work provides both an essential reference for researchers adopting the Brain Interchange platform. The ecosystem lowers technical barriers to implantable neurotechnology research, promotes reproducibility, and provides a foundation for accelerating the development and clinical translation of next-generation adaptive neuromodulation and implantable BCI therapies for patients with neurological and psychiatric disorders.

bioengineering↗

Generalized brain-state modeling with KenazLBM

The large-scale functional state of a human brain remains difficult to characterize, much less predict. Regardless, techniques have been engineered to electrically neuromodulate the brain to treat a subset of neurologic and psychiatric disorders with moderate efficacy. Accurate characterization of a brains instantaneous functional state has stymied the development of more effective neuromodulation paradigms. Advanced computational methods are required to address this gap and enable large-scale neuroscience. Here we define the concept of generalized brain-state modeling across humans as Large Brain-State Modeling (LBM) and present KenazLBM as the worlds first example. KenazLBM can instantaneously characterize the functional state of a persons brain with raw iEEG data, and predict future brain-states. KenazLBM was trained on over 17.9 billion unique multichannel tokens from people undergoing intracranial electroencephalography (iEEG) recordings, and has learned to interrelate brain-states between people into a common interpretable topology. Most importantly, the model generalizes to unseen subject data with significant recording channel heterogeneity from the training set. We offer KenazLBM as a first generalized brain-state model to serve as a new paradigm of basic neuroscience inquiry and potential translation into neuromodulation therapeutics.

neuroscience↗

Large Animal Epilepsy Model Platform: Kainic Acid Porcine Model of Mesial Temporal Lobe Epilepsy

Translational large-animal models that can accommodate human-scale implantable devices are essential for advancing neuromodulation therapies in epilepsy. This study establishes a kainic acid (KA)-induced porcine model of mesial temporal lobe epilepsy (mTLE) using clinical imaging, stereotactic surgery, and a fully implantable neural stimulation and recording (INSR) device designed for humans. Seven pigs (six KA-treated and one saline control) underwent MRI-guided stereotactic implantation of electrodes targeting bilateral hippocampus (HPC) and anterior thalamus (ANT), followed by intra-hippocampal KA or saline infusion. Local field potentials (LFP) were recorded continuously with synchronized video monitoring. Seizures and LFP interictal epileptiform-like discharges (IEDs) were quantified using validated automated detectors. Histology was performed in the saline control and the longest surviving KA-treated pig. Intra-hippocampal KA infusion induced acute status epilepticus in all (6/6) treated pigs. Four animals survived to chronic monitoring with spontaneous seizures observed in three pigs (2,733 seizures; mean duration of 27.2 {+/-} 17.6 seconds). IEDs were observed in bilateral HPC of all animals, including saline control, with higher rates in the lesioned HPC (p <0.0001). While the IED morphology is consistent with epileptiform activity; IEDs alone are not specific for epilepsy and physiological transients (e.g. sharp-wave ripples) and injury-related hyperexcitability or strain-specific hyperexcitability cannot be excluded. Histological analysis revealed patchy neuronal loss and cytoarchitectural changes in HPC. This porcine model reproduces electrophysiological features of human mTLE. This approach provides a powerful translational bridge for developing and testing next-generation INSR and neuromodulation strategies in freely behaving large animals.

neuroscience↗

Bred for affection: The canine anterior ectosylvian gyrus responds selectively to social reinforcement

Studying mammalian brain function aids our understanding of human brain evolution. We implanted a beagle with a prototype human neuromodulation platform that measures activity from the brain surface. One year later, a set of simple sensory tasks was performed, finding visual and somatosensory representation in the canine homologs of the expected areas in humans. Surprisingly, the canine anterior ectosylvian gyrus, which is anatomically homologous to human receptive speech areas, was selectively active during independent social reinforcement tasks. This suggests that human speech understanding may have evolved from more general mammalian brain structures that are specialized for social reinforcement.

animal behavior and cognition↗

Impaired microglial phagocytosis promotes seizure development

In the central nervous system, triggering receptor expressed on myeloid cells 2 (TREM2) is exclusively expressed by microglia and is critical for microglial proliferation, migration, and phagocytosis. TREM2 plays an important role in neurodegenerative diseases, such as Alzheimers disease and amyotrophic lateral sclerosis. However, little is known about the role TREM2 plays in epileptogenesis. To investigate this, we utilized TREM2 knockout (KO) mice within the murine intra-amygdala kainic acid seizure model. Electroencephalographic analysis, immunocytochemistry, and RNA sequencing revealed that TREM2 deficiency significantly promoted seizure-induced pathology. We found that TREM2 KO increased both acute status epilepticus and spontaneous recurrent seizures characteristic of chronic focal epilepsy. Mechanistically, phagocytic clearance of damaged neurons by microglia was impaired in TREM2 KO mice and the reduced phagocytic capacity correlated with increased spontaneous seizures. Analysis of human tissue from patients who underwent surgical resection for drug resistant temporal lobe epilepsy also showed a negative correlation between microglial phagocytic activity and focal to bilateral tonic-clonic generalized seizure history. These results indicate that microglial TREM2 and phagocytic activity may be important to epileptogenesis and the progression of focal temporal lobe epilepsy. One Sentence SummaryPhagocytic activity of microglia may impact generalized seizure development within both mice and humans.

neuroscience↗

Method for cycle detection in sparse, irregularly sampled, long-term neuro-behavioral timeseries: Basis pursuit denoising with polynomial detrending of long-term, inter-ictal epileptiform activity

Numerous physiological processes are cyclical, but sampling these processes densely enough to perform frequency decomposition and subsequent analyses can be challenging. Mathematical approaches for decomposition and reconstruction of sparsely and irregularly sampled signals are well established but have been under-utilized in physiological applications. We developed a basis pursuit denoising with polynomial detrending (BPWP) model that recovers oscillations and trends from sparse and irregularly sampled timeseries. We validated this model on a unique dataset of long-term inter-ictal epileptiform discharge (IED) rates from human hippocampus recorded with a novel investigational device with continuous local field potential sensing. IED rates have well established circadian and multiday cycles related to sleep, wakefulness, and seizure clusters. Given sparse and irregular samples of IED rates from multi-month intracranial EEG recordings from ambulatory humans, we used BPWP to compute narrowband spectral power and polynomial trend coefficients and identify IED rate cycles in three subjects. In select cases, we propose that random and irregular sampling may be leveraged for frequency decomposition of physiological signals. Author SummaryCircadian and multiday cycles are an important part of many long-term neuro-behavioral phenomena such as pathological inter-ictal epileptiform discharges (IEDs) in epilepsy. Long-term, ambulatory, neuro-behavioral monitoring in human patients involves complex recording systems that can be subject to intermittent, irregular data loss and storage limitations, resulting in sparse, irregularly sampled data. Cycle identification in sparse data or irregular data using traditional frequency decomposition techniques typically requires interpolation to create a regular timeseries. Using unique, long-term recordings of pathological brain activity in patients with epilepsy implanted with an investigational device, we developed a method to identify cycles in sparse, irregular neuro-behavioral data without interpolation. We anticipate this approach will enable retrospective cycle identification in sparse neuro-behavioral timeseries and support prospective sparse sampling in monitoring systems to enable long-term monitoring of patients and to extend storage capacity in a variety of ambulatory monitoring applications.

neuroscience↗

Chronic modulation of human memory and thalamic-hippocampal theta activities.

Electrical stimulation is a powerful therapeutic tool for treating neurologic and neuropsychiatric disorders. Sensing and modulating electrophysiological biomarkers of memory over extended timescales is necessary for tracking and improving memory in humans. Here, we describe results from humans in their natural home environments using a novel, investigational system enabling chronic stimulation and multi-channel recording of anterior thalamic and hippocampal local field potentials during memory tasks. Four people with focal epilepsy performed a free recall verbal memory task repeatedly for up to fifty months on a touch-screen device with wireless signal acquisition with electrophysiology and behavioral data streaming to a cloud environment. Anterior thalamic-hippocampal spectral activities in the theta frequency range were found to correlate with memory processing, to predict task performance, and to be modulated by deep brain stimulation. Our results provide a new biomarker-based technology for chronic remote tracking of memory performance and modulation of the associated neural activities. One Sentence SummaryElectrical stimulation in the anterior thalamic nuclei modulates theta frequency activities and improves human verbal memory performance chronically.

neuroscience↗

Microglial process dynamics enhance neuronal activity by shielding GABAergic synaptic inputs

Microglia are resident immune cells of the central nervous system (CNS) and play key roles in brain homeostasis. During anesthesia, microglia increase their dynamic process surveillance and interact more closely with neurons. However, the functional significance of microglial process dynamics and neuronal interaction has remained unclear. Using in vivo two-photon imaging in awake mice, we discover that microglia enhance neuronal activity after the cessation of general anesthesia. Hyperactive neuron somata are directly contacted by microglial processes, which specifically co-localize with GABAergic boutons. Electron microscopy-based synaptic reconstruction after two-photon imaging reveals that microglial processes enter into the synaptic cleft to shield GABAergic inputs. Microglial ablation or loss of microglial {beta}2-adrenergic receptors prevent post-anesthesia neuronal hyperactivity. Together, our study demonstrates a previously unappreciated function of microglial process dynamics, which allow microglia to transiently boost neuronal activity by physically shielding inhibitory inputs.

neuroscience↗

Integrated human-machine interface for closed-loop stimulation using implanted and wearable devices

Recent development in implantable devices for electrical brain stimulation includes sensing and embedded computing capabilities that enable adaptive stimulation strategies. Applications include stimulation triggered by pathologic brain activity and endogenous rhythms, such as circadian rhythms. We developed and tested a system that integrates an electrical brain stimulation & sensing implantable device with embedded computing and uses a distributed system with commercial electronics, smartphone and smartwatch for patient annotations, extensive behavioral testing, and adaptive stimulation in subjects in their natural environments. The system enables precise time synchronization of the external components with the brain stimulating device and is coupled with automated analysis of continuous streaming electrophysiology synchronized with patient reports. The system leverages a real-time bi-directional interface between devices and patients with epilepsy living in their natural environment.

neuroscience↗

Distinct signatures of loss of consciousness during Focal Impaired Awareness (FIA) versus Focal to Bilateral Tonic-Clonic (FBTC) seizures

Loss of consciousness (LOC) is a hallmark of many epileptic seizures and carries risks of serious injury and sudden death. While cortical sleep-like activities accompany LOC during focal impaired awareness (FIA) seizures, the mechanisms of LOC during focal to bilateral tonic-clonic (FBTC) seizures remain unclear. Quantifying differences in markers of cortical activation and ictal recruitment between FIA and FBTC seizures may also help to understand their different consequences for clinical outcomes and to optimize neuromodulation therapies. We quantified clinical signs of LOC and intracranial EEG (iEEG) activity during 129 FIA and 50 FBTC from 41 patients. We characterized iEEG changes both in the seizure onset zone (SOZ) and in areas remote from SOZ with a total of 3386 electrodes distributed across brain areas. First, we compared the dynamics of iEEG sleep-like activities: slow-wave activity (SWA; 1-4 Hz) and beta/delta ratio (B/D; a validated marker of cortical activation) during FIA vs. FBTC. Second, we quantified differences between FBTC and FIA for a marker validated to detect ictal cross-frequency coupling: phase-locked high-gamma (PLHG; high gamma phased locked to low frequencies) and a marker of ictal recruitment: the epileptogenicity index (i.e. the number of channels crossing an energy ratio threshold for high vs. low frequency power). Third, we assessed changes in iEEG activity preceding and accompanying behavioral generalization onset and their correlation with electromyogram (EMG) channels. In addition, we analyzed human cortical multi-unit activity recorded with Utah arrays during three FBTC. Compared to FIA, FBTC seizures were characterized by deeper LOC and by stronger increases in SWA in parieto-occipital cortex. FBTC also displayed more widespread increases in cortical activation (B/D), ictal cross-frequency coupling (PLHG) and ictal recruitment (epileptogenicity index). Even before generalization, FBTC displayed deeper LOC; this early LOC was accompanied by a paradoxical increase in B/D in fronto-parietal cortex. Behavioral generalization coincided with complete loss of responsiveness and a subsequent increase in high-gamma in the whole brain, which was especially synchronous in deep sources and could not be explained by EMG. Similarly, multi-unit activity analysis of FBTC revealed sustained increases in cortical firing rates during and after generalization onset in areas remote from the SOZ. Unlike during FIA, LOC during FBTC is characterized by a paradoxical increase in cortical activation and neuronal firing. These findings suggest differences in the mechanisms of ictal LOC between FIA and FBTC and may account for the more negative prognostic consequences of FBTC.

neuroscience↗

Independent dynamics of slow, intermediate, and fast intracranial EEG spectral activities during human memory formation

A wide spectrum of brain rhythms are engaged throughout the human cortex in cognitive functions. How the rhythms of various low and high frequencies are spatiotemporally coordinated across the human brain during memory processing is inconclusive. They can either be coordinated together across a wide range of the frequency spectrum or induced in specific bands. We used a large dataset of human intracranial electroencephalography (iEEG) to parse the spatiotemporal dynamics of spectral activities induced during formation of verbal memories. Encoding of words for subsequent free recall activated slow theta, intermediate alpha and beta, and fast gamma frequency power in discrete cortical sites. A majority of the electrode sites recorded activity in only one of these frequencies, except for the visual cortex where spectral power was induced across multiple bands. Each frequency band showed characteristic dynamics of the induced power specific to cortical area and hemisphere. The power of the low, intermediate, and fast activities propagated in distinct spatiotemporal patterns across the visual, temporal and prefrontal cortical areas as the words were presented for encoding. Our results suggest anatomically and temporally distributed spectral activities in the formation of human memory.

neuroscience↗

Distributed Brain Co-Processor for Neurophysiologic Tracking and Adaptive Stimulation: Application to Drug Resistant Epilepsy

Early implantable epilepsy therapy devices provided open-loop electrical stimulation without brain sensing, computing, or an interface for synchronized behavioral inputs from patients. Recent epilepsy stimulation devices provide brain sensing but have not yet developed analytics for accurately tracking and quantifying behavior 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 hand-held 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 9 humans and 8 canines with epilepsy, and then implemented prospectively in out-of-sample testing in 2 pet canines and 4 humans with drug resistant epilepsy living in their natural environments.

bioengineering↗

Chronic wireless streaming of invasive neural recordings at home for circuit discovery and adaptive stimulation

Invasive neural recording in humans shows promise for understanding the circuit basis of brain disorders. Most recordings have been done for short durations from externalized brain leads in hospital settings, or from first-generation implantable sensing devices that offer only intermittent brief streaming of time series data. Here we report the first human use of an implantable neural interface for wireless multichannel streaming of field potentials over long periods, with and without simultaneous therapeutic neurostimulation, untethered to receiving devices. Four Parkinsons disease patients streamed bilateral 4-channel motor cortical and basal ganglia field potentials at home for over 500 hours, paired with wearable monitors that behaviorally categorize states of inadequate or excessive movement. Motor state during normal home activities was efficiently decoded using either supervised learning or unsupervised clustering algorithms. This platform supports adaptive deep brain stimulation, and may be widely applicable to brain disorders treatable by invasive neuromodulation.

neuroscience↗