Background

Brain sensing devices are approved today for Parkinson's, 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 modeling 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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心电图污染对脑机接口手术植入部位的敏感性

背景

大脑传感设备今天已获准用于治疗帕金森病、特发性震颤和癫痫症。植入物的临床决策通常受到患者将从使用传感技术中受益这一前提的影响。然而，诸如 ECG 污染之类的伪影会使此类治疗变得不可靠。因此，临床医生需要了解手术决策如何影响伪影概率。

目标

在启用传感的神经刺激系统中研究 ECG 活动对神经信号的污染，特别是影响信号保真度的植入位置等临床选择。

方法

电场建模和来自 85 名患者的经验信号被用来研究植入物位置和 ECG 污染之间的关系。

结果

对神经记录的影响取决于 ECG 信号和电生理记录的本底噪声之间的差异。根据经验，我们证明与右侧植入物 (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。颅骨植入物未显示心电图污染。

结论

鉴于损坏的神经信号的相对频率，我们得出结论，植入位置将影响大脑传感设备用于“闭环”算法的能力。植入物位置等临床调整会显着影响信号完整性，需要加以考虑。