Background: Brain sensing devices are approved today for Parkinson, essential tremor, and epilepsy therapies. Clinical decisions for implants are often influenced by the premise that patients will benefit from using sensing technology. However, artifacts, such as ECG contamination, can render such treatments unreliable. Therefore, clinicians need to understand how surgical decisions may affect artifact probability. Objectives: Investigate neural signal contamination with ECG activity in sensing enabled neurostimulation systems, and in particular clinical choices such as implant location that impact signal fidelity. Methods: Electric field modelling and empirical signals from 85 patients were used to investigate the relationship between implant location and ECG contamination. Results: The impact on neural recordings depends on the difference between ECG signal and noise floor of the electrophysiological recording. Empirically, we demonstrate that severe ECG contamination was more than 3.2x higher in left-sided subclavicular implants (48.3%), when compared to right-sided implants (15.3%). Cranial implants did not show ECG contamination. Conclusions: Given the relative frequency of corrupted neural signals, we conclude that implant location will impact the ability of brain sensing devices to be used for closed-loop algorithms. Clinical adjustments such as implant location can significantly affect signal integrity and need consideration.

中文翻译：

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自适应闭环神经刺激系统中ECG污染对手术植入部位的敏感性

背景：脑部感应设备今天已获批准用于帕金森症，原发性震颤和癫痫治疗。植入物的临床决策通常受患者受益于使用传感技术的前提影响。但是，诸如ECG污染之类的伪影可能会使这种治疗不可靠。因此，临床医生需要了解外科手术决策如何影响假象的可能性。目标：在感应启用的神经刺激系统中，研究具有ECG活动的神经信号污染，尤其是临床选择，例如影响信号保真度的植入物位置。方法：采用电场建模和来自85位患者的经验信号，研究植入物位置与ECG污染之间的关系。结果：对神经记录的影响取决于ECG信号与电生理记录的本底噪声之间的差异。根据经验，与右侧植入物（15.3％）相比，左侧锁骨下植入物（48.3％）的严重ECG污染高出3.2倍以上。颅骨植入物未显示ECG污染。结论：鉴于受损神经信号的相对频率，我们得出结论，植入物的位置将影响大脑感应设备用于闭环算法的能力。诸如植入物位置之类的临床调整会严重影响信号的完整性，因此需要考虑。与右侧植入物相比（15.3％）。颅骨植入物未显示ECG污染。结论：鉴于受损神经信号的相对频率，我们得出结论，植入物的位置将影响大脑感应设备用于闭环算法的能力。诸如植入物位置之类的临床调整会严重影响信号的完整性，因此需要考虑。与右侧植入物相比（15.3％）。颅骨植入物未显示ECG污染。结论：鉴于受损神经信号的相对频率，我们得出结论，植入物的位置将影响大脑感应设备用于闭环算法的能力。诸如植入物位置之类的临床调整会严重影响信号的完整性，因此需要考虑。