Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Germany.
MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom.
Brain Stimul. 2021 Sep-Oct;14(5):1301-1306. doi: 10.1016/j.brs.2021.08.016. Epub 2021 Aug 21.
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.
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.
Electric field modeling and empirical signals from 85 patients were used to investigate the relationship between implant location and ECG contamination.
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.
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.
脑传感设备如今已获准用于帕金森病、原发性震颤和癫痫的治疗。植入物的临床决策通常基于这样的前提，即患者将从传感技术的使用中受益。然而，心电图（ECG）污染等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的概率。
研究在启用感应功能的神经刺激系统中，ECG 活动对神经信号的污染情况，特别是研究对信号保真度有影响的临床选择，如植入物位置。
利用 85 名患者的电场建模和实际信号，研究植入物位置与 ECG 污染之间的关系。
植入物位置对神经记录的影响取决于 ECG 信号与电生理记录噪声基底之间的差异。从经验上看，与右侧植入物（15.3%）相比，左侧锁骨下植入物（48.3%）的 ECG 污染严重程度高出 3.2 倍以上。颅内置入物未显示 ECG 污染。
鉴于神经信号污染的相对频率，我们得出结论，植入物位置将影响脑传感设备用于“闭环”算法的能力。临床调整，如植入物位置，可能会显著影响信号完整性，需要加以考虑。
