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Brain-Computer Interface: High-impact Emerging Technology - What You Need to Know: Definitions, Adoptions, Impact, Benefits, Maturity, Vendors

Brain-Computer Interface: High-impact Emerging Technology - What You Need to Know: Definitions, Adoptions, Impact, Benefits, Maturity, Vendors

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Published by Emereo Publishing
A brain–computer interface (BCI), sometimes called a direct neural interface or a brain–machine interface (BMI), is a direct communication pathway between the brain and an external device. BCIs are often aimed at assisting, augmenting or repairing human cognitive or sensory-motor functions.

Research on BCIs began in the 1970s at the University of California Los Angeles (UCLA) under a grant from the National Science Foundation, followed by a contract from DARPA. The papers published after this research also mark the first appearance of the expression brain–computer interface in scientific literature.

The field of BCI research and development has since focused primarily on neuroprosthetics applications that aim at restoring damaged hearing, sight and movement. Thanks to the remarkable cortical plasticity of the brain, signals from implanted prostheses can, after adaptation, be handled by the brain like natural sensor or effector channels. Following years of animal experimentation, the first neuroprosthetic devices implanted in humans appeared in the mid-nineties.

This book is your ultimate resource for Brain-Computer Interface. Here you will find the most up-to-date information, analysis, background and everything you need to know.

In easy to read chapters, with extensive references and links to get you to know all there is to know about Brain-Computer Interface right away, covering: Brain–computer interface, Bereitschaftspotential, Brain implant, BrainGate, Neurotrophic electrode, Comparison of consumer brain–computer interfaces, Comparison of neurofeedback software, Cyberkinetics, Cyberware, Electrocorticography, Electroencephalography, Emotiv Systems, Force Trainer, Intracranial EEG, Mindball, Eduardo Reck Miranda, Neural Impulse Actuator, Neurochip, NeuroSky, Miguel Nicolelis, OpenVibe, Optogenetics, Thought recording and reproduction device, Transcranial alternating current stimulation, Neil Weste, Neuroprosthetics, Artificial pacemaker, Auditory brainstem implant, Biological pacemaker, Brain pacemaker, Giles Brindley, Jorge Cham, Chronic electrode implants, Cochlear implant, Deep brain stimulation, Diaphragmatic pacemaker, EABR, Exocortex, Functional electrical stimulation, Implantable cardioverter-defibrillator, Implantable Gastric Stimulation, Intracortical visual prosthesis, Prosthesis, Retinal implant, RNS System, Sacral anterior root stimulator, Sensory substitution, Thalamic stimulator, Vagus nerve stimulation, Visual prosthesis, Neural engineering, Cultured neuronal network, Neurally controlled animat, Neurotechnology Industry Organization, Spinal cord stimulator, Wirehead.

This book explains in-depth the real drivers and workings of Computer-Brain Interface. It reduces the risk of your technology, time and resources investment decisions by enabling you to compare your understanding of Computer-Brain Interface with the objectivity of experienced professionals.
A brain–computer interface (BCI), sometimes called a direct neural interface or a brain–machine interface (BMI), is a direct communication pathway between the brain and an external device. BCIs are often aimed at assisting, augmenting or repairing human cognitive or sensory-motor functions.

Research on BCIs began in the 1970s at the University of California Los Angeles (UCLA) under a grant from the National Science Foundation, followed by a contract from DARPA. The papers published after this research also mark the first appearance of the expression brain–computer interface in scientific literature.

The field of BCI research and development has since focused primarily on neuroprosthetics applications that aim at restoring damaged hearing, sight and movement. Thanks to the remarkable cortical plasticity of the brain, signals from implanted prostheses can, after adaptation, be handled by the brain like natural sensor or effector channels. Following years of animal experimentation, the first neuroprosthetic devices implanted in humans appeared in the mid-nineties.

This book is your ultimate resource for Brain-Computer Interface. Here you will find the most up-to-date information, analysis, background and everything you need to know.

In easy to read chapters, with extensive references and links to get you to know all there is to know about Brain-Computer Interface right away, covering: Brain–computer interface, Bereitschaftspotential, Brain implant, BrainGate, Neurotrophic electrode, Comparison of consumer brain–computer interfaces, Comparison of neurofeedback software, Cyberkinetics, Cyberware, Electrocorticography, Electroencephalography, Emotiv Systems, Force Trainer, Intracranial EEG, Mindball, Eduardo Reck Miranda, Neural Impulse Actuator, Neurochip, NeuroSky, Miguel Nicolelis, OpenVibe, Optogenetics, Thought recording and reproduction device, Transcranial alternating current stimulation, Neil Weste, Neuroprosthetics, Artificial pacemaker, Auditory brainstem implant, Biological pacemaker, Brain pacemaker, Giles Brindley, Jorge Cham, Chronic electrode implants, Cochlear implant, Deep brain stimulation, Diaphragmatic pacemaker, EABR, Exocortex, Functional electrical stimulation, Implantable cardioverter-defibrillator, Implantable Gastric Stimulation, Intracortical visual prosthesis, Prosthesis, Retinal implant, RNS System, Sacral anterior root stimulator, Sensory substitution, Thalamic stimulator, Vagus nerve stimulation, Visual prosthesis, Neural engineering, Cultured neuronal network, Neurally controlled animat, Neurotechnology Industry Organization, Spinal cord stimulator, Wirehead.

This book explains in-depth the real drivers and workings of Computer-Brain Interface. It reduces the risk of your technology, time and resources investment decisions by enabling you to compare your understanding of Computer-Brain Interface with the objectivity of experienced professionals.

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10/31/2014

Sections

  • Brain–computer interface
  • Bereitschaftspotential
  • Brain implant
  • BrainGate
  • Neurotrophic electrode
  • Comparison of consumer brain–computer interfaces
  • Comparison of neurofeedback software
  • Cyberkinetics
  • Cyberware
  • Electrocorticography
  • Electroencephalography
  • Emotiv Systems
  • Force Trainer
  • Intracranial EEG
  • Mindball
  • Eduardo Reck Miranda
  • Neural Impulse Actuator
  • Neurochip
  • NeuroSky
  • Miguel Nicolelis
  • OpenVibe
  • Optogenetics
  • Thought recording and reproduction device
  • Transcranial alternating current stimulation
  • Neil Weste
  • Neuroprosthetics
  • Artificial pacemaker
  • Auditory brainstem implant
  • Biological pacemaker
  • Brain pacemaker
  • Giles Brindley
  • Jorge Cham
  • Chronic electrode implants
  • Cochlear implant
  • Deep brain stimulation
  • Diaphragmatic pacemaker
  • EABR
  • Exocortex
  • Functional electrical stimulation
  • Implantable cardioverter-defibrillator
  • Implantable Gastric Stimulation
  • Intracortical visual prosthesis
  • Prosthesis
  • Retinal implant
  • RNS System
  • Sacral anterior root stimulator
  • Sensory substitution
  • Thalamic stimulator
  • Vagus nerve stimulation
  • Visual prosthesis
  • Neural engineering
  • Cultured neuronal network
  • Neurally controlled animat
  • Neurotechnology Industry Organization
  • Spinal cord stimulator
  • Wirehead (science fiction)
  • Article Sources and Contributors
  • Image Sources, Licenses and Contributors
  • License

Brain-Computer Interface

IN-DEPTH: THE REAL DRIVERS AND
WORKINGS

Kevin Roebuck

REDUCES THE RISK OF YOUR TECHNOLOGY, TIME AND RESOURCES
INVESTMENT DECISIONS

ENABLING YOU TO COMPARE YOUR
UNDERSTANDING WITH THE OBJECTIVITY OF EXPERIENCED PROFESSIONALS

High-impact Emerging Technology - What You Need to Know: Definitions, Adoptions, Impact, Benefits, Maturity, Vendors

Topic relevant selected content from the highest rated entries, typeset, printed and shipped. Combine the advantages of up-to-date and in-depth knowledge with the convenience of printed books. A portion of the proceeds of each book will be donated to the Wikimedia Foundation to support their mission: to empower and engage people around the world to collect and develop educational content under a free license or in the public domain, and to disseminate it effectively and globally. The content within this book was generated collaboratively by volunteers. Please be advised that nothing found here has necessarily been reviewed by people with the expertise required to provide you with complete, accurate or reliable information. Some information in this book maybe misleading or simply wrong. The publisher does not guarantee the validity of the information found here. If you need specific advice (for example, medical, legal, financial, or risk management) please seek a professional who is licensed or knowledgeable in that area. Sources, licenses and contributors of the articles and images are listed in the section entitled “References”. Parts of the books may be licensed under the GNU Free Documentation License. A copy of this license is included in the section entitled “GNU Free Documentation License” All used third-party trademarks belong to their respective owners.

Contents
Articles
Brain–computer interface Bereitschaftspotential Brain implant BrainGate Neurotrophic electrode Comparison of consumer brain–computer interfaces Comparison of neurofeedback software Cyberkinetics Cyberware Electrocorticography Electroencephalography Emotiv Systems Force Trainer Intracranial EEG Mindball Eduardo Reck Miranda Neural Impulse Actuator Neurochip NeuroSky Miguel Nicolelis OpenVibe Optogenetics Thought recording and reproduction device Transcranial alternating current stimulation Neil Weste Neuroprosthetics Artificial pacemaker Auditory brainstem implant Biological pacemaker Brain pacemaker Giles Brindley Jorge Cham Chronic electrode implants Cochlear implant 1 14 17 22 23 27 28 30 31 33 37 51 55 56 57 58 63 65 66 68 70 71 80 81 82 84 96 107 109 110 111 112 113 119

Deep brain stimulation Diaphragmatic pacemaker EABR Exocortex Functional electrical stimulation Implantable cardioverter-defibrillator Implantable Gastric Stimulation Intracortical visual prosthesis Prosthesis Retinal implant RNS System Sacral anterior root stimulator Sensory substitution Thalamic stimulator Vagus nerve stimulation Visual prosthesis Neural engineering Cultured neuronal network Neurally controlled animat Neurotechnology Industry Organization Spinal cord stimulator Wirehead (science fiction) 135 141 142 142 146 149 154 155 155 169 170 171 172 179 180 185 190 191 195 196 197 202 References Article Sources and Contributors Image Sources. Licenses and Contributors 203 207 Article Licenses License 209 .

whereas BCIs usually connect the brain (or nervous system) with a computer system. peripheral nerves—while the term "BCI" usually designates a narrower class of systems which interface with the central nervous system. which.[1] [2] The papers published after this research also mark the first appearance of the expression brain–computer interface in scientific literature. Research on BCIs began in the 1970s at the University of California Los Angeles (UCLA) under a grant from the National Science Foundation. followed by a contract from DARPA.000 people worldwide.[4] There are also several neuroprosthetic devices that aim to restore vision.Brain–computer interface 1 Brain–computer interface A brain–computer interface (BCI). Neuroprosthetics and BCIs seek to achieve the same aims. after adaptation. sight and movement. as of 2006. BCI versus neuroprosthetics Neuroprosthetics is an area of neuroscience concerned with neural prostheses—using artificial devices to replace the function of impaired nervous systems and brain related problems or sensory organs. BCIs are often aimed at assisting. Animal BCI research Several laboratories have managed to record signals from monkey and rat cerebral cortices in order to operate BCIs to carry out movement. and even cognitive function. Thanks to the remarkable cortical plasticity of the brain. The most widely used neuroprosthetic device is the cochlear implant. The terms are sometimes used interchangeably.[5] In May 2008 photographs that showed a monkey operating a robotic arm with its mind at the Pittsburgh University Medical Center were published in a number of well known science journals and magazines. hearing.[3] Following years of animal experimentation. Both use similar experimental methods and surgical techniques. The field of BCI research and development has since focused primarily on neuroprosthetics applications that aim at restoring damaged hearing. The differences between BCIs and neuroprosthetics are mostly in the ways the terms are used: neuroprosthetics typically connect the nervous system to a device. including retinal implants. augmenting or repairing human cognitive or sensory-motor functions. Practical neuroprosthetics can be linked to any part of the nervous system—for example. the first neuroprosthetic devices implanted in humans appeared in the mid-nineties. movement. ability to communicate. be handled by the brain like natural sensor or effector channels. Monkeys have navigated computer cursors on screen and commanded robotic arms to perform simple tasks simply by thinking about the task and without any motor output. such as restoring sight. is a direct communication pathway between the brain and an external device. has been implanted in approximately 100. sometimes called a direct neural interface or a brain–machine interface (BMI).[6] Other research on cats has decoded visual signals. Rats implanted with BCIs in Theodore Berger's experiments . signals from implanted prostheses can.

which decodes signals from the retina. By 2000. and their neuron firings were recorded. In the 1980s. Prominent research successes Phillip Kennedy and colleagues built the first intracortical brain–computer interface by implanting neurotrophic-cone electrodes into monkeys. But the monkeys could not see the arm moving and did not receive any feedback. Yang Dan and colleagues' recordings of cat vision using a BCI implanted in the lateral geniculate nucleus (top row: original image. and Andrew Schwartz. which control movement.[9] There has been rapid development in BCIs since the mid-1990s. Researchers targeted 177 brain cells in the thalamus lateral geniculate nucleus area. The team used an array of electrodes embedded in the thalamus (which integrates all of the brain’s sensory input) of sharp-eyed cats. Using mathematical filters. date back to the brain–computer interfacing 1970s. Phillip Kennedy. John Donoghue. remotely over Internet protocol.[7] Such work in the 1970s established that monkeys could quickly learn to voluntarily control the firing rates of individual and multiple neurons in the primary motor cortex if they were rewarded for generating appropriate patterns of neural activity. Nicolelis and his colleagues developed BCIs that decoded brain activity in owl monkeys and used the devices to reproduce monkey movements in robotic arms. Monkeys have advanced reaching and grasping abilities and good hand manipulation skills. Apostolos Georgopoulos at Johns Hopkins University found a mathematical relationship between the electrical responses of single motor-cortex neurons in rhesus macaque monkeys and the direction that monkeys moved their arms (based on a cosine function).[11] Similar results in humans have been since then achieved by researchers in Japan (see below). Berkeley decoded neuronal firings to reproduce images seen by cats. which could make it difficult to operate a BCI.Brain–computer interface 2 Early work The operant conditioning studies of Fetz and colleagues first showed that monkeys could learn to control the deflection of a biofeedback meter arm with neural activity. a so-called open-loop BCI. Such neural ensembles are said to reduce the variability in output produced by single electrodes.[10] Several groups have been able to capture complex brain motor centre signals using recordings from neural ensembles (groups of neurons) and use these to control external devices. including research groups led by Richard Andersen. the researchers decoded the signals to generate movies of what the cats saw and were able to reconstruct recognizable scenes and moving objects. researchers led by Yang Dan at University of California. Miguel Nicolelis. the group succeeded in building a BCI that reproduced owl monkey movements while the monkey [12] The BCI operated in real time and could also control a separate robot operated a joystick or reached for food. bottom row: recording) Miguel Nicolelis has been a prominent proponent of using multiple electrodes spread over a greater area of the brain to obtain neuronal signals to drive a BCI. .[8] Studies that developed algorithms to reconstruct movements from Monkey operating a robotic arm with motor cortex neurons. The cats were shown eight short movies. In 1999. After conducting initial studies in rats during the 1990s. making them ideal test subjects for this kind of work. He also found that dispersed groups of neurons in different areas of the brain collectively controlled motor commands but was only able to record the firings of neurons in one area at a time because of technical limitations imposed by his equipment.

[19] In addition to predicting kinematic and kinetic parameters of limb movements. The jury consists of world-leading BCI experts recruited by the . and Lebedev et al. In the context of a simple learning task. accurate. endowed with 3. These researchers were able to produce working BCIs even though they recorded signals from far fewer neurons than Nicolelis (15–30 neurons versus 50–200 neurons). 3 Diagram of the BCI developed by Miguel Nicolelis and colleagues for use on Rhesus monkeys Other labs that develop BCIs and algorithms that decode neuron signals include John Donoghue from Brown University. It is conceivable or even likely that such a sensor will be developed within the next twenty years. Andrew Schwartz from the University of Pittsburgh and Richard Andersen from Caltech.[21] The Annual BCI Award [22]. This work made possible creation of brain–machine interfaces — electronic devices that read arm movement intentions and translate them into movements of artificial actuators. including signals created when experimental animals anticipated receiving a reward. called BCI2000. Miguel Nicolelis et al. and robust access to brain signals.000 USD. USA. New York. The BCI used velocity predictions to control reaching movements and simultaneously predicted hand gripping force. is an accolade to recognize outstanding and innovative research done in the field of Brain-Computer Interfaces.[13] [14] The monkeys were later shown the robot directly and learned to control it by viewing its movements. In response to this problem. in virtual reality and also reproduced BCI control in a robotic arm.Brain–computer interface Later experiments by Nicolelis using rhesus monkeys succeeded in closing the feedback loop and reproduced monkey reaching and grasping movements in a robot arm.[14] argued that brain networks reorganize to create a new representation of the robotic appendage in addition to the representation of the animal's own limbs. With their deeply cleft and furrowed brains.[17] [18] Andersen's group used recordings of premovement activity from the posterior parietal cortex in their BCI. rhesus monkeys are considered to be better models for human neurophysiology than owl monkeys. showed that activity of large neural ensembles can predict arm position. Each year. The use of such a sensor should greatly expand the range of communication functions that can be provided using a BCI. illumination of transfected cells in the somatosensory cortex influenced the decision making process of freely moving mice.[16] The group created headlines when they demonstrated that a monkey could feed itself pieces of zucchini using a robotic arm controlled by the animal's own brain signals. Donoghue's group reported training rhesus monkeys to use a BCI to track visual targets on a computer screen with or [15] Schwartz's group created a BCI for three-dimensional tracking without assistance of a joystick (closed-loop BCI). BCI2000 has been in development since 2000 in a project led by the Brain–Computer Interface R&D Program at the Wadsworth Center of the New York State Department of Health in Albany. a renowned research laboratory is asked to judge the submitted projects and to award the prize.[13] programmed the neural coding in a brain–machine interface allowed a monkey to control reaching and grasping movements by a robotic arm. The biggest impediment of BCI technology at present is the lack of a sensor modality that provides safe. Gerwin Schalk has been developing a general-purpose system for BCI research. Dr. Development and implementation of a Brain–Computer Interface (BCI) system is complex and time consuming. The monkeys were trained to reach and grasp objects on a computer screen by manipulating a joystick while corresponding movements by a robot arm were hidden. Carmena et al. BCIs that predict electromyographic or electrical activity of muscles are being developed. A new 'wireless' approach uses light-gated ion channels such as Channelrhodopsin to control the activity of genetically defined subsets of neurons in vivo.[20] Such BCIs could be used to restore mobility in paralyzed limbs by electrically stimulating muscles.

Researchers at Emory University in Atlanta led by Philip Kennedy and Roy Bakay were first to install a brain implant in a human that produced signals of high enough quality to simulate movement.Brain–computer interface awarding laboratory. allowed Jerry to see shades of grey in a limited field of vision at a low being interviewed about his vision BCI on CBS's The Early Show frame-rate. BCIs focusing on motor neuroprosthetics aim to either restore movement in individuals with paralysis or provide devices to assist them. 4 Human BCI research Invasive BCIs Invasive BCI research has targeted repairing damaged sight and providing new functionality to persons with paralysis. Their patient. but shrinking electronics and faster computers made his artificial eye more portable and now enable him to perform simple tasks unassisted. causing the signal to become weaker or even lost as the body reacts to a foreign object in the brain. Jens Naumann. Dobelle's first prototype was implanted into "Jerry". invasive devices produce the highest quality signals of BCI devices but are prone to scar-tissue build-up. the 96-electrode BrainGate implant allowed Nagle to . eventually learning to control a computer cursor. Dummy unit illustrating the design of a BrainGate interface Tetraplegic Matt Nagle became the first person to control an artificial hand using a BCI in 2005 as part of the first nine-month human trial of Cyberkinetics Neurotechnology’s BrainGate chip-implant. direct brain implants have been used to treat non-congenital (acquired) blindness. Jens was able to use his imperfectly restored vision to drive slowly around the parking area of the research institute. One of the first scientists to come up with a working brain interface to restore sight was private researcher William Dobelle.[23] In 2002. such as interfaces with computers or robot arms. Initially. Ray’s implant was installed in 1998 and he lived long enough to start working with the implant. In vision science. marking one of the earliest commercial uses of BCIs. A single-array BCI containing 68 electrodes was implanted onto Jerry’s visual cortex and succeeded in producing phosphenes. in 1978. Implanted in Nagle’s right precentral gyrus (area of the motor cortex for arm movement). he died in 2002 of a [24] brain aneurysm. As they rest in the grey matter. This also required him to be hooked up to a two-ton mainframe. Immediately after his implant. the implant Jens Naumann. Phosphenes are spread out across the visual field in what researchers call the starry-night effect. suffered from ‘locked-in syndrome’ after suffering a brain-stem stroke in 1997. Johnny Ray (1944–2002). a man with acquired blindness. Invasive BCIs are implanted directly into the grey matter of the brain during neurosurgery. a man blinded in adulthood. the sensation of seeing light. The system included cameras mounted on glasses to send signals to the implant. also blinded in adulthood. became the first in a series of 16 paying patients to receive Dobelle’s second generation implant. The second generation device used a more sophisticated implant enabling better mapping of phosphenes into coherent vision.

the only manner to acquire the signal for study is through the use of patients requiring invasive monitoring for localization and resection of an epileptogenic focus.[27] This research indicates that control is rapid.[26] ECoG technologies were first trialed in humans in 2004 by Eric Leuthardt and Daniel Moran from Washington University in St Louis. but the electrodes are embedded in a thin plastic pad that is placed above the cortex. dispersing and blurring the electromagnetic waves created by the neurons. the laser light pattern and wavelengths it reflects would change slightly. (Note: These electrodes were not implanted in the patients for BCI experiments. They produce better resolution signals than non-invasive BCIs where the bone tissue of the cranium deflects and deforms signals and have a lower risk of forming scar-tissue in the brain than fully-invasive BCIs. professor Jonathan Wolpaw received the prize of the Altran Foundation for Innovation to develop a Brain Computer Interface with electrodes located on the surface of the skull. The patient was suffering from severe epilepsy and had the electrodes temporarily implanted to help his physicians localize seizure foci.) Light Reactive Imaging BCI devices are still in the realm of theory. and probably superior long-term stability than intracortical single-neuron recording. lower clinical risk. This would allow researchers to monitor single neurons but require less contact with tissue and reduce the risk of scar-tissue build-up.[25] One year later. lights and TV. better signal-to-noise ratio. Although they are easy to wear. 5 Partially-invasive BCIs Partially invasive BCI devices are implanted inside the skull but rest outside the brain rather than within the grey matter. Electrocorticography (ECoG) measures the electrical activity of the brain taken from beneath the skull in a similar way to non-invasive electroencephalography (see below). . but is not taken from within the brain parenchyma itself.Brain–computer interface control a robotic arm by thinking about moving his hand as well as a computer cursor. In a later trial. This signal can be either subdural or epidural. the researchers enabled a teenage boy to play Space Invaders using his ECoG implant. non-invasive implants produce poor signal resolution because the skull dampens signals. Signals recorded in this way have been used to power muscle implants and restore partial movement in an experimental volunteer. Non-invasive BCIs As well as invasive experiments. Currently. there have also been experiments in humans using non-invasive neuroimaging technologies as interfaces. beneath the dura mater. and lesser training requirements than scalp-recorded EEG. the researchers simply took advantage of this. These would involve implanting a laser inside the skull. Although the waves can still be detected it is more difficult to determine the area of the brain that created them or the actions of individual neurons. It has not been studied extensively until recently due to the limited access of subjects. wider frequency range. ECoG is a very promising intermediate BCI modality because it has higher spatial resolution. This feature profile and recent evidence of the high level of control with minimal training requirements shows potential for real world application for people with motor disabilities. and may be an ideal tradeoff with regards to signal fidelity and level of invasiveness. instead of directly in the brain. When the neuron fires. requires minimal training. The laser would be trained on a single neuron and the neuron's reflectance measured by a separate sensor. and at the same time has lower technical difficulty.

and (4) cognitive event-related potentials. In 2000.[30] In the early 90s Babak Taheri. restoring some 6 . Lawrence Farwell and Emanuel Donchin developed an EEG-based brain–computer interface in the 1980s. Niels Birbaumer of the University of Tübingen in Germany trained severely paralysed people to self-regulate the slow cortical potentials in their EEG to such an extent that these signals could be Recordings of brainwaves produced by an used as a binary signal to control a computer cursor. (2) no skin preparation. below average off. By contrast. Birbaumer's later research with Jonathan Wolpaw at New York State University has focused on developing technology that would allow users to choose the brain signals they found easiest to operate a BCI. for example. no gel requirements (dry). researchers at Case Western skin preparation. As well as enabling Jatich to control a computer cursor the signals were also used to drive the nerve controllers embedded in his hands. A basic pattern was identified and used to control a switch: Above average activity was set to on. The process was slow. The performance of the dry electrode compared favorably with that of the standard wet Ag/AgCl electrodes in terms of [32] In 1999.) The experiment saw ten patients trained to move a computer cursor by controlling their brainwaves. ease of use. The device consisted of four sites of sensors with integrated electronics to reduce noise by impedance matching. research by Jessica Bayliss at the University of Rochester showed that volunteers wearing virtual reality helmets could control elements in a virtual world using their P300 EEG readings. Patterns of P300 waves are generated involuntarily (stimulus-feedback) when people see something they recognize and may allow BCIs to decode categories of thoughts without training patients first. including turning lights on and off and bringing a mock-up car to a stop.[28] (Birbaumer electroencephalogram had earlier trained epileptics to prevent impending fits by controlling this low voltage wave. mainly due to its fine temporal resolution. including mu and beta rhythms. But as well as the technology's susceptibility to noise. at UC DAVIS demonstrated the first single and also multichannel dry active electrode arrays using micro-machining. and simple commands to a computer and thereby to speak through a speech synthesizer driven by the computer. The single channel dry EEG electrode construction and results were published in 1994. (3) significantly reduced sensor size. A number of similar devices have been developed since then. portability and low set-up cost. and (4) compatibility with EEG monitoring systems. The active electrode array is an integrated system made of an array of capacitive sensors with local integrated circuitry housed in a package with batteries to power the circuitry. another substantial barrier to using EEG as a brain–computer interface is the extensive training required before users can work the technology. requiring more than an hour for patients to write 100 characters with the cursor. including one paralyzed Locked-In syndrome patient. used 64-electrode EEG skullcap to return limited hand movements to quadriplegic Jim Jatich. The advantages of such electrodes are: (1) no electrolyte used. A further parameter is the method of feedback used and this is shown in studies of P300 signals.Brain–computer interface EEG Electroencephalography (EEG) is the most studied potential non-invasive interface. the biofeedback methods described above require learning to control brainwaves so the resulting brain activity can be detected. The electrode was tested on an electrical test bench and on human subjects in four modalities of EEG activity. Another research parameter is the type of waves measured. while training often took many months. namely: (1) spontaneous EEG. letters. to communicate words. his beta-rhythm EEG output was analysed using software to identify patterns in the noise. (3) brain stem potentials.[31] The arrayed electrode was also demonstrated to perform well compared to Ag/AgCl electrodes. This level of integration was required to achieve the functional performance obtained by the electrode. For example.[29] Their "mental prosthesis" used the P300 brainwave response to allow subjects. As Jatich concentrated on simple but opposite concepts like up and down. Reserve University led by Hunter Peckham. in experiments beginning in the mid-1990s. (2) sensory event-related potentials. and higher signal-to-noise ratio.

fMRI allowed two users being scanned to play Pong in real-time by altering their haemodynamic response or brain blood flow through biofeedback techniques.[41] 7 fMRI (top row: original image. MEG and MRI Magnetoencephalography (MEG) and functional magnetic resonance imaging (fMRI) have both been used successfully as non-invasive BCIs. weighted the electrodes with Common Spatial Patterns. calculated the running variance and used a linear discriminant analysis [38] .[34] Experiments by Eduardo Miranda aim to use EEG recordings of mental activity associated with music to allow the disabled to express themselves musically through an encephalophone.[43] [44] ATR Labs' reconstruction of human vision using Commercialization and companies John Donoghue and fellow researchers founded Cyberkinetics. and even view or record dreams.[33] Electronic neural networks have been deployed which shift the learning phase from the user to the computer. [36] [37] The first BCI session with 100 % accuracy (based on 80 right hand and 80 left hand movement imaginations) was recorded 1998 by Christoph Guger. The BCI system used 27 electrodes overlaying the sensorimotor cortex. Avery Biomedical Devices [46]. As well as an invasive BCI. Experiments by scientists at the Fraunhofer Society in 2004 using neural networks led to noticeable improvements within 30 minutes of training.Brain–computer interface movement. The company markets its electrode arrays under the BrainGate product name and has set the development of practical BCIs for humans as its major goal. and Stony Brook University are continuing development of the implant. which has not yet received Food and Drug Administration approval in the United States for human implantation. A company controlled by Dobelle. The article announcing these achievements was the cover story of the journal Neuron of 10 December 2008. the company also sells an implant to restore speech. The Audeo is being developed to create a human–computer interface for communication without the need of .[40] fMRI measurements of haemodynamic responses in real time have also been used to control robot arms with a seven second delay between thought and movement. according to the researchers further development of the technology may make it possible to achieve color images. demoed a product they have in development call The Audeo. The Epoc uses electromagnetic sensors.[47] Ambient. Japan allowed the scientists to reconstruct images directly from the brain and display them on a computer. at a TI developers conference in early 2008. The BrainGate is based on the Utah Array developed by Dick Normann. Although 16 paying patients were treated using William Dobelle's vision BCI. since December 2009. new implants ceased within a year of Dobelle's death in 2004. research developed in the Advanced reconstruction from mean of combined readings) Telecommunications Research (ATR) Computational Neuroscience Laboratories in Kyoto.[39] In a widely reported experiment.[42] While the early results are limited to black and white images of 10x10 squares (pixels). known as the Epoc.[35] The Emotiv company has been selling a commercial video game controller. bottom row: More recently. Neural Signals' Brain Communicator BCI device uses glass cones containing microelectrodes coated with proteins to encourage the electrodes to bind to neurons. [45] in 1987 to develop BCIs that would allow paralysed patients to Philip Kennedy founded Neural Signals communicate with the outside world and control external devices.

tec [52]. Starlab [53]. has entered this market in 2009 with a wireless 4-channel system called Enobio. including the P300 Speller.Brain–computer interface physical motor control or speech production.and PC-users: • Neural Impulse Actuator (April. . constructing basic computers and manipulating robotic devices. 2008) • Emotiv Systems (December.[48] Mindball is a product developed and commercialized by Interactive Productline in which players compete to control a ball's movement across a table by becoming more relaxed and focused. let the computer speak the written text. Designed for research purposes the system provides a platform for application development. the research is focused on military uses. Besides writing a text the patient can also use the system to trigger an alarm. 2009) 2010 the world's first personal EEG-based spelling system came to the market: intendiX [55]. As well as furthering research on animal implantable devices. Guger Technologies. Uncle Milton Force Trainer – Fall 2009.[56] As of 2009.[50] An Austrian company. Research into techniques for stimulating and recording from individual neurons grown on semiconductor chips is sometimes [57] referred to as neuroelectronics or neurochips.[49] Interactive Productline is a Swedish company whose objective is to develop and sell easy understandable EEG products that train the ability to relax and focus. 8 Artificial telepathy Research is ongoing into synthetic or computer-mediated telepathy which would allow user-to-user communication through analysis of neural signals.[54] There are three main consumer-devices commercial-competitors in this area (launch date mentioned in brackets) which have launched such devices primarily for gaming. The company provides base BCI models as development platforms for the research community to build upon. and mu-rhythm. They commercialized a Steady State Visual Evoked Potiential BCI solution in 2008 with 4 degrees of machine control. experiments on cultured neural tissue have focused on building problem-solving networks. print out or copy the text into an e-mail or to send commands to external devices. 2009) • NeuroSky (MindSet – June. and to see if the patterns are generalizable. using EEG. 2009.[56] The research aims to detect and analyze the word-specific neural signals. unpronounced speech representing the thought of the mind can be translated from intercepted neurological signals. which occur before speech is vocalized.[56] Cell-culture BCIs Researchers have built devices to interface with neural cells and entire neural networks in cultures outside animals. Mattel MindFlex – Summer. has been offering Brain Computer Interface systems since 1999.[51] g. A Spanish company. Using signal processing. Motor Imagery. It works with 8 active EEG electrodes and uses the P300 principle to type on a keyboard like matrix.

[58] The Caltech chip had room for 16 neurons. who is responsible for erroneous actions with a neuroprosthesis). shared responsibility of BCI teams (e. neurofeedback of sensorimotor rhythm training is reported to affect sleep quality). the cortical neurons were cultured in a petri dish and rapidly began to reconnect themselves to form a living neural network. the consequences of BCI technology for the quality of life of patients and their families. Emory University neuroscience professor Michael Crutcher has expressed concern about BCIs. it puts everyone else at a disadvantage. he suggests that bioethics is well-prepared to deal with the issues that arise with BCI technologies. Important topics in the neuroethical debate are:[61] [62] [63] • • • • • • • • • • • • • obtaining informed consent from people who have difficulty communicating. selective enhancement and social stratification. personal responsibility and its possible constraints (e. mind-reading and privacy. In 2003.[61] Moreover. The study's focus was on understanding how the human brain performs and learns computational tasks at a cellular level. . and could theoretically be used to modify other behaviours. Furthermore. questions of research ethics that arise when progressing from animal experimentation to application in human subjects. standard protocols can be implemented to ensure ethically sound informed-consent procedures with locked-in patients. how to ensure that responsible group decisions can be made). specifically ear and [64] Clausen concluded in 2009 eye implants: "If only the rich can afford it. The neurochip was designed to function in rat brains and is intended as a prototype for the eventual development of higher-brain prosthesis. risk/benefit analysis.g.Brain–computer interface Development of the first working neurochip was claimed by a Caltech team led by Jerome Pine and Michael Maher in 1997. therapeutic applications and their possible exceedance. even though there are several commercially available systems such as brain pacemakers used to treat neurological conditions.000 neurons taken from a rat's brain to fly a F-22 fighter jet aircraft simulator.[60] After collection. mind-control. The hippocampus was chosen because it is thought to be the most ordered and structured part of the brain and is the most studied area. side-effects (e. but these are conceptually similar to those that bioethicists have addressed for other realms of therapy”. Its function is to encode experiences [59] for storage as long-term memories elsewhere in the brain. issues concerning personality and personhood and its possible alteration. and communication to the media. Haselager and colleagues[62] pointed out that expectations of BCI efficacy and value play a great role in ethical analysis and the way BCI scientists should approach media. a team led by Theodore Berger at the University of Southern California started work on a neurochip designed to function as an artificial or prosthetic hippocampus. Ethical considerations There has not been a vigorous debate about the ethical implications of BCIs.g. 9 World first: Neurochip developed by Caltech researchers Jerome Pine and Michael Maher Thomas DeMarse at the University of Florida used a culture of 25." that “BCIs pose ethical challenges. The cells were arranged over a grid of 60 electrodes and used to control the pitch and yaw functions of the simulator.g.

IEEE Proceedings 65: 633–641. pdf). IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society 8 (2): 180–5. Pitt Chronicle. appropriately moderated enthusiasm in media coverage and education about BCI systems will be of utmost importance for the societal acceptance of this technology.1977. a game designed to create the illusion of possessing the force. Schwartz. References [1] Vidal. doi:10. ucla. J. chronicle. Passaro. M. LA. MA. Retrieved 2009-07-06. some of these toys have been extremely commercially successful like the NeuroSky and Mattel MindFlex. Trends in neurosciences 29 (9): 536–46. PMID 4583653. which can be dampened with a saline solution for a better connection. Petrides.2911737.1016/j.060173. NeuroSky. Schuh.[67] • In 2008 OCZ Technology developed device for use in video games relying primarily on electromyography. "Mental rotation of the neuronal population vector". DA et al. "Brain-machine interfaces: past. . MA (2006).". pdf).[72] • In 2010 NeuroSky added an electromyography function for recognising eye blink to the MindSet. doi:10.02.1126/science. See brain implants in fiction and philosophy for a review of this literature. Kushwaha. doi:10. This technology has been built into toys and gaming devices. rebuilt the technology from the ground up) to create inexpensive BCIs. uu.Brain–computer interface Researchers are well aware that sound ethical guidelines. "Monkey Uses Brain Power to Feed Itself With Robotic Arm" (http:/ / www. [7] Fetz. JJ (1973). .[68] [69] • In 2009 Mattel partnered with NeuroSky to release the Mindflex. PMID 10896180. Science 163 (870): 955.tins. Annual review of biophysics and bioengineering 2: 157–80. "University of Michigan News Service" (http:/ / www. E. Lurito. a 14 channel EEG device.".. [2] J. E.[68] [70] • In 2009 Uncle Milton Industries partnered with NeuroSky to release the Star Wars Force Trainer.10542. development and dissemination. (1969). html?Releases/ 2006/ Feb06/ r020606a).1016/0014-4886(78)90252-2. PMID 101388. "A direct brain interface based on event-related potentials. RK. [3] Levine. "Operant Conditioning of Cortical Unit Activity". JS. PMID 2911737. A.bb.001105. pitt. McIntosh.[66] • In 2007 NeuroSky released the first affordable consumer based EEG along with the game NeuroBoy. "Real-Time Detection of Brain Events in EEG" (http:/ / www. [10] Lebedev." (http:/ / www.[68] [71] • In 2009 Emotiv released the EPOC. (1989). This was also the first large scale EEG device to use dry sensor technology. Bak.07. [5] Miguel Nicolelis et al. (2000). SL. "Fine control of operantly conditioned firing patterns of cortical neurons. "Toward direct brain-computer communication". 2006. . PMID 4974291. Science 243 (4888): 234. Massey. Bement. Rohde. Retrieved February 6. umich. EM. Ross. cs.. .[73] Theme in fiction The prospect of BCIs and brain implants of all kinds have been important themes in science fiction.004. By far the best selling consumer based EEG to date. SP. PMID 16859758.1146/annurev. [9] Georgopoulos. cs. (2001) Duke neurobiologist has developed system that allows monkeys to control robot arms via brain signals (http:/ / www. • In 2006 Sony patented a neural interface system allowing radio waves to affect signals in the neural cortex. doi:10. Judecca. MJ (1978).1126/science.1109/PROC. MM. Thus. Huggins. doi:10. edu/ news/ index. [4] Laura Bailey. J. Michele (2008=09-06). Vidal (1977). L. edu/ ~vidal/ Real_Time_Detection.163. Experimental neurology 61 (2): 349–69.955. present and future. • In 2008 the Final Fantasy developer Square Enix announced that it was partnering with NeuroSky to create a game. JE.3870.. Durelli. The EPOC is the first commercial BCI to use dry sensor technology. Nicolelis. org/ AboutUs/ Facts_and_Statistics/ historical_highlights/ index/ view) [6] Baum.[65] 10 BCI based toys Recently a number of companies have scaled back medical grade EEG technology (and in one case. a game that used an EEG to steer a ball through an obstacle course. . edu/ ?p=1478). dukemedicine. [8] Schmidt. recently more effort is made inside the BCI community to create consensus on ethical guidelines for BCI research.2006. A. nl/ docs/ vakken/ mmpi/ papers/ Lebedev 2006. EA. doi:10.

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com/news180620740.org/downloads.. 16 September 2002. article on Jim Jatich’s implant • Controlling robots with the mind (http://touchlab.com/neuro/ journal/v9/n10/full/nn1768.html) Wired Magazine. article on Matt Nagle .mit. 2004. academic paper on a cell-culture BCI Functional alignment of feedback effects from visual cortex to thalamus (http://www.physorg.net/doc/) and Programmable chip version (http://pceeg.08/assist_pr. article on cell-culture BCI How to talk when you can't speak (http://www.nlm.uk/sciencetech/ article-1346900/The-app-read-mind-iPhone-brainwave-detector-matter-time. Wired Magazine. article on artificial vision 'Brain' in a dish flies flight simulator (http://www.org/doi/abs/10.com/id/2113353/).html) PhysOrg. August 2001.Brain–computer interface 13 External links Portals • The open-source Electroencephalography project (http://openeeg. • Monkey Neural Interfacing (http://danshope. Journal of Neuroscience Research. Team PhyPA's public hub for BCI data exchange Articles • The app that can read your mind: iPhone brainwave detector arrives (http://www. 10 February 2005.co.ncbi.com/wired/archive/13.html) Nature Neuroscience 9. a survey • • • .fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15079856). recent advances in decoding LGN visual signals Lymnaea stagnalis and the development of neuroelectronic technologies (http://www.dailymail.html). Journal of Neurosurgery.ncbi.edu/news/documents/ScinetificAmerican_2002. fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15961304).com/news/showarticle. Sourceforge open source EEG projects • BCI database (http://www.03/brain.nlm. 17 September 2006.sourceforge.09/vision.. by Lisa Zyga.sourceforge. December 21. CNN. Monkeys Consciously Control A Robot Arm Using Only Brain Signals • The Next Brainiacs (http://www.com.com/2004/TECH/11/02/brain.wired. September 2002.php?article_id=10).nature. academic paper on a cell-culture BCI Evolution of brain-computer interfaces: going beyond classic motor physiology (http://thejns.a step towards neuron-based functional chips (http://www. 4 November 2004.nih.com/wired/archive/9. July 2009.html).phypa. Biosens Bioelectron. January 2006.html).FOCUS0979).gov/entrez/query. • Machine Translates Thoughts into Speech in Real Time (http://www.nih. Wired Magazine. 3171/2009.gov/ entrez/query.net/).com/wired/archive/10. January 15.4. article on using EEG to communicate with minimally conscious patients Mind Control (http://www. 2011. • • • • • Scientific American.dish/). 1330-1336 (2006). March 2005. UK. Slate.wired. article on Miguel Nicolelis Vision quest (http://www.html) Daily Mail.slate.wired.cnn. 2009.pdf).

[3] After detailed investigation and control experiments such as passive finger movements the Citation Classic with the term Bereitschaftspotential was published. It was first recorded and reported in 1964 by Hans Helmut Kornhuber and Lüder Deecke at the University of Freiburg in Germany.Brain–computer interface 14 Lectures and videos • "Brain–Computer Interfaces" video lecture (http://www. Sitting alone in the beautiful garden they discussed their frustration with the passive brain research prevailing worldwide and their desire to investigate self-initiated action of the brain and the will.youtube. A potential preceding human voluntary movement was discovered and published in the same year.com/watch?v=I7lmJe_EXEU) by Krishna Shenoy (Stanford University) • "Brain–Computer Interfaces" video lecture (http://www. In 1965 the full publication appeared after many control experiments. university hospital Freiburg im Breisgau) and Lüder Deecke (his doctoral student) went for lunch to the 'Gasthaus zum Schwanen' at the foot of the Schlossberg hill in Freiburg. except of an inconstant diminution of the α. primitive instrument available at that time in the Freiburg laboratory. the Bereitschaftspotential or BP (from German. literally turning the tape over for analysis since they had no reversal playback or programmable computer. The young researchers stored the electroencephalogram and electromyogram of self-initiated movements (fast finger flexions) on tape and analyzed the cerebral potentials preceding movements time-reversed with the start of the movement as the trigger.[1] . In the electroencephalogram little is to be seen preceding actions.org/prog/displayevent. The BP is a manifestation of cortical contribution to the pre-motor planning of volitional movement. is a measure of activity in the motor cortex of the brain leading up to voluntary muscle movement.' the first. "readiness potential"). also called the pre-motor potential or readiness potential (RP).researchchannel. aspx?rID=4931&fID=345) by Brendan Allison (now with the Brain–Computer Interfaces Laboratory at the Technical University of Graz) Bereitschaftspotential In neurology. head Professor Richard Jung.(or μ-) rhythm.[1] Discovery In the spring of 1964 Hans Helmut Kornhuber (then docent and chief physician at the department of neurology. Consequently they decided to look for cerebral potentials in man related to volitional acts and to take voluntary movement as their research paradigm.[2] The possibility to do research on electrical brain potentials preceding voluntary movements came with the advent of the 'computer of average transients.

C. relating the electrical potentials to the onset of the movement it becomes apparent. knee. writing and also swallowing.[6] The magnetoencephalographic (MEG) equivalent of the Bereitschaftspotential (BP). was hostile to freedom in those years. which is especially difficult preceding speech movements. arm. The tradition of behaviourism and Freudism was deterministic.. or CNV. these are unipolar recordings with linked ears as reference. Recording positions are left precentral (L prec. the BP has been recorded accompanying willful movements of the wrist. Canada in 1982. foot and toes.5 to shortly before 0 sec. Figure shows the typical slow shifts of the cortical DC potential.[9] Outcomes The Bereitschaftspotential was received with great interest by the scientific community. 'Bereitschafts(magnetic)field' (BF). Superimposed are the results of eight experiments as obtained in the same subject (B. Note that the BP has two components. [8] Another ERP component which was discovered in 1964 is the contingent negative variation. the early one (BP1) lasting from about −1. shoulder. While will and . it was believed that freedom is an illusion. while the late component. mouth-movements and respiration have to be eliminated before averaging because such artifacts may be of a magnitude which makes it difficult to render them negligible even after hundreds of sweeps. mid-parietal (Pz). BP2 or BF2. hip. lid-. The terminal CNV has similar characteristics as the BP and many researchers have claimed that the BP and the terminal CNV are the same component. BP 1 or BF1.) on different days.[11] The spirit of the time.[7] It was confirmed that the early component. or readiness field (RF) was first recorded in Hal Weinberg's laboratory at Simon Fraser University Burnaby B. and the motor-potential which starts about fifty to sixty milliseconds before the onset of movement and has its maximum over the contralateral precentral hand area is still smaller. the initial wave (i. MI.. it took many years until some of the other laboratories were able to confirm the details of Kornhuber & Deecke's results.[10] The interest was even greater in psychology and philosophy because volition is traditionally associated with human freedom (cf. however. In some cases animal experiments were necessary to clarify the origin of potentials such as the R-wave.e. preceding volitional.2 to −0. was generated by the primary motor area. The difference between the BP in C3 and in C4 is displayed in the lowest graph (L/R prec). The vertical line indicates the instant of triggering t = 0 (first activity in the EMG of the agonist muscle). Thus. only by averaging. rapid flexions of the right index finger. The CNV also composes two waves. right precentral (R prec. It was also recorded prior to speaking. including the pre-SMA.L. E wave). Kornhuber 1984).[5] In the case of eye movements eye muscle potentials have to be distinguished from cerebral potentials. O wave) and the terminal wave (i. respectively was generated by the supplementary motor area (SMA). Therefore. C4). eye-.[4] The pre-motion positivity is even smaller.5. as reflected by Sir John Eccles's comment: “There is a delightful parallel between these impressively simple experiments and the experiments of Galileo Galilei who investigated the laws of motion of the universe with metal balls on an inclined plane”. called Bereitschaftspotential. Furthermore artifacts due to head-.Bereitschaftspotential 15 Mechanism The BP is ten to hundred times smaller than the α-rhythm of the EEG. the late component (BP2) from −0. C3). Other researchers have shown that they can be disassociated.e. it takes great care to see Typical recording of a Bereitschaftspotential these potentials: exact triggering by the real onset of movement is important. In addition to the finger or eye movements as mentioned above.

motor and sensory processes of the brain: Electrical potentials.L. Hirnpotentialänderungen bei Willkürbewegungen und passiven Bewegungen des Menschen: Bereitschaftspotential und reafferente Potentiale. Deecke. [12] Heckhausen. [11] Kornhuber. L.' Libet concludes that we have no free will in the initiation of our movements. the Smith predictor has been suggested in the discussion).. Schöpf A. Perspektiven einer Psychologie des Wollens.[15] and found that the BP started about 0. Magnetic fields of the human brain accompanying voluntary movement. for example control of computer displays or control of peripheral motor units in spinal cord injuries. Deecke. Gould. Jenseits des Rubikon: Der Wille in den Humanwissenschaften.. Readiness for movement – The Bereitschaftspotential-Story. Zürich. as are system analysis. L. L. [6] Huckabee.. (1978). eds. Brickett. Biol Cybern 23: 99–119.. H.[17] Applications An interesting use of the Bereitschaftspotential is in Brain-Computer Interface (BCI) applications. behaviour and clinical use. after the end of the second world war this declined. [5] Grözinger. upenn. pp 798–804 in Kornhuber H. eds. Deecke. The Bereitschaftspotential preceding the act of speaking.[18] References [1] Kornhuber. Von der Freiheit pp 83–112 in Lindauer M.P. Westphal.C.... J.. [8] Walter. Exp. Hirnpotentialänderungen beim Menschen vor und nach Willkürbewegungen. V. which starts activity prior to the primary motor area. Brain Res. Cannito. Berlin. H. Geistes und Naturwissenschaftler im Dialog. J.G. K. R. Kornhuber H. H. An electrical sign of participation of the mesial “supplementary” motor cortex in human voluntary finger movement.P.H.. M.. H. [9] Tecce.J. H. [10] Eccles.. garfield. (1980). Elsevier.. L.H. (1964). Fühlens und Handelns. Cortical control mechanisms in volitional swallowing: the Bereitschaftspotential. this signal feature can be identified from scalp recording (even from single-trial measurements) and interpreted for various uses.[14] EEGs and EMGs are used in combination with Bayesian inference to construct Bayesian networks which attempt to predict general patterns of Motor Intent Neuron Action Potentials firing.H.C. H. Contingent Negative Variation: an electric sign of sensorimotor association and expectancy in the human brain.H. since subjects were able to prevent intended movement at the last moment. Benjamin Libet studied the relationship between conscious experience of volition and the BP e.H..g. edu/ classics1990/ A1990CH18100001. et al. (explanation needed!) 16 BP and free will In a series of experiments in the 1980s. Deecke L. L. (1972). (1990). B. L. Contingent negative variation (CNV) and psychological processes in man. Pflügers Arch Eur J Physiologie 281: 52. J. W. 4 Citation Classics January 22: 14. pdf) [3] Kornhuber.. Bereitschaftsmagnetfeld. (1987). pp 121–142 in Heckhausen. [4] Deecke. W. we do have a veto. (http:/ / www.. J. library.T. (1965).J. dargestellt mit Magnetbandspeicherung und Rückwärtsanalyse. W.. Kornhuber. Ernst Klett Stuttgart. Wie erkennt der Mensch die Welt? Grundlagen des Erkennens. Psychological Bulletin 77: 73-108.. (1984). P. B. H. (1982). Pflügers Arch 284: 1–17 "Citation Classic". McCallum. Brain Res 159: 473–476. (1980) Gehirn und Geist. H. Brain Topogr. 48: 144–148. . eds. 2010).. Kindler. the closing chapter in the recent book "The Bereitschaftspotential"). H. Deecke.[16] See also the recent extensive critique by Klemm. though.J. H.. [2] Kornhuber. Grözinger. Winter.[12] The BP is an electrical sign of participation of the supplementary motor area (SMA) prior to volitional movement. Voluntary finger movement in man: Cerebral potentials and theory. Researchers attempting to develop non-intrusive brain-machine interfaces are interested in this. Szirtes.. Springer.L. Current Contents Life Sciences 33. H..35 sec earlier than the subject's reported conscious awareness that 'now he or she feels the desire to make a movement. Aldridge. M. and epistemology (e. Weinberg. Kriebel.Bereitschaftspotential volition were frequently leading concepts in psychological research papers before and after the first world war and even during the second war. Cooper. Progr Brain Res 54.. Kornhuber.[13] The BP has preciptated a worldwide discussion about free will (cf. Zeier. 16: 3–17 (2003). L.H. Mayr. A. Motivation.g. Nature 203: 380-384. These studies have provoked widespread debate.H.. and by the mid-sixties these key words completely disappeared and were abolished in the thesaurus of the American Psychological Association. operations research. (1964).H. Amsterdam. [7] Deecke. [13] Deecke. Also an analysis of artifacts.. (1976).

Bielefeld/Locarno.. Kluwer Academic / Plenum Publishers [ISBN 0-306-47407-7] pp. or attached to the brain's cortex. Human freedom.nih. Not so fast. H.. R. block[1] or record (or both record and stimulate simultaneously[2] ) signals from single neurons or groups of neurons (biological neural networks) in the brain.cmds. 283–320. Zhang. The blocking technique is called intra-abdominal vagal blocking[1] . movement-related cortical potentials. (2003). A.edu/homes/rao/shenoy_rao05.. L.usually placed on the surface of the brain.) Neural-implants such as deep brain stimulation and Vagus nerve stimulation are increasingly becoming routine for patients with Parkinson's disease and clinical depression respectively.H.) The Bereitschaftspotential. IEEE Transactions on Biomedical Engineering 51(6): 1081–1086. Y. Edition Sirius. Some brain implants involve creating interfaces between neural systems and computer chips.ac. 283–320. M Hallett (Eds.. F. Kluwer Academic / Plenum Publishers [ISBN 0-306-47407-7] pp. (2003). Z. M. This includes sensory substitution. The Bereitschaftspotential story... This work is part of a wider research field called brain-computer interfaces.pdf • MeSH Bereitschaftspotential (http://www.pdf • http://www. . L.nlm. Behav & Brain Sci 8: 529–566. are technological devices that connect directly to a biological subject's brain . [18] Wang. and the brain. BCI competition 2003-data set IV: An algorithm based on CSSD and FDA for classifying single-trial EEG. The Bereitschaftspotential story. (Brain-computer interface research also includes technology such as EEG arrays that allow interface between mind and machine but do not require direct implantation of a device.6: 47-65. Purpose Brain implants electrically stimulate. the application of brain implants has been seriously limited until recent advances in neurophysiology and computer processing power. Y. reasoned will. often referred to as neural implants. in vision.washington. In: M Jahanshahi. Kornhuber. B.g. On some bold neuroscientific claims concerning human angency. proving themselves as a boon for people with diseases which were previously regarded as incurable..) The Bereitschaftspotential.canterbury.cs.. A common purpose of modern brain implants and the focus of much current research is establishing a biomedical prosthesis circumventing areas in the brain that have become dysfunctional after a stroke or other head injuries. Neuroethics 3: 23-41. (2010). Human freedom. reasoned will. H.Bereitschaftspotential [14] Deecke.1007/s12152-009-9053-9] [17] Klemm. movement-related cortical potentials. Gao. Li.gov/cgi/mesh/2011/MB_cgi?mode=& term=Bereitschaftspotential) Brain implant Brain implants. and the brain.H. This can only be done where the functional associations of these neurons are approximately known. De Caro. Deecke L (2007) Wille und Gehirn [will and the brain]. M Hallett (Eds. [15] Libet. W. Gao. (1985) Unconscious cerebral initiative and the role of conscious will in voluntary action. X. In: M Jahanshahi. [16] Lavazza. Because of the complexity of neural processing and the lack of access to action potential related signals using neuroimaging techniques. 149 pp [ISBN 987-3-89528-628-5] External links • http://www. (2004). e. Kornhuber. S.nz/documents/huckabee_swallowing. "Advances in Cognitive Psychology. 2010 Free will debates: simple experiments are not so simple. • Kornhuber HH. 17 Further reading • Deecke. Other brain implants are used in animal experiments simply to record brain activity for scientific reasons. [DOI 10. Yang.

[22] Currently a number of groups are conducting preliminary motor prosthetic implants in humans. Future brain implants may make use of more exotic materials such as nanoscale carbon fibers (nanotubes).[4] These same electrodes. platinum-iridium.[12] [13] [14] [15] Schematic of the "Utah" Electrode Array Breakthroughs include studies of the process of functional brain re-wiring throughout the learning of a sensory discrimination.[18] remote control of mechanical devices by monkeys and humans. researchers at the NIH led by Edward Schmidt made action potential recordings of signals from Rhesus monkey motor cortexes using immovable "hatpin" electrodes. dystonia and recently depression. are currently used in visual prosthetics laboratories. and Martin Bak. or derivations thereof using the same biocompatible electrode materials.[7] A competing series of electrodes and projects is sold by Plexon including Plextrode Series of Electrodes [8]. the first reported use of the Utah Array in a human for bidirectional signalling. Especially in vision. As early as 1976. due to the knowledge of the working of the visual system. The vestibulocochlear nerve is part of the peripheral nervous system.[6] and motor prosthetics approaches other than the Cyberkinetics probes. and consistent recordings for greater than three years from the best electrodes.[17] monkeys over robotic arms. For hearing. and polycarbonate urethane. cochlear implants are used to stimulate the auditory nerve directly. Rehabilitation Brain pacemakers have been in use since 1997 to ease the symptoms of such diseases as epilepsy.[10] and the FMAs from MicroProbe that emerged from the visual prosthetic project collaboration between Phil Troyk. eye implants (often involving some brain implants or monitoring) have been applied with demonstrated success. David Bradley. or even stainless steel. silicon.[16] control of physical devices by rat brains.[5] laboratories studying the neural basis of learning.[11] Other laboratory groups produce their own implants to provide unique capabilities not available from the commercial products. These are variously the "Michigan Probes".[19] remote control over the movements of roaches. The "hatpin" electrodes were made of pure iridium and insulated with Parylene-c. .[3] including recording from single neurons for over 30 days.[20] [21] electronic-based neuron transistors for leeches. but the interface is similar to that of true brain implants. Parkinson's Disease. These studies are presently limited to several months by the longevity of the implants. materials that are currently used in the Cyberkinetics implementation of the Utah array. Multiple projects have demonstrated success at recording from the brains of animals for long periods of time.[9] the microwire arrays first used at MIT. Current brain implants are made from a variety of materials such as tungsten.Brain implant 18 Research Research in sensory substitution has made slow progress in recent years.

Heath experimented with aggressive mental patients. Perhaps because he received funding for some research through the US Office of Naval Research. often with a dystopian outlook. It raises controversy similar to other forms of human enhancement. Yale University physiologist Jose Delgado demonstrated limited control of animal and human subjects' behaviours using electronic stimulation. where he stated: "the feasibility of remote control of activities in several species of animals has been demonstrated [. to change human perception of reality. there may be some behavioural side effects. where he argues that brains which were directly fed with an input from a computer would not know the deception from reality. In the 1981 BBC serial The Nightmare Man the pilot of a high-tech mini submarine is linked to his craft via a brain implant but becomes a .Brain implant 19 Historical research on brain implants In 1870. Literature in the 1970s delved into the topic. see brain implants as part of a next step for humans in progress and evolution. For instance.g. Reports in the literature describe the possibility of apathy. called "Physical Control of the Mind".. it is argued that implants would technically change people into cybernetic organisms (cyborgs). Prominent research was conducted in the 1950s. a study on proving self existence. where as others. Brain implants in fiction and philosophy Brain implants are now part of modern culture but there were early philosophical references of relevance as far back as René Descartes. and depression. He invented the stimoceiver or transdermal stimulator a device implanted in the brain to transmit electrical impulses that modify basic behaviours such as aggression or sensations of pleasure. Philosopher Hilary Putnam provided a modern parallel of Descartes argument in his 1989 discussion of a brain in a vat." In the 1950s. Robert Bartholow showed the same to be true for humans in 1874. aiming to influence his subjects' moods through electrical stimulation. He denied this claim in a 2005 article in Scientific American describing it only as a speculation by conspiracy-theorists. Ethical considerations Whilst deep brain stimulation is increasingly becoming routine for patients with Parkinson's disease. compulsive gambling. Some people fear implants may be used for mind control. Eduard Hitzig and Gustav Fritsch demonstrated that electrical stimulation of the brains of dogs could produce movements. hallucinations. including The Terminal Man by Michael Crichton. Delgado was later to write a popular book on mind control. e. such as Raymond Kurzweil and Kevin Warwick. it has been suggested (but not proven) that Delgado also received backing through the CIA. Fear that the technology will be misused by the government and military is an early theme. However. Robert G. Popular science fiction discussing brain implants and mind control became widespread in the 20th century. with humankind losing essential human qualities. which he abuses by triggering for pleasure.] The ultimate objective of this research is to provide an understanding of the mechanisms involved in the directional control of animals and to provide practical systems suitable for human application. view them as unnatural. cognitive dysfunction.. In his 1638 Discourse on the Method.[23] Some transhumanists. where a man suffering from brain damage receives an experimental surgical brain implant designed to prevent seizures. By the start of the 20th century Fedor Krause began to systematically map human brain areas. Descartes wrote that a person would not know if an evil demon had trapped his mind in a black box and was controlling all inputs and outputs. especially bioconservatives. these may be temporary and related to correct placement and calibration of the stimulator and so are potentially reversible. hypersexuality. He stated that his research was only progressively scientifically-motivated to understand how the brain works. the CIA also funded research into mind control techniques. using patients that had undergone brain surgery. through programs such as MKULTRA.

and see better. Longer & Uncut: The "V-chip" implant is a satirical implant for foul-mouthed children. Implants of powerful computers provide vastly increased memory capacity. in the 1989 roleplaying game Shadowrun. The Manchurian Candidate (2004): For a means of mind control. Perhaps the most influential novel exploring the world of brain implants was William Gibson's 1984 novel Neuromancer. . and numerous computer/video games. Gibson coins the term "matrix" and introduces the concept of "jacking in" with head electrodes or direct implants. the use (and misuse) of "zone implant" technology is key to several plotlines. The extreme box office success of the Matrix films. and serves a related purpose to the true V-chip (it delivers an electric shock to the child whenever they swear). a fictional geopolitical organization aimed at making parts of the government sleeper cells. He also explores possible entertainment applications of brain implants such as the "simstim" (simulated stimulation) which is a device used to record and playback experiences. Donaldson's series of novels. combined with earlier science fiction references. the downsides being cyberbrain hacking. feelings. Film Brainstorm (1983): The military tries to take control over a new technology that can record and transfer thoughts. and sensations. and the deliberate distortion of subjective reality and experience. Gibson's work led to an explosion in popular culture references to brain implants. Users can also initiate a telepathic conversation with other cyberbrain users. Pulp fiction with implants or brain implants include the novel series Typers. The Matrix Trilogy. 20 Cyberbrain implants in the Ghost in the Shell TV series In the video games PlanetSide and Chrome. The Gap Cycle (The Gap into): In Stephen R. Its influences are felt. South Park: Bigger.Brain implant savage killer after ripping out the implant. total recall. This was the first novel in a genre that came to be known as "cyberpunk". run faster. vision. The implants in Gibson's novels and short stories formed the template for the 1995 film Johnny Mnemonic and later. the presidential hopeful Raymond Shaw unknowingly has a chip implanted in his head by Manchurian Global. It follows a computer hacker through a world where mercenaries are augmented with brain implants to enhance strength. along with other enhancements. memory. Ghost in the Shell anime and manga franchise: Cyberbrain neural augmentation technology is the focus. as well as the ability to view his or her own memories on an external viewing device. etc. players can use implants to improve their aim. have made brain implants ubiquitous in popular literature. the TV series Earth: Final Conflict. or puppets for their monetary advancement. which borrowed his term "datajack" to describe a brain-computer interface. film Spider-Man 2. for example. malicious memory alteration.

Cogan. (2006). rsc. (1976). Retrieved 2008-04-25.Brain implant 21 Television Blake's 7: A character has a brain implant which is supposed to prevent future aggression after being convicted of killing an officer from the oppressive Federation. McCreery. Physiology & Behavior 9 (4): 671–4. Robert. com/ Products/ AcuteProbe. Kufta. Dark Angel: The notorious Red Series use neuro-implants pushed into their brain stem at the base of their skull to amp them up and hyper-adrenalize them and make them almost unstoppable. [22] Warwick.. Artificial Organs 27 (11): 1005–15. gov/ Intramural/ lsr/ wurtz/ wurtz. "Robot arm controlled using command signals recorded directly from brain neurons" (http:/ / www. Joshua. References [1] http:/ / www. Michael M. htm) Blake lab at MCG [14] (http:/ / www. com/ products/ electrodes/ plextrode_top. Chemistry World (Royal Society of Chemistry).1616216. edu/ institution/ personnel?personnel_id=9023) Itzhak Fried Neurosurgical lab at UCLA [16] "Making the connection between a sound and a reward changes brain and behavior" (http:/ / www. "Implant could free power of thought for paralyzed" (http:/ / www.. wireheading. ..1016/0014-4886(76)90220-X.1016/0031-9384(72)90030-3. Michael (2004-09). [7] Caltech (July 8. D. "A sweet new multiple electrode for chronic single unit recording in moving animals". Star Trek franchise: Members of the Borg collective are equipped with brain implants which connect them to the Borg collective consciousness. AI (2004). Bak.. Goodhew.neuron. Boston Globe. Philip. Bak. J. html [9] (http:/ / www. et al. Stuart. PMC 2826987. [17] Chapin. S.. Cogan.. Andrews.x. [21] Gross. "A Model for Intracortical Visual Prosthesis Research". PMID 15312281. I.1177/0891988704267466.. PMID 14568806. Journal of Geriatric Psychiatry and Neurology 17 (3): 172–80. doi:10. Bradley. Retrieved 2008-04-25. Retrieved 2008-04-25. David. ns?id=dn4262).S.M. "Monkey's brain signals control 'third arm'" (http:/ / www. com/ misc/ implant.07308. Archives of Neurology 60 (10): 1369–73. Bradley. Duncan (2003-10-13). jp/ engn/ r-world/ research/ lab/ nokagaku/ cognitive/ integrative/ index. PMID 821770. Bak. PMID 14616519. New Scientist. com/ roboroach/ ).Approach and Progress. 2006-10-19.08. ucla. Experimental Neurology 52 (3): 496–506. M. doi:10. B. "Long-term chronic recording from cortical neurons". .. doi:10. (2005). edu/ press_releases/ 12553). Physorg. Retrieved February 26. com/ news80492303. Matthew. asp) Wurtz lab at NEI [15] (http:/ / faculty. (2003). [23] Burn. doi:10. [12] (http:/ / www. D. [11] Troyk. Berg. com/ viewarticle/ 577292 [2] http:/ / machinedesign.. html). [18] Graham-Rowe. [4] http://www. downstate. M. . nei.R. doi:10. McIntosh. 7376–9. P. E.J. org/ chemistryworld/ Issues/ 2004/ September/ computers. Retrieved 2008-04-25. Douglas et al. Tröster. Martin. edu/ centers/ SCNC/ blakelab/ index. Marc A. PMID 17046698. Gasson. Kufta.009. Conrad.1109/IEMBS. wireheading. mcg. physorg. Erickson. edu/ pharmacology/ faculty/ chapin. plexoninc. Erickson. "Japan's latest innovation: a remote-control roach" (http:/ / www. Eric (2001-07). The X-Files (episode?): FBI Agent Dana Scully discovers an implant set under the skin at the back of her neck which can read her every thought and change memory through electrical signals that alter the brain chemistry. David T. Hu. [20] Talmadoe.2006.1369. [19] Mishra.com. nih.com/pdf/cyber. Z. html).cyberkineticsinc. Retrieved 2008-04-25. aspx [3] Schmidt. R. Caywood. A (1972). doi:10. M. Shad. "Neuroscientists Demonstrate New Way to Control Prosthetic Device with Brain Signals" (http:/ / media. [6] Blake.. pp.2003. html).. "Plugging brains into computers" (http:/ / www. newscientist. aspx) Neuronexus "Michigan" probes [10] Chorover. "The Application of Implant Technology for Cybernetic Systems". "Neuropsychiatric Complications of Medical and Surgical Therapies for Parkinson's Disease". "Experience-Dependent Adult Cortical Plasticity Requires Cognitive Association between Sensation and Reward". B. doi:10. 2011. html) Tanifuji lab at RIKEN [13] (http:/ / www. McCreery. .pdf Cyberkinetics array [5] Troyk. Press release. J. Hutt. . Associated Press.. . Heiser. asp). riken. Merzenich.. . Raja (2004-10-09). 2004).1046/j. [8] http:/ / www. D. Neuron 52 (2): 371–81. . P.1001/archneur. medscape. John K.2005. Deluca. K.60. C. S. Unfortunately the effects of the implant burn out their system between six months to a year and kill them.1525-1594.10. neuronexustech.. SUNY Downstate Medical Center. Teddy. Kyberd. Retrieved 2008-04-25.1016/j. com/ article. Intracortical Visual Prosthesis Research . caltech. A (2003). bri. com/ ContentItem/ 67966/ Wirelessisgettingunderourskin. P.

htm Jose Delgado's book Physical Control of the Mind] BrainGate BrainGate is a brain implant system developed by the bio-tech company Cyberkinetics in 2008 in conjunction with the Department of Neuroscience at Brown University.angelfire. Toward replacement parts for the brain: implantable biomimetic electronics as neural prostheses.000 and Counting. such as patients with amyotrophic lateral sclerosis (ALS) or spinal cord injury.zdnet.usc.com/2010/09/08/ 80000-and-counting-brain-implants-on-the-rise-world-wide/) Further reading • Berger.edu/tools/download/?asset=/assets/002/ 16239.com) • 80. the Braingate array is also capable of recording electrical data for later analysis. or other bodily functions. In 2009..com (http://blogs. whilst another has advanced ALS.pdf&name=berger_discovery_piece. for example.pdf) • Neurotech Reports article on neural-silicon hybrid chips (http://www. three patients have been implanted with the BrainGate system. which can move a robotic arm. html) • Brain Machine implant website (http://www. eds (2005). [1] Dummy unit illustrating the design of a BrainGate interface . Mass: MIT Press. According to the Cyberkinetics' website. ISBN 0-262-02577-9.. the area that controls arm movement. Dennis L.mesolimbic. or even a wheelchair. which is implanted into the brain.com/ emergingtech/?p=1009) • Theodore Berger's Website (http://www.com/pages/hybrids. The activity is translated into electrically charged signals and are then sent and decoded using a program. The computer chip.com/delgado/brainchips.braingate. The device was designed to help those who have lost control of their limbs. Currently the chip uses 96 hair-thin electrodes that sense the electro-magnetic signature of neurons firing in specific areas of the brain.com/) • Scientific American article on Jose Delgado (http://www. a monkey code named JI1021 used a device very similar to BrainGate to control a robotic arm.neurotechreports. In addition to real-time analysis of neuron patterns to relay movement.pdf) • Discover Magazine article on brain implants (http://viterbi. Cambridge.Brain implant 22 External links • Exclusive: A robot with a biological brain | Emerging Technology Trends | ZDNet. a computer cursor. Brain Implants on the Rise World Wide (http://singularityhub. The company has confirmed that one patient (Matt Nagle) has a spinal cord injury. monitors brain activity in the patient and converts the intention of the user into computer commands. Theodore W. Glanzman.neural-prosthesis. A potential use of this feature would be for a neurologist to study seizure patterns in a patient with epilepsy.com/or/mctrl/delgado. • http://www.

gizmag. as well as those who have suffered a severe stroke or spinal cord injury. It consists of a small.braingate2. July 13.virtualworldlets.com/go/3503/1/) Wired Article (http://www.[3] Patients with other motor diseases. so as the technology improves and the risks of the procedure are reduced.com/) BrainGate Research and Trials homepage (http://www. The term neurotrophic means "relating to the nutrition and maintenance of nerve tissue" and the device gets its name from the fact that it is coated with Matrigel and nerve growth factor to encourage the expansion of neurites through its tip. but cannot move or communicate due to near complete paralysis of voluntary muscles.html) VWN News article (http://www.[1] It was invented by neurologist Dr. However. hollow glass cone attached to several electrically conductive gold wires.php?News=1726) Neurotrophic electrode The neurotrophic electrode is an intracortical device designed to read the electrical signals that the brain uses to process information.gov/ct2/show/NCT00912041 External links • • • • • • BrainGate Homepage (http://www. 2009 [2] (http:/ / www. Background Motivation for development Victims of locked-in syndrome are cognitively intact and aware of their surroundings. org) [3] www.braingate.[2] The neurotrophic electrode: teflon-coated gold wires extend from the back of the glass cone. EEG lacks the speed and precision that can be obtained by using a direct cortical interface. 2009. Sky News.wired. com/ skynews/ Home/ UK-News/ Monkey-Fitted-With-Hi-Tech-Chip-Moves-Robot-Using-Mind-Control-Thomas-Moore-Reports/ Article/ 200907215336347?lpos=UK_News_News_Your_Way_Region_4& lid=NewsYourWay_ARTICLE_15336347_Monkey_Fitted_With_Hi-Tech_Chip_Moves_Robot_Using_Mind_Control.com/2009/05/20/braingate-frees-trapped-minds/) Gizmag Article (http://www. braingate2. In early attempts to return some degree of control to these patients.org/) Braingate Overview (http://singularityhub. researchers used cortical signals obtained with electroencephalography (EEG) to drive a mouse cursor.net/Archive/IndividualNews. also stand to benefit from implanted electrodes.[4] . direct interfacing may even provide assistance for amputees.clinicaltrials. sky. such as amyotrophic lateral sclerosis and cerebral palsy. while neurites (shown in blue) grow through it. Cortical signals can be used to control robotic limbs._Thomas_Moore_Reports).com/wired/archive/13. clinical Trials are being conducted for the Brain Gate 2 Neural Interface System.BrainGate 23 Clinical Trials As of July 8. Philip Kennedy and was successfully implanted for the first time in a human patient in 1996 by neurosurgeon Roy Bakay.03/brain. [2] [3] References [1] Monkey Moves Robot Using Mind Control (http:/ / news.

Parylene.Neurotrophic electrode 24 Design development When Dr. biologically compatible. to make it biocompatible and to protect the electronics from fluids. The antenna.[7] Data acquisition system On the outside of the patient's scalp rests the corresponding induction coil and an antenna that sends the FM signal to the receiver. The tips are stripped of their Teflon coating. he knew he needed a device that would be wireless. which are fixed to the inside of the skull. The wires are coiled so as to relieve strain because they are embedded in the cortex on one end and attached to the amplifiers. and FM transmitters are all contained in a standard surface mount printed circuit board that sits just under the scalp. The whole ensemble is coated in protective gels. they rejoin with the neuropil on that side. where they are converted to FM signals and broadcast with an antenna.[6] The cone sits with its tip near layer five of the cortex. and then bent to an angle of 45° just above the point of contact with the cone in order to limit the implantation depth. and Silastic. amplifiers. a phenomenon that would not have been observable if the electrode was not capable of long term implantation.[7] Assembly Most of the neurotrophic electrode is made by hand. As a result. and are insulated with Teflon. The receiver demodulates the signal and sends it to the computer for spike sorting and data recording. The gold wires are cut to the correct length. because without transdermal wiring. Kennedy was designing the electrode. and capable of chronic implantation. they travel up the gold wires and through the cranium. and the ones farthest from the cone are soldered and then sealed with dental acrylic to a component connector.[5] This longevity was invaluable for the studies because while the monkeys were being trained at a task. As neural signals are collected by the electrodes.[7] Gold wires Three or four gold wires are glued to the inside of the glass cone and protrude out the back. on the other. Elvax.[1] Components Glass cone The glass cone is only 1–2 mm long. and is inserted at an angle of 45° from the surface. Two wires are plugged into each amplifier to provide differential signalling. Initial studies with Rhesus monkeys and rats demonstrated that the neurotrophic electrode was capable of chronic implantation for as long as 14 months (human trials would later establish even greater robustness). When the neurites reach the back end of the cone. The amplified signals are sent through a switch to a transmitter. which anchors the glass cone in place. coiled. the risk of infection is significantly reduced. The amplifiers and the transmitters are powered by a 1 MHz induction signal that is rectified and filtered. They record the electrical activity of the axons that have grown through the cone. among corticospinal tract cell bodies. stable and robust long-term recording is attainable.[7] Wireless transmitter One of the greatest strengths of the neurotrophic electrode is its wireless capability. where they are passed on to the differential amplifiers. analog switches. about 5 or 6 mm deep. One more bend in the opposite direction is added where the wires pass through the skull. These devices are temporarily held in place with a water-soluble paste. The glass cone is made by heating and pulling a glass rod to a point and then cutting the tip at the desired . neurons that were initially silent began firing as the task was learned. and is filled with trophic factors in order to encourage axons and dendrites to grow through its tip and hollow body.

However. However. Kennedy's patients have been used to formulate vowel sounds using a speech synthesizer in real time. Dr. Three distinct neural signals from the device were correlated with cursor movement along the x-axis. as described above. because every component is completely biocompatible.[9] In one experiment. with care taken to avoid covering the conductive tips.[8] Comparison to other recording methods The neurotrophic electrode. Researchers implanted the electrode in the area of the motor cortex associated with the movement of speech articulators because a pre-surgery fMRI scan indicated high activity there during a picture naming task. but it has the advantage of not requiring surgery. suggesting that less invasive techniques can be used to restore functionality to locked-in patients. Kennedy's patients. meaning the scalp cannot be completely closed. Movement in a given direction was triggered by an increase in neuron firing rate on the associated channel.[9] . In addition. and a "select" function. the synthesizer itself. is a wireless device. respectively. Lastly. because the electronics it uses to transmit its signal require so much space on the scalp that only four can fit on a human skull. Johnny Ray. The other end is not a straight cut. because the electrodes can be kept on the scalp indefinitely. along the y-axis. with the addition of a post-receiver neural decoder. EEG has the potential for long term use as a brain-computer interface.[3] Speech synthesis Neural signals elicited from another of Dr. but transmits more information. the ECoG device is wired. It is limited in the amount of information it can provide. the study did not address the degree of control possible with LFPs or make a formal comparison between LFPs and single unit activity. in an attempt to record the summed activity of tens of thousands to millions of neurons.[9] Electrocorticography (ECoG) records the cumulative activity of hundreds to thousands of neurons with a sheet of electrodes placed directly on the surface of the brain. and aerated.[2] Alternatively. and transmits its signals transcutaneously.Neurotrophic electrode length. researchers investigating ECoG claim that the grid "possesses characteristics suitable for long term implantation". but rather is carved at an angle to provide a shelf onto which the gold wires can be attached. The average delay from neural firing to synthesizer output was 50 ms. and of course. so it has high resolution and can record from many individual neurons. however.[10] Electroencephalography (EEG) involves the placement of many surface electrodes on the patient's scalp. It has been implanted in a human for over two years and consists of 100 conductive silicon needle-like electrodes. In addition to requiring surgery and having low resolution. the Utah array is currently a wired device. the device is sterilized using glutaraldehyde gas at a low temperature. Kennedy adapted the neurotrophic electrode to read local field potentials (LFPs). The temporal and spatial resolutions and signal to noise ratios of EEG have always lagged behind those of comparable intracortical devices. was able to learn how to control a computer cursor with the neurotrophic electrode. He demonstrated that they are capable of controlling assistive technology devices. increasing the risk of infection. The electronics setup was very similar to that used for the cursor. it has demonstrated longevity of over four years in a human patient.[7] 25 Implementation Computer cursor control One of Dr. which is approximately the same as the delay for a intact biological pathway. The wires are then placed on the shelf and a methylmethacrylate gel glue is applied in several coats.

[5] Kennedy. P. R. Two of Dr. K. 181-193. THE CONE ELECTRODE .. 142(1). but in both cases only the external devices needed to be replaced. [Review]. the possibility of bleeding. [Article].. Kennedy was forced to rely on the remaining devices. Bakay. Mirra.Neurotrophic electrode 26 Drawbacks Activation delay The neurotrophic electrode is not active immediately after implantation because the axons must grow into the cone before the device can pick up electrical signals. Studies have shown that tissue growth is largely complete as early as one month after the procedure. (1992). and brain damage.ULTRASTRUCTURAL STUDIES FOLLOWING LONG-TERM RECORDING IN RAT AND MONKEY CORTEX. The standard advantages and disadvantages of invasive versus non-invasive interfaces still apply. M. 536-546. J.[2] Silent speech Silent speech is "speech processing in the absence of an intelligible acoustic signal" to be used either as an aid for the speech-handicapped or to communicate in areas with required silence or high background noise.. but takes as many as four months to stabilize. Kennedy is working on the speech synthesis application of the electrode. In addition. (2000). Adams. A. M. (1989). the procedure will be reserved for extreme or experimental cases. E. Journal of Neuroscience Methods.. Senior Research Scientist. R. & Bakay. 760(1-2). present and future. one of which is restoring movement with neuroprosthetics. Trends in Neurosciences. Moore. Kennedy's patients accidentally caused damage during spasms. Brain Research. 29(3). is to enable silent speech by decoding the "speaker's" neural signals and transmitting the audio output to headphones worn by the intended listener. and as a result. 251-254. seizures.[8] References [1] Kennedy.. R. M. M. Activity of single action potentials in monkey motor cortex during long-term task learning. R. & Goldwaithe. A. S.[2] Device failure When Johnny Ray was implanted in 1998. P. E. there is still a possibility that the electronics will fail. for this particular application. L. R. & Nicolelis.[1] Surgery risks The risks involved with the implantation are those that are usually associated with brain surgery. Kennedy. but has plans to expand its uses to many different areas. Ieee Transactions on Rehabilitation Engineering. while the implants themselves are encased in the skull and are therefore relatively safe from physical damage. THE CONE ELECTRODE . E. A. Dr.. [2] Interview with Dr. R. & Bakay. [Article]. 198-202. A. R. Dr. and brain computer interfaces in general.. Direct control of a computer from the human central nervous system. P. S. . [Article]. 8(2). (2006). Neuroscience Letters.. 89-94.A LONG-TERM ELECTRODE THAT RECORDS FROM NEURITES GROWN ONTO ITS RECORDING SURFACE. the electronics on the outside of the skull are vulnerable.[7] Future applications Neuroprosthetics As of November 2010. one of the neurotrophic electrodes started providing an intermittent signal after it had become anchored in the neuropil. even if there is no complication from surgery. Inc. 29(9). infection. Until the technology advances to the point that these risks are considerably reduced. namely.[11] However. (1997). Brain-machine interfaces: past.. P. Neural Signals.[3] Therefore. stroke. A. [4] Lebedev. [6] Kennedy. One of the proposed future uses of the neurotrophic electrode. the neurotrophic electrode has an advantage in that it has already been shown to be effective for restoring communication to disabled patients. 9/30/2010 [3] Kennedy.

4 ago May 2008. Kirby. It was built by reverse-engineering the encrypted protocol. S. T.. 27 Comparison of consumer brain–computer interfaces Device Emotiv EPOC Electrodes 14 [1] Sensors Interpret: 4 Mental states (based on brainwaves). Hueber. facial muscle and eye movements 1 Mental state Yes Yes Yes Yes [9] [10] [11] 1 No Open-source projects The OpenEEG [12] (OpenEEG) project is about creating a low cost EEG device and free software to go with it. H. R. & Mallory.. E... J. [Article].. & Guenther. Tourville. Wright. T. (2008). A. J. 168-176.. 4(12). 52(4).. P. A... 22 ago Producer Emotiv Systems Mindball Mindflex (based on MindSet) MindSet Neural Impulse Actuator Star Wars Force Trainer (based on MindSet) 1 [5] No - Interactive Productline Mattel (Neurosky [6] partner ) NeuroSky OCZ Technology Uncle Milton (Neurosky [6] partner ) 1 No [7] 1 3 2 "Mental states"(based on 4 brainwaves). Andreasen.. facial expressions. M. 52(4). 13 conscious thoughts. Emokit [13] is an open-source Python library for reading out sensor data from the EPOC (Emotiv Systems) by Cody Brocious. A Wireless Brain-Machine Interface for Real-Time Speech Synthesis. Seibert. B. M.. (2004). et al. & Brumberg. Honda.. Kennedy. A. F. 16 ago March 2007. Ieee Transactions on Neural Systems and Rehabilitation Engineering. Journal of Neuroscience Methods. test and use BCI[15] . S.. [8] eyeblinks 2 brainwaves (Alpha & Beta). 12(3). D. J. E.. Brain-computer interfaces for speech communication. [11] Denby. [9] Brumberg. 339-344. (2010). Moore... Neurotrophic electrode: Method of assembly and implantation into human motor speech cortex. [10] Kennedy. Panko. [Article].. J. M.. Gilbert. OpenVibe is a LGPL software platform (C++) to design. F. S. H. Schultz. 174(2). J. [Article]. M. et al. Nieto-Castanon.. (2010).Neurotrophic electrode [7] Bartels. The software comes with an acquisition server that is currently compatible with many EEG device including Neurosky Mindset. King.. Speech Communication.. Nieto-Castanon. S. Ehirim... B.[14] EEGLAB is a GNU Matlab toolbox for processing data from electroencephalography (EEG). Mao. K. A. J. Wright. P. 3 ago 21 June 2009. T. The software is developed at INRIA. [2] head movements(sensed by 2 gyros) 1 Mental state 1 Mental state Peripheral Yes SDK Yes [3] [4] Released 21 December 2009. J. 367-379. Emotiv EPOC (Research Edition or above) and OpenEEG. 8 ago 21 December 2009. 16 ago 21 March 2003. Brumberg. Speech Communication. R. H. 270-287. Silent speech interfaces. J. can be used as neurofeedback tool. Plos One. . (2009).. [8] Guenther. Computer control using human intracortical local field potentials. M. P.

Brain activity is monitored and processed to provide feedback to the user in one of several ways. neurosky. fr) External links • Porting Digital Memory (http://www. com/ products/ ) [7] NeuroSky MindSet (http:/ / www.Comparison of consumer brain–computer interfaces 28 Technology All of these. learn to gain more control over their brainwaves and therefore how they think and feel in every day situations. com/ daeken/ Emokit/ blob/ master/ Announcement. or a film or music might pause when undesired brainwaves are produced (negative feedback). inria. It has been used to help a range of conditions including ADHD and addictions. 25 May 2010 Comparison of neurofeedback software Introduction to Neurofeedback Neurofeedback (NFB). com/ apps/ epoc/ 299/ ) [2] (http:/ / en. net/ [13] http:/ / github. General . neurosky. neurobiofeedback or EEG biofeedback (EEGBF) is a therapy technique that presents the user with real-time information about activity within their brain. html) [6] NeuroSky partners (http:/ / company. also called neurotherapy. for example a video game rocket ship might accelerate when desired brainwaves are produced (positive feedback). a Python interface to OCZ's Neural Impulse Actuator (http:/ / code. com/ daeken/ Emokit/ ) open source SDK [5] Mindball Accessories (http:/ / www. com/ bci-technology-application-march) [9] NeuroSky Developer (http:/ / developer.hplusmagazine. ocztechnology. com/ ) [8] (http:/ / company. neurosky. mindball. References [1] Emotiv headset (http:/ / www. google. org/ wiki/ Emotiv_Systems) [3] Emotiv SDK (http:/ / www. emotiv. com/ apps/ sdk/ 646/ ) [4] Emokit (https:/ / github. md) on Github [15] home of the OpenViBE software (http:/ / openvibe. as measured by electrical or blood-flow sensors on the scalp. unless otherwise stated. The user then uses this feedback to develop the brainwaves they wish to create and as a consequence. use electroencephalography. com/ ) [10] OCZ Peripherals . com/ products/ ocz_peripherals/ nia-neural_impulse_actuator) [11] pynia.com/articles/neuro/porting-digital-memory). H+ Magazine. com/ p/ pynia/ ) [12] http:/ / openeeg. com/ daeken/ Emokit [14] Python library for the Emotiv EPOC headset (http:/ / github.Neural Impulse Actuator (http:/ / www. se/ accessories. neurosky. sourceforge. emotiv. wikipedia.

Analysis. com/ cygnet [9] http:/ / www.1 3.Comparison of neurofeedback software 29 Software [1] [2] Type Version Operating systems Developer License BioEra Biofeedback: visual designer Neurofeedback Neurofeedback & Biofeedback Game Neurofeedback: MIDI. sourceforge.0 1. net [2] http:/ / www. com/ [3] http:/ / www. somaticvision. inria. zengar.0 BWView Cygnet [7] [8] Dual Drive Pro [9] eBioo [10] [11] Neurofeedback & Analysis Neurofeedback Neurofeedback 0. eeginfo.0.0 [Rudi Cilibrasi] BrainTrain.9. net/ bwview/ [8] http:/ / www. org/ brainbay/ [6] http:/ / www. Jim Peters EEG Info.4 2. com/ dualdrivepro/ [10] http:/ / www. Proprietary Open source GPL Proprietary GPL Proprietary Proprietary [3] [4] Brainathalon BrainBay [5] ? BrainMaster [6] v2010 1. Windows Gottfried Arens.D. htm [12] http:/ / www. com/ professionals/ smartmind_neurofeedback/ smartmind. com/ brainathlon/ [5] http:/ / www. net/ doc/ sw/ NeuroServer/ [14] http:/ / www.5 1.0 Windows XP & Vista Windows Windows Vista & Windows 7 Linux.5 V2009 ? Windows Windows Windows XP & Vista & 7 Java Windows Windows XP & Vista & Windows 7 Linux. webkitchen. shifz. Visual Designer. Proprietary Open source Proprietary ElectricGuru NeurOptimal® [12] NeuroServer SmartMind [13] Raw EEG to TCP/IP + EDF converter Neurofeedback BCI. soft-dynamics. fr/ . Windows Windows XP & Vista Windows XP & Vista PROATECH LLC Proprietary BioExplorer BioTrace+ Cyberevolution. com/ [13] http:/ / openeeg. com [7] http:/ / uazu. Inc. org/ page/ topics/ electric_guru. mindmedia. cyberevolution. php [4] http:/ / www. realization. Brown. nl/ english/ biotrace. brainmaster. braintrain. Inc. htm [15] http:/ / openvibe. Physicist Rob Sacks Valdeane W. Windows Windows XP & Vista & Windows 7 Linux. Larry Janow Proprietary Mind Media Netherlands Amy Palke Chris Veigl and Jeremy Wilkerson BrainMaster Technologies. Inc Somatic Vision Inc.7. particle display Neurofeedback Brainwave viewer Neurofeedback Biofeedback GSR & Temp 2. Ph. com/ [11] http:/ / www. Neurofeedback 0. [15] GPL Proprietary LGPL [14] OpenViBE INRIA References [1] http:/ / bioera.4 v2010 0.92 0.

Cyberkinetics 30 Cyberkinetics Cyberkinetics is an American company. Clinical Trials Update: July 8.3 million in first round funding led by Oxford Bioscience Partners. Inc. Their work helped develop early-stage bionics in the form of implantable electronic devices and now spinoff Cyberkinetics is taking the technology several steps further.clinicaltrials. co-founded by Brian Hatt and Richard Normann (the inventor of the Utah Array) added to a tech team armed with intellectual property rights gained from Brown. as stated in their Q1 2007 shareholder conference.OB.braingate2. Mijail Serruya. and Gerhard Friehs of Brown University and Nicho Hatsopoulos of the University of Chicago. Funding Scientists behind the project used $9.gov. Dummy unit illustrating the design of a BrainGate interface According to their latest SEC filing. MIT. it currently trades on the OTC BB (over the counter bulletin board.K.org Update: July 16.A "pink sheets") cyberkinetics plans to get a NYSE listing before 2010.gov/ct2/show/NCT00912041[3] . the Founders of the company resigned from the Board of Directors at the end of October. and others. A. They say they're three to five years away from putting a product on the market. [2] Additional information on Brain Gate can be accessed at www. Merger & Renaming In late 2004. details can be viewed at the following location: www. 2009 The pilot clinical trial of the BrainGate2 Neural Interface System is registered at ClinicalTrials. The resulting company was renamed Cyberkinetics Neurotechnology Systems. 2009 Clinical Trials are now being conducted for the Brian Gate 2 Neural Interface System. A 2002 merger with Bionic Technologies. Cyberkinetics initiated a reverse merger with a Texas company in order to gain access to the public market. The Food and Drug Administration (FDA) has approved a clinical trial to implant the BrainGate technology into five severely disabled patients to determine if they can use the technology to send simple computer commands through channeled thought. It was cofounded by John Donoghue. [1] and its shares are listed under the symbol CYKN. 2008.

braingate2. com/ http:/ / www. neuro. Dallas. but current research tends to approach the field from one of two different angles: Interfaces or Prosthetics. com/ Cyberware For other uses. braingate2. Unfortunately. brown. More formally: Cyberware is technology that attempts to create a working interface between machines/computers and the human nervous system. 1996]. the cartoon Exosquad. having heavily featured in works of fiction (even in mainstream productions such as Johnny Mnemonic. cyberkinetics. it is currently the most difficult object to implement. Interfaces ("Headware") The first variety attempts to connect directly with the brain. com/ (http:/ / www. see Cyberware (disambiguation) Cyberware is a relatively new and unknown field (a proto-science. org) (http:/ / www. and to translate something from a computer into meaningful thoughts for humans. recording and translating the many different electrical signals that the brain transmits. but it is also the most important in terms of interfacing directly with the mind. Florida [6] External links • • • • [1] [2] [3] [4] [5] [6] [7] [8] [9] Cyberkinetics Neurotechnology Official Website [7] Donoghue Lab [8] Hatsopoulos Lab [9] Brain Gate Official Website [10] http:/ / www. or more adequately a “proto-technology”). The mainstream research currently focuses on electrical impulse monitoring. plexoninc. org) http:/ / www. com/ http:/ / donoghue. tdt. In science fiction the data-jack is the envisioned I/O port for the brain. it is commonly known to mean the hardware or machine parts implanted in the human body and acting as an interface between the central nervous system and the computers or machinery connected to it. For ethical reasons.Cyberkinetics 31 Competitors • Neuralynx [4] • Plexon Inc. The data-jack is probably the best-known. including (but not limited to) the brain. it would allow direct communication between computers and the human mind. These interfaces . neuralynx. Examples of potential cyberware cover a wide range. com/ http:/ / www. however. edu/ oba/ faculty/ Hatsopoulos/ lab/ [10] http:/ / www. Large university laboratories conduct most of the experiments done in the area of direct neural interfaces. and The Matrix). Its job is to translate thoughts into something meaningful to a computer. A number of companies are working on what is essentially a "hands-free" mouse or keyboard [Lusted. the tests are usually performed on animals or slices of brain tissue from donor brains. braingate. cyberkineticsinc. This technology uses these brain signals to control computer functions. In science fiction circles. uchicago. com/ http:/ / www. edu/ http:/ / pondside. Texas [5] • Tucker-Davis Technologies. Once perfected.

A tiny device inserted into the inner ear. Editor R. but experiments are also being performed to tap into the brain itself. pp. or missing. This device comes firmly under the field of prosthetics. An early success in this field is the cochlear implant. The patient is then taught how to operate the prosthetic. 2003 External links • • • • • • • The open-source programmable chip Electroencephalography project [2] The programmable chip Electroencephalography project BLog [3] The programmable chip Electroencephalography project open circuits wiki [4] The programmable chip Electroencephalography project WikiCities wiki [5] The open-source Electroencephalography project [6] Cyberware Technology by Taryn East [7] .Cyberware are sometimes called Brain-Machine Interfaces (BMI). and Brain". In the sub-field where prosthetics and cyberware cross over. concerning full in-brain interfaces. "RB Controlling Computers with Neural Signals". Wired Issue 1. Current research has reached the level where limited control over a computer is possible using thought commands alone. find the work slow-going and very far from the ultimate goals. October 1993 Lusted. 1993]. trying to learn how to move it as though it were a natural limb [Lusted. Gareth "The desire to be wired". References • • • • Branwyn. a quadriplegic man was able to compose and check email. capable of controlling the movements of an artificial limb. and those who can. this could be a direct link to the speech centres of the brain [Branwyn. is being studied. Germany [8] . Peter. October 1996 Hooper. Few can afford the huge cost of such enterprises. Scientific American. Berlin. Modern prostheses attempt to deliver a natural functionality and appearance. but is in its infancy. The more intense research. create the sensation of sound). 781–810.Source containing the rest of the work found on this article Department of Membrane and Neurophysics at the Max-Planck-Institute in Martinsried. after being implanted with a Massachusetts-based firm Cyberkinetics chip called BrainGate. 32 Prosthetics ("Bodyware") The second variety of cyberware consists of a more modern form of the rather old field of prosthetics. experiments have been done where microprocessors. Most recently. Waser. Nanoelectronics and Information Technology. "Neuroelectronic Interfacing: Semiconductor Chips with Ion Channels. Crossing over between prostheses and interfaces are those pieces of equipment attempting to replace lost senses. are attached to the severed nerve-endings of the patient. Simon (October 21. when stimulated.an institute working on nerve cell/chip interconnection • Wetware Technology [9] .04. Nerve Cells. HS and Knapp. it replaces the functionality of damaged. Coupled with a speech-processor. 1996]. hair cells (the cells that. Wiley-VCH. 2004) Brain chip offers hope for paralyzed [1] CNN Fromherz.

html http:/ / www. org/ freeside/ mab_cyber.[5] . html http:/ / pceeg. com/ http:/ / www. wetwarehacker. wikia. mapping speech areas and identifying the somatosensory and somatomotor cortex areas to be excluded from surgical removal. the local field potential gives a measure of a neural population in a sphere with a radius of 0. [2] This procedure was used to explore the functional anatomy of the brain. The cortical potentials recorded by ECoG were used to identify epileptogenic zones – regions of the cortex that generate epileptic seizures. com/ 2004/ TECH/ 10/ 20/ explorers. Because a craniotomy (a surgical incision into the skull) is required to implant the electrode grid. braingate/ index. com/ Programmable_Chip_EEG http:/ / pceeg. For this reason. These zones would then be surgically removed from the cortex during resectioning. depth electrodes can also measure action potentials. biochem. [5] With a sufficiently high sampling rate (more than about 10 kHz).35 mm. [1] The two developed ECoG as part of their groundbreaking Montreal procedure. cerebrospinal fluid (CSF). However. ECoG is currently considered to be the “gold standard” for defining epileptogenic zones in clinical practice.5-3 mm around the tip of the electrode. net/ doc/ http:/ / www. de/ mnphys/ index.Cyberware 33 References [1] [2] [3] [4] [5] [6] [7] [8] [9] http:/ / edition. html http:/ / www. Electrophysiological basis ECoG signals are composed of synchronized postsynaptic potentials (local field potentials). pia mater. net/ http:/ / pceegbci. The potentials occur primarily in cortical pyramidal cells. opencircuits. [6] In which case the spatial resolution is down to individual neurons. ECoG may be performed either in the operating room during surgery (intraoperative ECoG) or outside of surgery (extraoperative ECoG). ECoG is an invasive procedure. where potentials rapidly attenuate due to the low conductivity of bone. and the field of view of an individual electrode is approximately 0. recorded directly from the exposed surface of the cortex. blog. sourceforge. com Electrocorticography Electrocorticography (ECoG) is the practice of using electrodes placed directly on the exposed surface of the brain to record electrical activity from the cerebral cortex. mpg. thus destroying the brain tissue where epileptic seizures had originated. a critical imaging advantage for presurgical planning. History ECoG was pioneered in the early 1950s by Wilder Penfield and Herbert Jasper. cyberpunks. cnn. and thus must be conducted through several layers of the cerebral cortex. electrical signals must also be conducted through the skull. neurosurgeons at the Montreal Neurological Institute. ECoG offers a temporal resolution of approximately 5 ms and a spatial resolution of 1 cm. and arachnoid mater before reaching subdural recording electrodes placed just below the dura mater (outer cranial membrane). Penfield and Jasper also used electrical stimulation during ECoG recordings in patients undergoing epilepsy surgery under local anesthesia.05-0. a surgical protocol used to treat patients with severe epilepsy. sourceforge. to reach the scalp electrodes of an electroencephalogram (EEG). com/ wiki/ Main_Page http:/ / openeeg. the spatial [3] resolution of ECoG is much higher than EEG. [4] Using depth electrodes.

This procedure may be performed either under general anesthesia or under local anesthesia if patient interaction is required for functional cortical mapping. Electrical stimulating currents applied to the cortex are relatively low. These electrodes are attached to an overlying frame in a “crown” or “halo” configuration. Electrodes are then surgically implanted on the surface of the cortex. [7] Subdural strip and grid electrodes are also widely used in various dimensions. and near 15 mA for cognitive stimulation. when using a subdural strip. though patient involvement varies with each mapping procedure. map out cortical functions. and language. each mounted on a ball and socket joint for ease in positioning. a handheld wand bipolar stimulator may be used at any location along the electrode array. during. and oral comprehension.[7] When using a crown configuration. ECoG electrode arrays typically consist of sixteen sterile. In order to access the cortex. The patient must be alert and interactive for mapping procedures. and are designed with enough flexibility to ensure that normal movements of the brain do not cause injury. disposable stainless steel. ECoG has been used to localize epileptogenic zones during presurgical planning. somatosensory mapping requires that the patient describe sensations experienced across the face and extremities as the surgeon stimulates different cortical regions. Electrodes may either be placed outside the dura mater (epidural) or under the dura mater (subdural). platinum. Language mapping may involve naming. and to predict the success of epileptic surgical resectioning. Standard spacing between grid electrodes is 1 cm. ECoG offers several advantages over alternative diagnostic modalities: • Flexible placement of recording and stimulating electrodes [2] • Can be performed at any stage before. or gold ball electrodes. having anywhere from 4 to 64 electrode contacts. with placement guided by the results of preoperative EEG and magnetic resonance imaging (MRI). Depth electrodes may also be used to record activity from deeper structures such as the hippocampus. between 2 to 4 mA for somatosensory stimulation. The electrodes sit lightly on the cortical surface. removing a part of the skull to expose the brain surface. identifying critical regions of the cortex to be avoided during surgery • Greater precision and sensitivity than an EEG scalp recording . individual electrodes are typically 5 mm in diameter. a surgeon must first perform a craniotomy. Strip electrodes and crown arrays may be used in any combination desired. and after a surgery • Allows for direct electrical stimulation of the brain. [7] The functions most commonly mapped through DCES are primary motor. DCES Direct cortical electrical stimulation (DCES) is frequently performed in concurrence with ECoG recording for functional mapping of the cortex and identification of critical cortical structures. sampling errors may occur . repetition. [7] Clinical applications Since its development in the 1950’s.Electrocorticography 34 Procedure The ECoG recording is performed from electrodes placed on the exposed cortex. The grids are transparent. reading aloud. However. A key advantage of strip and grid electrode arrays is that they may be slid underneath the dura mater into cortical regions not exposed by the craniotomy. primary sensory. carbon tip. flexible. stimulation must be applied between pairs of adjacent electrodes due to the nonconductive material connecting the electrodes on the grid.spatial resolution is higher and signal-to-noise ratio is superior due to greater proximity to neural activity Limitations of ECoG include: • Limited sampling time – seizures (ictal events) may not be recorded during the ECoG recording period • Limited field of view – electrode placement is limited by the area of exposed cortex and surgery time. and numbered at each electrode contact.

It is vital to precisely localize critical brain structures.Electrocorticography • Recording is subject to the influence of anesthetics. while a valuable diagnostic tool. and speech. and (TLE) with MRI evidence of mesial temporal sclerosis (MTS). intraoperative ECoG may also be performed to monitor the epileptic activity of the tissue and ensure that the entire epileptogenic zone is resectioned. and site of origin within the brain. Residual spikes on the ECoG. [2] Once a lesion has been identified. The success of the surgery depends on accurate localization and removal of the epileptogenic zone. indicate poor seizure control. Intraoperative ECoG The objective of the resectioning surgery is to remove the epileptogenic tissue without causing unacceptable neurological consequences. [8] Epileptic seizures are chronic and unrelated to any immediately treatable causes. Extraoperative ECoG Before a patient can be identified as a candidate for resectioning surgery. such as toxins or infectious diseases. somatosensory integration. and to determine the success of the surgery. and may vary widely based on etiology. ECoG is also performed following the resectioning surgery to detect any remaining epileptiform activity.5 million people in the United States alone. supported by EEG evidence of epileptogenic tissue. brief bursts of neuronal activity recorded between epileptic events. and thus is performed under local rather than general anesthesia. Quesney. in multiple subpial transections (MST). and is widely used for presurgical planning to guide surgical resection of the lesion and epileptogenic zone. During the resectioning surgery. ECoG data is assessed with regard to ictal spike activity – “diffuse fast wave activity” recorded during a seizure – and interictal epileptiform activity (IEA). In addition to identifying and localizing the extent of epileptogenic zones. narcotic analgesics. For patients with intractable epilepsy – epilepsy that is unresponsive to anticonvulsants – surgical treatment may be a viable treatment option. Rasmussen demonstrated the presurgical significance of ECoG in frontal lobe epilepsy (FLE) cases. and the surgery itself [2] 35 Intractable epilepsy Epilepsy is currently ranked as the third most commonly diagnosed neurological disorder. Kuruvilla and Flink reported that while intraoperative ECoG plays a critical role in tailored temporal lobectomies. identifying which regions the surgeon must spare during resectioning (the “eloquent cortex”) in order to preserve sensory processing. [11] . unaltered by the resection. Electrical stimulation using cortical and acute depth electrodes is used to probe distinct regions of the cortex in order to identify centers of speech. MRI must be performed to demonstrate the presence of a structural lesion within the cortex. ECoG used in conjunction with DCES is also a valuable tool for functional cortical mapping. [9] [10] . and in the removal of malformations of cortical development (MCDs). and somatomotor processing. Functional mapping requires that the patient be able to interact with the surgeon. lacks the precision necessary to localize the epileptogenic region. and incomplete neutralization of the epileptogenic cortical zone. Although the use of extraoperative and intraoperative ECoG in resectioning surgery has been an accepted clinical practice for several decades. afflicting approximately 2. recent studies have shown that the usefulness of this technique may very based on the type of epilepsy a patient exhibits. ECoG is considered to be the gold standard for assessing neuronal activity in patients with epilepsy. ECoG may be performed to determine the location and extent of the lesion and surrounding irritative region. The scalp EEG. clinical symptoms. it has been found impractical in standard resection of medial temporal lobe epilepsy [2] A study performed by Wennberg. Additional surgery may be necessary to completely eradicate seizure activity. motor coordination.

PMID 11248342. References [1] Andre Palmini (2006). "Multiple microelectrode-recording system for human intracortical applications". Drury (1996). doi:10. Csaba Juhasz. Otto Muzik. [4] Eishi Asano. FINE (first principle vectors) to image the locations and estimate the extents of current sources from the scalp EEG. Logothetis (2003). "The underpinning of the BOLD functional magnetic resonance imaging signal". A recent study by Shenoy et al. two patients are seizure-free and the third has experienced a significant reduction in seizures. doi:10. FINE offers a promising alternative to preoperative ECoG. long-term video EEG monitoring with scalp electrodes. providing information about both the location and extent of epileptogenic sources through a noninvasive imaging procedure.1111/j.1016/j. PMID 16026561.x. and subsequently with subdural electrodes. or communication devices via direct use of the individual’s brain signals. Aashit Shah. Gary Heit. Journal of Neuroscience 23 (10): 3963–3971. "The concept of the epileptogenic zone: a modern look at Penfield and Jasper’s views on the role of interictal spikes'". Brain signals may be recorded either invasively.05205. The ECoG data was then recorded from implanted subdural electrode grids placed directly on the surface of the cortex. PMID 14630497.2005. Journal of Neuroscience Methods 106 (1): 69–79. Bin He et al. The epileptogenic zones identified from preoperative EEG data were validated by observations from postoperative ECoG data in all three patients. . "Correlation between scalp-recorded electroencephalographic and electrocorticographic activities during ictal period". [13] seek to integrate the information provided by a structural MRI and scalp EEG to provide a noninvasive alternative to ECoG. George Karmos (2001). PMID 12764080. with encouraging clinical results. Chugani (2005). [2] A.[12] Recent advances in ECoG technology The electrocorticogram is still considered to be the “gold” standard for defining epileptogenic zones. EEG findings were further validated by the surgical outcomes of all three patients.[12] BCIs are direct neural interfaces that provide control of prosthetic.Electrocorticography 36 Research applications ECoG has recently emerged as a promising recording technique for use in brain-computer interfaces (BCI).1016/S1059-1311(03)00095-5. doi:10. This study investigated a high-resolution subspace source localization approach. After surgical resectioning. [7] L. Tomio Sasaki (2007). PMID 17236792. Seminars in Anesthesia 16: 46–55. I. Fumiaki Yoshida. [6] Istvan Ulbert. Seizure 12 (8): 577–584. ECoG serves to provide a partially invasive compromise between the two modalities – while ECoG does not penetrate the blood-brain barrier like invasive recording devices. using EEG scalp electrodes. doi:10. This method was tested in three pediatric patients with intractable epilepsy. R. Schuh. [3] Kimiaki Hashiguchi. Takato Morioka. Flink (2003). A thresholding technique was applied to the resulting tomography of subspace correlation values in order to identify epileptogenic sources.010.seizure. These preliminary results suggest that it is possible to direct surgical planning and locate epileptogenic zones noninvasively using the described imaging and integrating methods. demonstrates the high movement classification accuracy potential of ECoG-based BCIs.2006. Jagdish Shad.1016/S0165-0270(01)00330-2. or noninvasively. electronic. Sandeep Sood. Yasushi Miyagi. it features a higher spatial resolution and higher signal-to-noise ratio than EEG. this procedure is risky and highly invasive. with recording devices implanted directly into the cortex. Recent studies have explored the development of a noninvasive cortical imaging technique for presurgical planning that may provide similar information and resolution of the invasive ECoG.12. Harry T. "Intraoperative electrocorticography in epilepsy surgery: useful or not?". PMC 1360692. however. Diane C. In one novel approach. Shinji Nagata. "Origin and Propagation of Epileptic Spasms Delineated on Electrocorticography". Epileptic Disorders 8(Suppl 2): S10–15. Seizure 16 (3): 238–247.1528-1167. Chugani. [5] Nikos K. "Intraoperative Electrocorticography and Direct Cortical Electrical Stimulation". MRI and computed tomography images were also obtained for each subject. Each patient was evaluated using structural MRI. Due to its clinical success. Ayumi Sakata. Eric Halgren. Epilepsia 46 (7): 1086–1097. Kuruvilla.

Xiaoliang Xu. Rao (2007) (PDF). Ojemann (2007). doi:10.[2] In clinical contexts. Wennberg. Journal of Clinical Neurophysiology 24 (2): 87–95. Marcel denNijs. [11] R. PMID 17414968. [12] Pradeep Shenoy. Miller. Electroencephalography Electroencephalography (EEG) is the recording of electrical activity along the scalp. PMID 17604183.1097/WNP. presentation of a stimulus of some sort (visual. cognitive psychology. Bobby Xu.1016/S0013-4694(97)00148-X. but this use has decreased with the advent of anatomical imaging techniques with high (<1 mm) spatial resolution such as MRI and CT. Seizure 16 (2): 120–127.2007. Olivier. "What is Epilepsy? Clinical Perspectives in the Diagnosis and Treatment".seizure. "Real-time functional brain mapping using electrocorticography". T. "Electrocorticography and outcome in frontal lobe epilepsy". doi:10.010. EEG used to be a first-line method for the diagnosis of tumors. stroke and other focal brain disorders.Electrocorticography [8] Michael Kohrman (2007). .1016/j. [1] Inc. and psychophysiological research. Bin He (2007). cs.05. Ojemann. doi:10.10. doi:10. [13] Lei Ding. 37 External links • Teenager moves video icons just by using mind electrocorticographic activity (http://mednews. Derivatives of the EEG technique include evoked potentials (EP). Rajesh P.neuroimage. Jeffrey G. Rao. An EEG recording net (Electrical Geodesics.1016/j. PMID 17158074. EEG continues to be a valuable tool for research and diagnosis. PMID 9741764. John W. PMID 17414964. especially when millisecond-range temporal resolution (not possible with CT or MRI) is required.2006. Miller. .edu/ news/page/normal/7800.wustl. Christopher Wilke. PMC 2758789. as recorded from multiple electrodes placed on the scalp.0b013e3180415b51. ) being used on a participant in a brain which involves averaging the EEG activity time-locked to the wave study.[3] A secondary clinical use of EEG is in the diagnosis of coma.html). Michael Kohrman. A. "Efficacy of intraoperative electrocorticography for assessing seizure outcomes in intractable epilepsy patients with temporal-lobe-mass lesions". the main diagnostic application of EEG is in the case of epilepsy.N. Wim van Drongelen. this technique is used in cognitive science. Hiroyuki Shimizu.029. EEG measures voltage fluctuations resulting from ionic current flows within the neurons of the brain. Jeffrey G. Shigeki Sunaga (2007). Kai J.0b013e318038fd52. or auditory). In neurology. Miller. somatosensory. as epileptic activity can create clear abnormalities on a standard EEG study.N.1097/WNP. edu/ homes/ pshenoy/ papers/ ecogclassif_tbme07preprint. [9] Hidenori Sugano. EEG refers to the recording of the brain's spontaneous electrical activity over a short period of time. Pradeep Shenoy. "EG source imaging: correlating source locations and extents with electrocorticography and surgical resections in epilepsy patients". Despite limited spatial resolution. Quesney. washington. and brain death. Event-related potentials (ERPs) refer to averaged EEG responses that are time-locked to more complex processing of stimuli. Rajesh P. doi:10. usually 20–40 minutes. Electroencephalography and Clinical Neurophysiology 106 (4): 357–368. encephalopathies. F. pdf). NeuroImage 37 (2): 504–507. Generalized Features for Electrocorticographic BCIs (http:/ / www. Journal of Clinical Neurophysiology 24 (2): 130–136. Rasmussen (1998). [10] Kai J.

particularly when it is necessary to record a patient while he/she is having a seizure. while EEG is constantly being recorded (along with time-synchronized video and audio recording). in certain instances. Neurons are constantly exchanging ions with the extracellular milieu.[6] Scalp EEG activity shows oscillations at a variety of frequencies. while many others are not (e. A recording of an actual seizure (i. for example to maintain resting potential and to propagate action potentials. Several of these oscillations have characteristic frequency ranges. EEG activity therefore always reflects the summation of the synchronous activity of thousands or millions of neurons that have similar spatial orientation.g. waking and the various sleep stages). and so on. the difference in push. The neuronal networks underlying some of these oscillations are understood (e. in patients with coma • to determine whether to wean anti-epileptic medications At times. activity from deep sources is more difficult to detect than currents near the skull. who push their neighbors. spatial distributions and are associated with different states of brain functioning (e.. or voltage. sub-cortical movement disorders and migraine variants. . Neurons are electrically charged (or "polarized") by membrane transport proteins that pump ions across their membranes. Because voltage fields fall off with the square of the distance.e. the patient may be admitted to the hospital for days or even weeks. syncope (fainting). Routine EEG is typically used in the following clinical circumstances: • to distinguish epileptic seizures from other types of spells. their ions do not line up and create waves to be detected. If the cells do not have similar spatial orientation.g.[7] [5] Clinical use A routine clinical EEG recording typically lasts 20–30 minutes (plus preparation time) and usually involves recording from scalp electrodes.. Ions of like charge repel each other..Electroencephalography 38 Source of EEG activity The brain's electrical charge is maintained by billions of neurons. • to differentiate "organic" encephalopathy or delirium from primary psychiatric syndromes such as catatonia • to serve as an adjunct test of brain death • to prognosticate. The electric potentials generated by single neurons are far too small to be picked by EEG or MEG. Recording these voltages over time gives us the EEG. the system that generates the posterior basic rhythm). between any two electrodes can be measured by a voltmeter. an ictal recording.[4] Epileptic spike and wave discharges monitored with EEG. Research that measures both EEG and neuron spiking finds the relationship between the two is complex with the power of surface EEG only in two bands that of gamma and delta relating to neuron spike activity. These oscillations represent synchronized activity over a network of neurons. in a wave. Since metal conducts the push and pull of electrons easily. they can push or pull electrons on the metal on the electrodes. In this case. This process is known as volume conduction. a routine EEG is not sufficient.. the thalamocortical resonance underlying sleep spindles). Pyramidal neurons of the cortex are thought to produce most EEG signal because they are well-aligned and fire together. rather than an inter-ictal recording of a possibly epileptic patient at some period between seizures) can give significantly better information about whether or not a spell is an epileptic seizure and the focus in the brain from which the seizure activity emanates. they can push their neighbors. When the wave of ions reaches the electrodes on the scalp. such as psychogenic non-epileptic seizures.g. and when many ions are pushed out of many neurons at the same time.

Hardware costs are significantly lower for EEG sensors versus an fMRI machine EEG sensors can be deployed into a wider variety of environments than can a bulky. sub-cortical movement disorders and migraine variants. rather than seconds EEG is relatively tolerant of subject movement versus an fMRI (where the subject must remain completely still) EEG is silent. Some clinical sites record from penetrating microelectrodes. are used extensively in neuroscience. smaller electrodes (which cover a smaller parcel of brain surface) allow even lower voltage.[2] 39 Research use EEG. This is because the cerebrospinal fluid. Low voltage. The signal recorded from ECoG is on a different scale of activity than the brain activity recorded from scalp EEG. Further. and the lower is a 10 Hz timing signal. faster components of brain activity to be seen. and psychophysiological research. The upper tracing is EEG. and its derivative. skull and scalp smear the electrical potentials recorded by scalp EEG. cognitive psychology. A different method to study brain function is functional magnetic resonance imaging (fMRI). EEG may be used to monitor certain procedures: • to monitor the depth of anesthesia • as an indirect indicator of cerebral perfusion in carotid endarterectomy • to monitor amobarbital effect during the Wada test EEG can also be used in intensive care units for brain function monitoring: • to monitor for non-convulsive seizures/non-convulsive status epilepticus • to monitor the effect of sedative/anesthesia in patients in medically induced coma (for treatment of refractory seizures or increased intracranial pressure) • to monitor for secondary brain damage in conditions such as subarachnoid hemorrhage (currently a research method) If a patient with epilepsy is being considered for resective surgery. Many techniques used in research contexts are not standardized sufficiently to be used in the clinical context. such as psychogenic non-epileptic seizures. immobile fMRI machine EEG enables higher temporal resolution. it is often necessary to localize the focus (source) of the epileptic brain activity with a resolution greater than what is provided by scalp EEG. through either a craniotomy or a burr hole. • to characterize seizures for the purposes of treatment • to localize the region of brain from which a seizure originates for work-up of possible seizure surgery Additionally. subdural EEG (sdEEG) or intracranial EEG (icEEG)--all terms for the same thing. high frequency components that cannot be seen easily (or at all) in scalp EEG can be seen clearly in ECoG. Some benefits of EEG compared to fMRI include: • • • • • • • • The first human EEG recording obtained by Hans Berger in 1924. In these cases. neurosurgeons typically implant strips and grids of electrodes (or penetrating depth electrodes) under the dura mater. The recording of these signals is referred to as electrocorticography (ECoG). ERPs. cognitive science. on the order of milliseconds. which allows for better study of the responses to auditory stimuli EEG does not aggravate claustrophobia EEG does not involve exposure to radio-ligangs (as in positron emission tomography) EEG does not involve exposure to high-intensity (>1 Tesla) magnetic fields (as in MRI) Limitations of EEG as compared with fMRI include: • Significantly lower spatial resolution .Electroencephalography Epilepsy monitoring is typically done: • to distinguish epileptic seizures from other types of spells. syncope (fainting).

Analog-to-digital sampling typically occurs at 256–512 Hz in clinical scalp EEG. Many systems typically use electrodes. During the recording. During (inpatient) epilepsy monitoring. processing that does not require a response) EEG can be used in subjects who are incapable of making a motor response Some ERP components can be detected even when the subject is not attending to the stimuli As compared with other reaction time paradigms. These procedures include hyperventilation. and the amplified signal is digitized via an analog-to-digital converter. MRI pulse artifact and the induction of electrical currents in EEG wires that move within the strong magnetic fields of the MRI. the signal is then filtered (next paragraph). however. such as the presence of ballistocardiographic artifact. photic stimulation (with a strobe light). respectively. the recording is obtained by placing electrodes on the scalp with a conductive gel or paste. are digital. a common system reference electrode is connected to the other input of each differential amplifier. a patient's typical seizure medications may be withdrawn.000–100.000 times. usually after preparing the scalp area by light abrasion to reduce impedance due to dead skin cells. Electrode locations and names are specified by the International 10–20 Neurovisor-BMM 40 [8] system for most clinical and research applications (except when high-density arrays are used). High-density arrays (typically via cap or net) can contain up to 256 electrodes more-or-less evenly spaced around the scalp. An additional notch filter is typically used to remove artifact caused by electrical power lines (60 Hz in the United States and 50 Hz in many other countries). each of which is attached to an individual wire. such as electrogalvanic signals and movement artifact. ERPs can elucidate stages of processing (rather than just the final end result) 40 Method In conventional scalp EEG. These amplifiers amplify the voltage between the active electrode and the reference (typically 1.[9] A smaller number of electrodes are typically used when recording EEG from neonates. Each electrode is connected to one input of a differential amplifier (one amplifier per pair of electrodes). after being passed through an anti-aliasing filter.Electroencephalography • ERP studies require relatively simple paradigms. In analog EEG. eye closure. compared with block-design fMRI studies EEG recordings have been successfully obtained simultaneously with fMRI scans. or 60–100 dB of voltage gain). Typical settings for the high-pass filter and a low-pass filter are 0. a series of activation procedures may be used. In most clinical applications. though successful simultaneous recording requires that several technical issues be overcome. Additional electrodes can be added to the standard set-up when a clinical or research application demands increased spatial resolution for a particular area of the brain. The high-pass filter typically filters out slow artifact. The digital EEG signal is stored electronically and can be filtered for display. sampling rates of up to 20 kHz are used in some research applications. Most EEG systems these days..e. Some systems use caps or nets into which electrodes are embedded. sleep and sleep deprivation.5-1 Hz and 35–70 Hz.[2] As part of an evaluation for Computer Electroencephalograph . and the EEG signal is output as the deflection of pens as paper passes underneath. such as electromyographic signals. These procedures may induce normal or abnormal EEG activity that might not otherwise be seen. This system ensures that the naming of electrodes is consistent across laboratories. this is particularly common when high-density arrays of electrodes are needed. mental activity. EEG also has some characteristics that compare favorably with behavioral testing: • • • • EEG can detect covert processing (i. 19 recording electrodes (plus ground and system reference) are used. whereas the low-pass filter filters out high-frequency artifacts.

and therefore display filtering is often not needed. Laplacian montage Each channel represents the difference between an electrode and a weighted average of the surrounding electrodes. For example. Referential montage Each channel represents the difference between a certain electrode and a designated reference electrode. the EEG can be viewed by the electroencephalographer in any display montage that is desired. Average reference montage The outputs of all of the amplifiers are summed and averaged. Also. [10] 41 and is Since an EEG voltage signal represents a difference between the voltages at two electrodes." represents the voltage difference between F3 and C3. it may be necessary to insert electrodes near the surface of the brain. all signals are typically digitized and stored in a particular (usually referential) montage.. the channel "Fp1-F3" represents the difference in voltage between the Fp1 electrode and the F3 electrode. and this averaged signal is used as the common reference for each channel. under the surface of the dura mater. This is done by visual inspection of the waveforms. structures.[11] When analog (paper) EEGs are used. the display of the EEG for the reading encephalographer may be set up in one of several ways. however. it is. the technologist switches between montages during the recording in order to highlight or better characterize certain features of the EEG. The entire montage consists of a series of these channels. and so on through the entire array of electrodes. waveform) represents the difference between two adjacent electrodes. . many of the artifacts that affect scalp EEG do not impact ECoG.Electroencephalography epilepsy surgery. optimally one who has specific training in the interpretation of EEGs for clinical purposes. called graphoelements. which are common epileptic foci and may not be "seen" clearly by scalp EEG. Bipolar montage Each channel (i. ECoG is typically recorded at higher sampling rates than scalp EEG because of the requirements of Nyquist theorem—the subdural signal is composed of a higher predominance of higher frequency components. The next channel in the montage. There is no standard position for this reference. The representation of the EEG channels is referred to as a montage. Midline positions are often used because they do not amplify the signal in one hemisphere vs. since any montage can be constructed mathematically from any other. "F3-C3. The use of computer signal processing of the EEG—so-called quantitative EEG—is somewhat controversial when used for clinical purposes (although there are many research uses)." which is a physical or mathematical average of electrodes attached to both earlobes or mastoids. Depth electrodes may also be placed into brain structures. with a couple of caveats. This is referred to variously as "electrocorticography (ECoG)". This is accomplished via burr hole or craniotomy.e. the other. The EEG is read by a clinical neurophysiologist or neurologist (depending on local custom and law regarding medical specialities). The electrocorticographic signal is processed in the same manner as digital scalp EEG (above). Another popular reference is "linked ears. "intracranial EEG (I-EEG)" or "subdural EEG (SD-EEG)". at a different position than the "recording" electrodes. such as the amygdala or hippocampus. A typical adult human EEG signal is about 10µV to 100 µV in amplitude when measured from the scalp about 10–20 mV when measured from subdural electrodes. With digital EEG.

these frequency bands are a matter of nomenclature (i..g. There are technical difficulties associated with combining these two modalities. EEG measures the brain's electrical activity directly. fMRI) or metabolic activity (e. The ionic currents involved in the generation of fast action potentials may not contribute greatly to the averaged field potentials representing the EEG . EEG vs fMRI and PET EEG has several strong points as a tool for exploring brain activity.5-130 milliseconds to propagate across a single neuron. much work has been done to produce remarkably good estimates of. currents can be induced in moving EEG electrode wires due to the magnetic field of the MRI. The rhythmic activity is divided into bands by frequency. cerebrospinal fluid and skull "smear" the EEG signal. Frequency bands are usually . however. However. SPECT. obscuring its intracranial source. EEG can be used simultaneously with fMRI so that high-temporal-resolution data can be recorded at the same time as high-spatial-resolution data. while other methods record changes in blood flow (e. have far less contribution to the EEG signal.[2] as some currents produce potentials that cancel each other out. which are indirect markers of brain electrical activity. the data sets do not necessarily represent exactly the same brain activity. but these designations arose because rhythmic activity within a certain frequency range was noted to have a certain distribution over the scalp or a certain biological significance.[15] EEG can be recorded at the same time as MEG so that data from these complementary high-time-resolution techniques can be combined..[5] [13] More specifically. To some degree. PET). in midline or deep structures (such as the cingulate gyrus or hippocampus). or producing currents that are tangential to the skull. The meninges. such as PET and fMRI have time resolution between seconds and minutes.. depending on the type of neuron. EEG is most sensitive to a particular set of post-synaptic potentials: those generated in superficial layers of the cortex. Normal activity The EEG is typically described in terms of (1) rhythmic activity and (2) transients. a localized electric dipole that represents the recorded currents. inside sulci. Furthermore. on the crests of gyri directly abutting the skull and radial to the skull.g. EEG vs MEG EEG reflects correlated synaptic activity caused by post-synaptic potentials of cortical neurons. since the data derived from each occurs over a different time course.[12] Other methods of looking at brain activity. the scalp electrical potentials that produce EEG are generally thought to be caused by the extracellular ionic currents caused by dendritic electrical activity. excellent considering an action potential takes approximately 0.Electroencephalography 42 Limitations EEG has several limitations. whereas the fields producing magnetoencephalographic signals[14] are associated with intracellular ionic currents . EEG's can detect changes within a millisecond timeframe.e. any rhythmic activity between 6–12 Hz can One second of EEG signal be described as "alpha"). at least. Most important is its poor spatial resolution. It is mathematically impossible to reconstruct a unique intracranial current source for a given EEG signal. which are deeper in the cortex. including the need to remove the MRI gradient artifact present during MRI acquisition and the ballistocardiographic artifact (resulting from the pulsatile motion of blood and tissue) from the EEG. Dendrites. This is referred to as the inverse problem.

and deficits in Mu suppression. under standard clinical recording techniques). Sato. Sauseng. sounds. Most of the cerebral signal observed in the scalp EEG falls in the range of 1–20 Hz (activity below or above this range is likely to be artifactual.Electroencephalography extracted using spectral methods (for instance Welch) as implemented for instance in freely available EEG software such as EEGLAB. 2006) young children drowsiness or arousal in older children and adults idling Associated with inhibition of elicited responses (has been found to spike in situations where a person is actively trying to repress a response or action) (Kirmizi-Alsan et al. • Mu 8 – 13 Sensorimotor cortex • • Mu suppression could be indicative for motor mirror neurons working. might play a role in [17] autism. Yeung. both sides.. While researchers tend to follow these guidelines. most evident frontally. busy or anxious thinking. • • • • • • • • subcortical lesions diffuse lesions metabolic encephalopathy hydrocephalus deep midline lesions focal subcortical lesions metabolic encephalopathy deep midline disorders some instances of hydrocephalus Theta 4 – <8 Alpha 8 – 13 posterior regions of head. 2005) It should be noted that while these are the universally recognized ranges. seemingly with the purpose of timing inhibitory activity in different locations across the brain (Klimesch. alert/working active. posteriorly in children. and thus in mirror neurons. [16] 1952). Nieuwenhuis. • • • • coma Beta >13 – 30 both sides. Frund. & Ohira 2007. this has not been proven for use as a clinical diagnostic measurement yet (Moretti et al. & Hanslmayr 2007. high amplitude waves Found in locations not related to task at hand • • • • • • • adults slow wave sleep in babies Has been found during some continuous attention tasks (Kirmizi-Alsan et al. or tactile sensations (Herrmann. many scholars use their own specific . they are not concrete definitions of the range of brain-waves. 2009). & Cohen 2004) Also is shown during short term memory matching of recognized objects. 2006). higher in amplitude on dominant side. relaxed/reflecting closing the eyes Also associated with inhibition control. symmetrical distribution. & Lenz 2009) Shows rest state motor neurons (Gastaut. however. especially when related the theta band. (Oberman et al. low amplitude waves Somatosensory cortex • • • benzodiazepines Gamma 30 – 100+ • • A decrease in gamma band activity may be associated with cognitive decline. Central sites (c3-c4) at rest . such as sound and sight) (Kisley & Cornwell 2006. active concentration Displays during cross-modal sensory processing (perception that combines two different senses. Kanayama. Coan & Allen 2008). 43 Comparison table Comparison of EEG bands Type Frequency (Hz) up to 4 Location Normally Pathologically Delta frontally in adults.

In addition to the posterior basic rhythm. metabolic encephalopathy hydrocephalus or deep midline lesions. it can be seen in generalized distribution in diffuse disorder or metabolic encephalopathy or deep midline disorders or some instances of hydrocephalus. there are other normal alpha rhythms such as the mu rhythm (alpha activity in the contralateral sensory and motor cortical areas that emerges when sensorimotor rhythm aka mu rhythm. It tends to be the highest in amplitude and the slowest waves. meditative.g.Occipital Intermittent Rhythmic Delta). It is also seen normally delta waves. FIRDA . and attenuates with eye opening or mental exertion. the hands and arms are idle. Generally. It is usually most prominent frontally in adults (e. It may be seen in drowsiness or arousal in older children and adults.1. • Theta is the frequency range from 4 Hz to 7 Hz. theta for age represents abnormal activity. for example. OIRDA . while still others sometimes divide the bands into sub-bands. some researchers define the bands using decimal values rather than rounding to whole numbers (for example. seen in the posterior regions of the head on both sides.g. and creative states. It emerges with closing of the eyes and with relaxation. and the "third rhythm" (alpha activity in the temporal or frontal lobes). one researcher may define the lower Beta band cut-off as 12. 44 Wave patterns • Delta is the frequency range up to 4 Hz. it can also theta waves. Additionally.Electroencephalography boundaries depending on the range they choose to focus on.[19] [20] Alpha can be abnormal. Hans Berger named the first rhythmic EEG activity he saw as the "alpha wave". Theta is seen normally in young children. called the "posterior dominant rhythm" or the "posterior alpha rhythm"). It can be seen as a focal disturbance in focal subcortical lesions. while another may use the value 13). . • Alpha is the frequency range from 8 Hz to 12 Hz. an EEG that has diffuse alpha occurring in coma and is not responsive to external stimuli is referred to as "alpha coma". On the contrary this range has been associated with reports of relaxed. in babies. It is seen normally in adults in slow wave sleep. this is only done for the sake of analysis.Frontal Intermittent Rhythmic Delta) and posteriorly in children (e. This was the "posterior basic rhythm" (also alpha waves. The posterior basic rhythm is actually slower than 8 Hz in young children (therefore technically in the theta range). It may occur focally with subcortical lesions and in general distribution with diffuse lesions. higher in amplitude on the dominant side. [18] Excess be seen in meditation.

but not associated with dysfunction or disease. Spikes and sharp waves may represent seizure activity or interictal activity in individuals with epilepsy or a predisposition toward epilepsy. Stage III and IV sleep are defined by the presence of delta frequencies and are often referred to collectively as "slow-wave sleep. Stage I sleep (equivalent to drowsiness in some systems) appears on the EEG as drop-out of the posterior basic rhythm. EEG under general anesthesia depends on the type of anesthetic employed. It is not typically recorded in a clinical context because the signal at these frequencies is susceptible to a number of artifacts.Electroencephalography • Beta is the frequency range from 12 Hz to about 30 Hz. such as propofol. busy or anxious thinking and active concentration. Some features of the EEG are transient rather than rhythmic. especially anteriorly. Beta activity beta waves. Other transient features are normal: vertex waves and sleep spindles are seen in normal sleep. Mu suppression is thought to reflect motor mirror neuron systems. nonreactive EEG pattern is seen over most of the scalp. and interfere with each other. Gamma rhythms are thought to represent binding of different populations of neurons together into a network for the purpose of carrying out a certain cognitive or motor function." Stages I-IV comprise non-REM (or "NREM") sleep. It reflects the synchronous firing of motor neurons in rest state. The normal EEG also varies depending on state.[17] "Ultra-slow" or "near-DC" activity is recorded using DC amplifiers in some research contexts. Stage II sleep is characterized by sleep spindles—transient runs of rhythmic activity in the 12–14 Hz range (sometimes referred to as the "sigma" band) that have a frontal-central maximum. The neonatal EEG is quite different from the adult EEG. The normal Electroencephalography (EEG) varies by age. EMG) to define sleep stages in polysomnography. • Mu ranges 8–13 Hz. There can be an increase in theta frequencies. in some older terminology this was known as a WAR (widespread anterior rapid) pattern. It may be absent or reduced in areas of cortical damage. It is the dominant rhythm in patients who are alert or anxious or who have their eyes open. The EEG in childhood generally has slower frequency oscillations than the adult EEG. Note that there are types of activity that are statistically uncommon.. Santamaria and Chiappa cataloged a number of the variety of patterns associated with drowsiness. Rhythmic beta with a dominant set of frequencies is associated with various pathologies and drug effects. Anesthetic effects on EEG signals are beginning to be understood at the level of drug actions on different kinds of synapses and . the pattern extinguishes. • Gamma is the frequency range approximately 30–100 Hz. is closely linked to motor behavior and is generally attenuated during active movements. a rapid (alpha or low beta).[21] Low amplitude beta with multiple and varying frequencies is often associated with active. With halogenated anesthetics. contrasted with a WAIS (widespread slow) pattern associated with high doses of opiates. Most of the activity in Stage II is in the 3–6 Hz range. especially benzodiazepines.[2] 45 gamma waves. The EEG in REM (rapid eye movement) sleep appears somewhat similar to the awake EEG. such as halothane or intravenous agents. because when an action is observed. These are often referred to as "normal variants. possibly because of the normal neuronal system and the mirror neuron system "go out of sync"." The mu rhythm is an example of a normal variant. and partly overlaps with other frequencies. The EEG is used along with other measurements (EOG. It is seen usually on both sides in symmetrical distribution and is most evident frontally.

EEG data is almost always contaminated by such artifacts. drowsiness or sleep. occurring mostly during blinking or vertical eye movements. Because of this. this corneo-retinal dipole does not affect EEG. elicit a large potential seen mostly in the difference between the Electrooculography (EOG) channels above and below the eyes. which are very important in polysomnography. but that originate from non-cerebral origin are called artifacts. for instance.[25] The spectrum of these SPs overlaps the gamma-band (see Gamma wave). Eyelid fluttering artifacts of a characteristic type were previously called Kappa rhythm (or Kappa waves).stanford. and should not technically be called a rhythm or wave. known as saccadic spike potentials (SPs). blinks occur several times per minute. Eyelid movements.edu/group/maciverlab/).[25] Purposeful or reflexive eye blinking also generates electromyographic potentials. They were named because they were believed to originate from the brain.[27] Some of these artifacts can be useful in various applications. EKG artifacts are quite common and can be mistaken for spike activity. rather than a Kappa rhythm (or wave). eye movements and extra-ocular muscle activity) EKG (cardiac) artifacts EMG (muscle activation)-induced artifacts Glossokinetic artifacts The most prominent eye-induced artifacts are caused by the potential difference between the cornea and retina. They are in fact noise in the EEG reading. modern EEG acquisition commonly includes a one-channel EKG from the extremities.[26] requiring tailored artifact correction approaches. and seriously confounds analysis of induced gamma-band responses. The EOG signals. When the eyes and eyelids are completely still. However. but more importantly there is reflexive movement of the eyeball during blinking that gives a characteristic artifactual appearance of the EEG (see Bell's phenomenon). can be used to detect[25] and track eye-movements. Glossokinetic artifacts are caused by the potential difference between the base and the tip of the tongue. Sometimes they are seen with mental activity. An established explanation of this potential regards the eyelids as sliding electrodes that short-circuit the positively charged cornea to the extra-ocular skin. 46 Artifacts Biological artifacts Electrical signals detected along the scalp by an EEG. . and consequently of the corneo-retinal dipole. and decrease the potentials in the opposing electrodes. Minor tongue movements can contaminate the EEG. Later study revealed they were generated by rapid fluttering of the eyelids. current usage in electroencephalography refers to the phenomenon as an eyelid fluttering artifact. that is. increases the potential in electrodes towards which the eyes are rotated.[22] [23] Rotation of the eyeballs. They are usually in the Theta (4–7 Hz) or Alpha (8–13 Hz) range. and is also in conventional EEG for assessing possible changes in alertness. It is usually seen in the prefrontal leads. which is quite large compared to cerebral potentials. sometimes so minute that it was difficult to see. the eyes movements occur several times per second. just over the eyes. The amplitude of artifacts can be quite large relative to the size of amplitude of the cortical signals of interest. This is one of the reasons why it takes considerable experience to correctly interpret EEGs clinically. This also allows the EEG to identify cardiac arrhythmias that are an important differential diagnosis to syncope or other episodic/attack disorders. especially in parkinsonian and tremor disorders.Electroencephalography the circuits that allow synchronized neuronal activity (see: http://www.[24] Eye movements called saccades also generate transient electromyographic potentials. Some of the most common types of biological artifacts include: • • • • Eye-induced artifacts (includes eye blinks. Therefore.

It may also appear as focal or unilateral decrease in amplitude of the EEG signal. presented his findings about electrical phenomena of the exposed cerebral hemispheres of rabbits and monkeys in the British Medical Journal in 1875. Berger also invented the . Poor grounding of the EEG electrodes can cause significant 50 or 60 Hz artifact. such devices can cause rhythmic. Intracortical Encephalogram electrodes and sub-dural electrodes can be used in tandem to discriminate and discretize artifact from epileptiform and other severe neurological events. German physiologist and psychiatrist Hans Berger (1873–1941) recorded the first human EEG in 1924. Napoleon Cybulski and Jelenska-Macieszyna photographed EEG-recordings of experimentally induced seizures. Movement by the patient. There are many source separation algorithms. synchronous potentials in a large number of neurons in a somewhat discrete area of the brain. In 1912. Polish physiologist Adolf Beck published an investigation of spontaneous electrical activity of the brain of rabbits and dogs that included rhythmic oscillations altered by light. many artifacts originate from outside the body. which use ICA. the principle behind any particular method usually allow "remixing" only those components that would result in "clean" EEG by nullifying (zeroing) the weight of unwanted components. It can also be separated into focal or diffuse. (See focal epilepsy. often assuming various behaviors or natures of EEG. Artifact correction Recently. Vladimir Vladimirovich Pravdich-Neminsky published the first animal EEG and the evoked potential of the mammalian (dog).[33] Abnormal activity Abnormal activity can broadly be separated into epileptiform and non-epileptiform activity. Regardless. or even just settling of the electrodes. Interictal discharges are not wholly reliable for determining whether a patient has epilepsy nor where his/her seizure might originate.Electroencephalography 47 Environmental artifacts In addition to artifacts generated by the body. and represent an area of cortical irritability that may be predisposed to producing epileptic seizures. Diffuse non-epileptiform abnormal activity may manifest as diffuse abnormally slow rhythms or bilateral slowing of normal rhythms. It often consists of an increase in slow frequency rhythms and/or a loss of normal higher frequency rhythms. fast. depending on the local power system's frequency. such as the PBR. A third source of possible interference can be the presence of an IV drip. More advanced measures of abnormal EEG signals have also recently received attention as possible biomarkers for different disorders such as Alzheimer's disease. They are strongly suggestive of a generalized epilepsy. may cause electrode pops. low-voltage bursts.[28] [29] [30] [31] [32] These techniques attempt to "unmix" the EEG signals into some number of underlying components. between seizures. Focal non-epileptiform abnormal activity may occur over areas of the brain where there is focal damage of the cortex or white matter. a physician practicing in Liverpool. but these are seen synchronously throughout the entire brain. spikes originating from a momentary change in the impedance of a given electrode.[35] Richard Caton (1842–1926). independent component analysis techniques have been used to correct or remove EEG contaminates.[36] In 1914. which may be confused for spikes. Focal epileptiform discharges represent fast.[34] History A timeline of the history of EEG is given by Swartz. In 1890. have also been developed. These can occur as interictal activity.) Generalized epileptiform discharges often have an anterior maximum.[37] Expanding on work previously conducted on animals by Richard Caton and others. Russian physiologist. Fully automated artifact rejection methods.

Two of these companies. and in its most advanced form is also attempted as the basis of brain computer interfaces. 48 Various uses The EEG has been used for many purposes besides the conventional uses of clinical diagnosis and conventional cognitive neuroscience. Franklin Offner (1911–1999). remarkable. The EEG is also used quite extensively in the field of neuromarketing. In the 1950s.[38] His discoveries were first confirmed by British scientists Edgar Douglas Adrian and B. [41] Games Recently a few companies have scaled back medical grade EEG technology (and in one case. The aim is to analyse neural signals that exist in the brain before words are spoken. Neurofeedback remains an important extension. . have even built commercial EEG devices retailing for under 100$. The American EEG Society was founded and the first International EEG congress was held. In 1953 Aserinsky and Kleitman describe REM sleep. In 1934.[43] [46] .[40] EEG and Telepathy DARPA budgeted $4 million in 2009 to investigate technology to enable soldiers on the battlefield to communicate via computer-mediated telepathy. By far the best selling consumer based EEG to date. rebuilt the technology from the ground up) to create inexpensive devices based on EEG. There are many commercial products substantially based on the EEG. In 1935 Gibbs. Fisher and Lowenback first demonstrated epileptiform spikes. a game that used an EEG to steer a ball through an obstacle course. • In 2007 NeuroSky released the first affordable consumer based EEG along with the game NeuroBoy. It was never accepted by neurologists and remains primarily a research tool. The same year. Long-term EEG recordings in epilepsy patients are used for seizure prediction. an invention described "as one of the most surprising. Judecca.[39] EEGs have been used as evidence in trials in the Indian state of Maharastra. William Grey Walter developed an adjunct to EEG called EEG topography. Matthews in 1934 and developed by them. In 1947. which began the field of clinical electroencephalography. NeuroSky and OCZ. C. in 1936 Gibbs and Jasper reported the interictal spike as the focal signature of epilepsy. a game designed to create the illusion of possessing the force.[42] • In 2008 OCZ Technology developed device for use in video games relying primarily on electromyography.[43] [44] • In 2009 Mattel partnered with NeuroSky to release the Mindflex. H.Electroencephalography electroencephalogram (giving the device its name). Davis and Lennox described interictal spike waves and the 3 cycles/s pattern of clinical absence seizures. This was also the first large scale EEG device to use dry sensor technology. and momentous developments in the history of clinical neurology". This enjoyed a brief period of popularity in the 1980s and seemed especially promising for psychiatry. NeuroSky.[43] [45] • In 2009 Uncle Milton Industries partnered with NeuroSky to release the StarWars Force Trainer. a technology it eventually hopes to incorporate into its automobiles. professor of biophysics at Northwestern University developed a prototype of the EEG that incorporated a piezoelectric inkwriter called a Crystograph (the whole device was typically known as the Offner Dynograph). which allowed for the mapping of electrical activity across the surface of the brain. Honda is attempting to develop a system to move its Asimo robot using EEG. the first EEG laboratory opened at Massachusetts General Hospital. Subsequently. • In 2008 the Final Fantasy developer Square Enix announced that it was partnering with NeuroSky to create a game.

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"Meditation states and traits: EEG. Whelan. [39] (http:/ / search.. com/ dangerroom/ 2009/ 05/ pentagon-preps-soldier-telepathy-push/ ). Humphries. wired. "Timeline of the history of EEG and associated fields" (http:/ / www. Lüders. Sejnowski. L.1016/j.1469-8986. doi:10. PMID 19164579. htm) International Society for the History of the Neurosciences (ISHN). [26] Yuval-Greenberg. detection and suppression".

engadget. is purchasable on their official website with a price tag of US$299. Emotiv Systems claims the headset will make it possible for games to be controlled and influenced by the player's mind. Emotiv Systems was founded in 2003 by four scientists and executives: neuroscientist Professor Allan Snyder.Electroencephalography [43] Li. story). 51 External links • Scholarpedia EEG (http://www. . and facial expressions. Physorg. Brainwave-Powered Games" (http:/ / www.NeuroSky Upgrades SDK. Gamasutra.[4] Chief Technology Officer (CTO) is Geoffrey MacKellar.com. com/ 2008/ 10/ 09/ brains-on-with-neurosky-and-squareenixs-judecca-mind-control-ga/ ).6235181. and may in the future work on other game platforms such as consoles. Retrieved 2010-12-02.[5] The EPOC. [44] "Brains-on with NeuroSky and Square Enix's Judecca mind-control game" (http:/ / www. see Comparison of consumer brain–computer interfaces. in 1998 from Monash University)[3] and Nam Do.0. The Epoc was designed by a Emotiv Systems in conjunction with the Sydney based Industrial Design [7] [8] consultancy 4design. The FASTER software is available here. Allows For Eye Blink.net/projects/faster) • OpenEEG (http://openeeg.Faster) A fully automated. .sourceforge.org/article/Electroencephalogram) • FASTER (http://www. Shan (2010-08-08).full. com/ ). "Toy trains 'Star Wars' fans to use The Force" (http:/ / www. com/ news150781868. [46] Snider. com/ view/ news/ 29190/ NeuroSky_Upgrades_SDK_Allows_For_Eye_Blink_BrainwavePowered_Games. [48] "News . Inputs The EPOC has 14 electrodes[9] [10] (compared to the 19 electrodes of a standard medical EEG. php). html). The hardware is aimed toward amateurs who would like to experiment with EEG. .net/doc/) The OpenEEG project makes hardware plans and software for do-it-yourself EEG devices in an Open Source manner. (https://sourceforge. Emotiv. and the 3 of OCZ's NIA features and a multiple of NeuroSky's single electrode). Retrieved 2009-12-29. their gaming-peripheral. • (http://www. physorg. Retrieved 2010-12-02.scholarpedia. it is free and the software is open source. .tcd. unsupervised method for processing of high density EEG data. Los Angeles Times. com/ life/ lifestyle/ 2009-01-06-force-trainer-toy_N. Retrieved 2010-12-02. latimes. It also has a two-axis gyro for measuring head rotation. [47] "Emotiv Systems Homepage" (http:/ / emotiv. . Retrieved 2010-05-01.[2] and technology entrepreneurs Tan Le (B. Emotiv EPOC Emotiv System's only current product is the Emotiv EPOC. Comm. USA Today. com/ business/ la-fi-mind-reader-20100808. gamasutra.caet.org) Canadian association of EEG techs (CAET) Emotiv Systems Emotiv Systems is an Australian-origin[1] electronics company developing brain–computer interfaces based on electroencephalography (EEG) technology. chip-designer Neil Weste. [45] "New games powered by brain waves" (http:/ / www. htm).com. Mike (2009-01-07). Engadget. It connects wirelessly with the PC. . "Mind reading is on the market" (http:/ / www. a $300 peripheral for gaming on Windows PCs.mee. 2010-06-30.[6] For a comparison with the OCZ Neural Impulse Actuator and other competing devices. A user wearing a wireless Emotiv EPOC headset.ie/neuraleng/Research. FASTER has been peer-reviewed. . usatoday.

The sky changes color according to the mood of the player. The EPOC also includes "EmoKey" software used to emulate keystrokes based on combinations of thoughts. Other expressions may be added prior to release. This is detected by gyros. then raising a temple from below the ground. Videos of Emotiv employees playing "The Game" show a high degree of difficulty in adapting and thinking right even as experienced users. with many different activities at different locations. instant messaging programs.[16] 52 Software The Emotiv EPOC will ship with a game by Demiurge Studios. the technology may still be useful in a support role like calling up a minimap or radar in a FPS game. forward. and "zoom") and 6 rotations ([anti-]clockwise rotation. clenching. up. turn left and right. and facial expressions. Future versions will also emulate the mouse based on the gyros. and says that they may be renamed before market launch. these detections are very fast (10ms)[14] conveying a decisive advantage and rendering them suitable for fast paced games in the FPS genre." (emphasis added)[12] ) or the much stronger EMG currents aside. these thought commands effectively become hotkeys. $2. eye position in the horizontal plane. the degrees of freedom are larger than a joystick's 2 df. but detection ability will be worse. Videos of portions of the game have been shown at conferences and in media interviews. right. but some users say it mainly measures facial expressions:[11] • Conscious thoughts (Cognitiv suite): Imagining 12 kinds of movement. and sway backward and forward). Emotiv admits that the names may not perfectly reflect exactly what the emotion is. Demonstrated activities in the game include pushing and rotating giant stone structures into the shape of stone henge. • Emotions (Affectiv suite): "Excitement".500 and $7. Ideomotor responses ("I found myself inadvertently tightening my stomach muscles. smiling. Zoz Brooks mind controlling a car with [17] EPOC. there is a slight lag in detecting thoughts. and smirking can currently be detected.500 respectively).Emotiv Systems The headset must first be "trained" to recognize what kind of thought pattern equates to a certain action. built on the Unreal engine. The expressions are detected by the EEG sensors picking up signals to facial muscles.[13] However. The Emotiv guy used his hands to try and cue himself to think the same way every time. Due to the complex detection algorithms involved. and "Frustration" can currently be measured. Research Plus or Enterprise Plus SDK licenses ($750. down. • Facial expressions (Expressiv suite): Individual eyelid and eyebrow positions. EPOC can be used to get EEG data (the raw electricity measurements). Any EPOC detection can be paired with keystrokes or string of keystrokes through a simple user interface by the end user. laughing. Unlike reading mental activity. • Head rotation: The angular velocity of one's head can be measured in the yaw and pitch (but not roll) directions. levitating a large rock and some smaller ones. Users can train the 13 visualizations to totally different thoughts than the ones specified. This software allows most existing games. rather than by reading brainwaves. Dr. and isn't related to the EEG features. previously called "The Game". feelings.those were in the demo application 6 directions (left. "Meditation". and . The game involves a first person view of the user walking around a virtual environment. repairing a bridge. For compatibility with non-compliant software EmoKey would be provided in order to bind commands to keys or combinations thereof transforming the device into an HID. "Engagement/Boredom".plus 1 other visualization ("disappear") that can be detected in µ rhythms. While the current driver may only be able to listen for any 4 of these at a time. It can measure four categories of inputs. bending a tree. Research. or raising an eyebrow when I tried to make the box float. with the Python Emokit[15] without the need for EPOC's proprietary software. and scaring away glowing spirits with scary facial expressions.

[3] Board of Directors (http:/ / emotiv. modified based on what the user is thinking and feeling. htm) at the Wayback Machine. There is also a planned web site known as "Emortal"." [13] "A Community for Disabled Gamers . g4tv. com/ ). in San Francisco an Emotiv headset was among the new video game input devices there.. References [1] "Corporate HP" (http:/ / emotiv.be. archive. on a graph. . asp?id=1307). com/ 358237/ mind-over-no-matter-hands+ on-with-the-psychic-controller) Memorable quote: "It worked ["levitation" thought command recognition from the cognitiv suite]. bobbing. Inc. – March 7. also seen in many videos. Retrieved 2009-11-14. com. Stephen (July 8. au/ application_detail. It was built by reverse-engineering the encrypted protocol. . com/ corporate/ 4_0/ 4_3. htm#nam) Archive copy (http:/ / web.com. and OCZ industries. [12] Field report (http:/ / kotaku. A SDK interface will give Linux users a more powerful control for recoding and modification of the Emotiv head set for other game consoles and programs. It has a 2D blue avatar that allows the user to view their own facial expressions.[15] 53 Marketing At the Game Developers Conference 2008. 2007. emotiv. 2008-03-22. I laughed in surprise and the box immediately dropped back down again. jsp?status=4& applicationID=7205) . . com/ ) of the corporate domain. pdf). The Emotiv EPOC has significantly more electrodes than its competitors and is not considerably more expensive. Emotiv. Ltd. Emokit [13] is an open-source Python library for reading out sensor data from the EPOC by Cody Brocious. . au) [9] Johnson. au/ portfolio/ news/ Emotiv-PR-March2007. ablegamers. [7] Emotiv EPOC (http:/ / www. com. gamedev. archive. htm#tan) Archive copy (http:/ / web. and adjust the sensitivity of those detections. com/ hardware-news/ 215-emotiv-interview. which allows users to train the various thoughts. Retrieved 2009-11-14. but is the only commercial EEG unit to still use wet sensor technology. Technology Venture Partners Pty. such as "excitement". and test them on a floating. com/ pub/ geoff-mackellar/ 6/ 82b/ 816) [6] "Blog Archive » Emotiv EPOC Neuroheadset Update" (http:/ / grinding. grinding. archive. It also allows users to view their emotional state. . linkedin.[20] Competitors The field of consumer BCI has three primary players. designawards. com/ corporate/ 4_0/ 4_3. 2008). Retrieved 2009-11-14. [2] Emotiv Emerges from Stealth to Revolutionize Human Computer Interaction (http:/ / www. html). emotiv. [5] Geoffrey MacKellar's LinkedIn profile (http:/ / au. Gamedev. net/ columns/ events/ gdc2008/ article. com/ thefeed/ blog/ post/ 686845/ Play_Games_With_Your_Mind. be/ 2008/ 03/ 22/ emotiv-epoc-neuroheadset-update/ ). "Headset makes empty Promises of Mind-Control Games" (http:/ / www. and other activities. htm) at the Wayback Machine. such as "push" and "disappear". com/ corporate/ 4_0/ 4_3. tvp. The demo played with the Emotiv was a puzzle where the player rebuilds Stonehenge. To do so.Australian International Design Awards [8] 4design Ltd (http:/ / www.[19] In July 2010.net.Disabled Gamers News/Hardware News" (http:/ / www. Retrieved 2009-11-14. com. AbleGamers. NeuroSky. for listening to music.[18] It includes software to emulate the Emotiv EPOC for developers who do not have one of the (beta version) headsets. G4 Media. org/ */ http:/ / web.Emotiv Systems other software to be controlled with the headset. [11] "Emotive Press Event . cube. org/ web/ 20080531145445/ http:/ / www. [4] Board of Directors (http:/ / emotiv.Inside the GDC 2008" (http:/ / www. html). org/ */ http:/ / web. 4design. archive. Tan Le gave a demo of the headset at a TED conference. A free SDK (called SDK Lite) is also available for download from the Emotiv website. Emotiv. . the wearer did hand motions such as pushing and pulling to restore Stonehenge. [10] Top mention under headset features on this site (http:/ / emotiv. viewing photos. com/ corporate/ 4_0/ 4_3. Another product is the Emotiv Control Panel. Retrieved 14 February 2009. org/ web/ 20080531145445/ http:/ / www.

com. com/ talks/ tan_le_a_headset_that_reads_your_brainwaves. com/ video/ id. . com/ videosearch?q=emotiv+ site:http:/ / youtube. 2008-02-21.Mind Reading Device (http://www. Retrieved 2009-11-14.emotiv. By Darren Waters. Pcworld. com/ daeken/ Emokit/ blob/ master/ Announcement. By David H. ted. [18] "Emotiv Systems. 2008-09-10. Retrieved 2009-11-14. html). Ted. [17] ""Prototype This: Mind Controlled Car" on The Discovery Channel" (http:/ / dsc.com. com/ watch?v=TwUyOmtxh-U& eurl=http:/ / video.com/) Emotiv Wiki (http://wiki. youtube. com/ corporate/ 1_0/ SDKLite-License.co.stm). Wired UK • Emotiv EPOC EEG Headset Hacked (http://hplusmagazine. pcworld.com/talks/ tan_le_a_headset_that_reads_your_brainwaves. BBC News • Reality Bites -. SDKLite License Agreement" (http:/ / emotiv. Dsc.bbc.uk/ magazine/archive/2010/12/features/mind-control). by Neal Pollack. com/ corporate/ 1_0/ 1_3.com. [19] "Game Developers Conference 2008" (http:/ / www.wired. [20] "Tan Le: A headset that reads your brainwaves | Video on" (http:/ / www.emotiv. com/ videos/ prototype-this-mind-controlled-car. archive.1-bid.co. Dec 1. html). Freedman.com/magazine/20081201/reality-bites. 54 External links • • • • Official website (http://http://www. Retrieved 2009-11-14. org/ web/ 20080516012142/ http:/ / emotiv.discovery.html) Articles • Brain control headset for gamers (http://news.Emotiv Systems [14] deep link to youtube (http:/ / www. archive.Emotiv -. .0/ video. 2008. htm) Archive copy (http:/ / web. Inc.inc.com/2010/09/13/ emotiv-epoc-eeg-headset-hacked/) . org/ */ http:/ / web. Retrieved 2010-09-10. Inc. html).com/) Emokit (https://github.uk/1/hi/technology/7254078. htm) at the Wayback Machine. 20 February 2008. discovery. com& so=0& num=100& feature=player_embedded#t=42m17s) where Randy Breen of Emotiv answers a question regarding this during a presentation at Stanford university [15] Python library for the Emotiv EPOC headset (http:/ / github. . Magazine profile • Mind control: How a £200 headset is redefining brain-computing interaction (http://www. com/ corporate/ 1_0/ 1_3.com/daeken/Emokit/) open source SDK Tan Le: A headset that reads your thoughts (http://www. google. .722-page. html). 29 November 2010. pdf) (PDF).ted. md) on Github [16] Emotiv Software Development Kit (http:/ / emotiv.

com/ business/ technology/ articles/ 2009/ 06/ 15/ may_the_force_be_with_you_for_just_130/ ). StarWars. and the higher the ball is suspended.2933.com/starwarsscience/).com. Fox News. For more information on the Force Trainer Toy. The Boston Globe. html?test=latestnews). 2009 External links • Uncle Milton Official website (http://http://www.html).Force Trainer 55 Force Trainer The Force Trainer is a Star Wars-themed toy being produced by Uncle Milton Industries that is said to allow its user to create the illusion of performing Force-powered telekinesis. foxnews.unclemilton. released as the company's Star Wars Science line in 2009.com/vault/collecting/20090209b. 2009 . com/ story/ 0. USA Today.starwars.usatoday. from Padawan all the way up to Jedi Master. 2009 [2] May the force be with you. 2009 • Toy trains 'Star Wars' fans to use The Force (http://www. for just $130 (http:/ / www. February 9. and others in the Star Wars Science line. The harder the user concentrates.[2] References [1] New Brain-Wave Toy Lets You Do 'Jedi Mind Trick' (http:/ / www. January 7.com/life/lifestyle/ 2009-01-06-force-trainer-toy_N. June 15. has a suggested retail price of $130. • Mysterious "Force Trainer" Toy Explained (http://www. The voice of Yoda instructs the user on developing their skills through various training stages.htm). boston.[1] The brain–computer interface toy.529539. It comes with a headset that senses EEG signals from the brain. the harder the fan blows.00. which relays the signals to a tube that uses a fan to blow a ball into the air. June 30.

1997.g. such as the hippocampus. clinical recordings in epilepsy patients are generally performed using macroelectrodes that measure coherent activity of local neuronal populations in the vicinity of the recording site . depth electrodes are semi-flexible one-dimensional linear arrays. such as the cingulate gyrus. Intracranial EEG in clinical epilepsy setting In patients with pharmacologically resistant epilepsy. While subdural grids provide widespread cortical coverage and cortical maps of gyral activity.. shaped as narrow needles that penetrate deep into the brain. the multilead depth electrodes record from both sulci and gyri and go beneath the cortical surface to probe deep cortical structures.. Such depth electrode implantations are often referred to as Stereotactic EEG because a stereotactic technique developed by Talairach and Bancaud is used to localize the electrodes [Kahane et al... 1988.. This sometimes implies that intra-cerebral electrodes are positioned in widely distributed brain regions that include pathological but also healthy tissue. with a typical inter-electrode distance of 1 cm [Engel et al. In contrast. This is also called "electrocorticography" (ECoG). such a clinical context can also provide a unique opportunity [2] to study fundamental questions about neural coding and cognition (Jerbi et al.Intracranial EEG 56 Intracranial EEG Intracranial EEG (iEEG) is an invasive technique based on recording electroencephalography (EEG) signals directly from the human cortex. Two Intracranial Recording Techniques: Stereotactic-EEG (SEEG) versus Electrocorticography (ECoG) Although microelectrodes have been used in humans to acquire single-neuron spiking data [Fried et al. The EEG signal then processes in the same manner as with a surface EEG. Subdural grids consist of 2D arrays (or sometimes one-dimensional strips) of electrodes positioned directly on the lateral surface of the brain. [2002]. such as the lateral geniculate nucleus [Krolak-Salmon . 2006]. 2005.. such as epileptic studies. 1955]. The EEG electrodes are placed under the surface of the scalp and skull directly on the brain surface. The most common choice in the clinical routine is to use either stereotactic electroencephalography (SEEG) or electrocorticography (ECoG) which acquire intracranial data using multilead depth electrodes or subdural grid electrodes respectively.. Electrodes can even be placed into specific brain areas. and occasionally subcortical structures. Kahane et al. Heit et al. Intracranial EEG is used to test one or several hypothesis regarding the anatomical organization of the epileptogenic network. 2002.. invasive recordings are used in patients with drug-resistant intractable epilepsy in order to chronically monitor neural activity in multiple brain structures during pre-surgical evaluation. as opposed to surface recordings in scalp-EEG. Engel et al.. Intracerebrally implanted electrodes sometimes stay in place for more than two weeks in order to localize the origin of fast electrophysiological rhythms that precede seizure onset and that are at the core of the epileptogenic network. as a result. 2005]. or using multi-lead depth electrodes. but with higher recording rates because of higher frequencies and little to no interference from outside sources — as with surface EEG. Depth recordings are for instance used during positioning of a deep brain stimulation (DBS) electrode in Parkinson's disease [Benazzouz et al. Ward and Thomas. deeper brain activity may not be recorded accurately by EEG.[1] In some cases. [2004]]. This is achieved either by using subdural grids or strips of electrodes placed directly on the surface of the cortex (also known as Electrocorticography). iEEG is used to identify cortical regions critical for seizure onset and identify others that need to be spared at the time of surgery [e. Furthermore. This is when a deeper EEG is required. Ojemann et al. 2009). Background : Invasive Recordings in Humans Intracerebral recordings in humans can be performed using a range of techniques that differ according to the neurological disorder and therapeutic strategy under consideration. due to the shielding effect of the scalp and skull.

Mindball is produced by the Swedish Company Interactive Productline. Human Brain Mapping 30 (6): 1758–1771.se/product. Jung J. Minotti L. aboutkidshealth. Senova S. a precision that is as good as. the local precision is highest when each recording site is referenced to its nearest neighbor (bipolar montage) than when one remote site is used as reference for all channels (common reference) [Lachaux et al. In SEEG data..mindball.. Lachaux JP (2009). Berthoz A.. 2008] and choice of reference electrode. Hamamé CM. 2003]. than what is achieved with fMRI. ca/ Epilepsy/ Intracranial-EEG. introduced in 2005.espacenet. Kahane P. A similar setup dubbed Will Ball has been realized back in 1974 though it processed biofeedback. Precursor What is novel about Mindball is the neurofeedback aspect. " Task-related gamma-band dynamics from an intracerebral perspective: review and implications for surface EEG and MEG ". Mindball Mindball is a two person game controlled by players’ brain waves in which players compete to control a ball's movement across a table by becoming more relaxed and focused.html) • Patent: Method for Playing Games Using Brainwaves (http://v3. Ossandón T. The concept. if not better. In addition. PMID 19343801.1002/hbm. A further difference between SEEG and ECoG is that while depth electrodes require small burr holes for implantation the implantation of two-dimensional subdural grids involves a larger craniotomy. [2003]] provide sufficient spatial resolution to localize neural activity at the gyral level.com/textdoc?DB=EPODOC& IDX=WO2005065794&F=16&RPN=EP0177075) • Principle of decoding of brain waves (http://v3.. the spatial precision of the analysis also depends on the accuracy of electrode localization [Dalal et al. Converging evidence suggests that both grid [Menon et al. 1996] and depth-electrodes recordings [Lachaux et al. Notes External links • Interactive Productline (http://www. 2008].com/publicationDetails/biblio?FT=E&DB=& locale=&CC=EP&NR=0177075&KC=A2) . doi:10. aspx?articleID=7016& categoryID=EP-nh3-03a10) [2] Jerbi K. A decade later a computer version existed..espacenet. a presenter on Beyond Tomorrow playing a game of Mindball at the Stockholm Museum of Technology.Intracranial EEG et al. originates from the prototype Brainball which was developed by the Smart Studio at The Interactive Institute also in Sweden. Matt Shirvington. Bertrand O. 57 References [1] AboutKidsHealth: Epilepsy: Intracranial EEG (http:/ / www. 2003] or the nucleus acumbens [Münte et al.20750.. Dalal SS.

At Sony. Miranda joined the Department of Music at the University of Glasgow. political and economical center. is a Brazilian composer of chamber and electroacoustic pieces but is most notable in the United Kingdom for his scientific research into computer music. he focused on musical knowledge representation. Miranda made his way to the United Kingdom. where he lectured music technology and electroacoustic music composition for a number of years. Miranda went briefly to Germany to study algorithmic composition at the Zentrum für Kunst und Medientechnologie in Karlsruhe. Desiring to learn more about music technology and experience more of the world. Miranda worked at the Edinburgh Parallel Computing Centre (EPCC). Miranda attended the University of Vale do Rio dos Sinos (UNISINOS) in Brazil where he received a degree in Data Processing Technology in 1985. While at Sony. electroacoustic Genres Occupations Composer Website neuromusic. Ph. Brazil Chamber.[2] [3] Biography Early life Miranda was born in the early 1960s in Porto Alegre. (born 1963).[2] Education In the early 1990s. machine learning of music and software sound synthesis. he developed an in-depth study into musical composition using cellular automata. he developed Chaosynth. Experiences After receiving his PhD.D. At EPCC.ac. At York. he received his MSc in Music Technology from York.soc.[4] In the mid 1990s. Miranda filed patents in the field of speech processing and made scientific contributions in the fields of speech .Eduardo Reck Miranda 58 Eduardo Reck Miranda Eduardo Reck Miranda Born 1963 Porto Alegre. Then he moved to Paris. Miranda then attended the Federal University of Rio Grande do Sul (UFRGS) where he studied music composition. Brazil. Miranda gained admittance to the Faculty of Music of the University of Edinburgh in Scotland where he obtained his PhD in the combined fields of music and artificial intelligence in 1995. In 1992. where he started his post-graduate research studies at the University of York. As one of the largest cities in Southern Brazil and a cultural. For his doctoral thesis. an innovative granular synthesis software that uses cellular automata to generate complex sound spectra.uk [1] Eduardo Reck Miranda. particularly in the field of human-machine interfaces where brain waves will replace keyboards and voice commands to permit the disabled to express themselves musically. In 1991. Porto Alegre had significant influence on Miranda's music.plymouth. After receiving his MSc. Miranda conducted research aimed at gaining a better understanding of the fundamental cognitive mechanisms employed in sound-based communication systems. This research led Miranda to focus on the evolution of the human ability to speak and the role of our musical capacity in the development of spoken languages. to take up a research position at Sony Computer Science Laboratory in the late 1990s.

He is also an active associate member of the Computer Music Lab [6] at the Federal University of Rio Grande do Sul (UFRGS). Mental ways to make music. Reader in Artificial Intelligence and Music at the University of Plymouth. 2004). In the early 2000s he was appointed Visiting Professor of Interactive Media Arts at MECAD (School of Media Arts and Design) in Barcelona and Adjunct Associate Professor of Computer Science at the American University of Paris. in The Wire magazine. Scotland). Triptych. [4] The Sonic Spot. "These are immensely sophisticated pieces that constitute an electronic global music of convincingly organic simplicity.[12] Just as IBM's Deep Blue showed the world a computer can play chess as well as a human master. the Festival Elektronischer Frühling (Vienna. uk/ pages/ view. (http:/ / www. Miranda aims to demonstrate a computer program able to compose original music. [11] Motron. ufrgs. His music has won prizes and distinctions in Europe and South America. Pg. 1995). 2005). What's Hot: Computers' Tuneful Tinkering is Music to His Ears. plymouth. thisisplymouth. including awards at the Concours International de Musique Électroacoustique de Bourges (1994). .[7] [8] [9] [10] A review of his latest solo CD Mother Tongue. [10] The University of Plymouth's cultural program included a quartet by Dr Eduardo Reck Miranda. So far. [8] The TTO will also premiere a new work commissioned by Peninsula Arts. com/ chaosynth/ chaosynth."[11] Scientific research Miranda is an active researcher in the field of Artificial Intelligence in Music. 1987). He is currently conducting research into neuroscience of music and into simulations of biological natural processes in music origins and evolution. Miranda is tackling this problem with an orchestra of virtual musician agents who interact to compose original music. Miranda has turned to artificial life models to coax computers into composing music. br/ lcm/ [7] The October 1996 Ferguson Concert in Edinburgh. Bryan. asp?WCI=SiteHome& ID=9050& PageID=68542) Pg. (2002). 1988–89. reads. plymouth. asp?page=11685) P. uk/ default. 1995). (January 6. com/ compdocs/ mirandae. Mary. reader in computer music and artificial intelligence at the university's Faculty of Technology. 1996). for Distributed Strings by the Brazilian composer Eduardo Reck Miranda. Plymouth Evening Herald. soc. (October 17. 2005). In 2003 Miranda moved to the University of Plymouth in the UK where he presently is a full Professor in Computer Music and Head of the Interdisciplinary Centre for Computer Music Research [5] (ICCMR). neural networks have succeeded in imitating distinct musical styles. (April 22. 1998). (November 1. [9] Plymouth Evening Herald. 2003). (October 22. soc. co. (February 23. ac. but truly original compositions have remained elusive.12. Western Morning News (UK). evolutionary music (computational) and cognitive neural modeling. html) [5] http:/ / cmr. sonicspot.[13] Footnotes and references [1] http:/ / neuromusic. Financial Times UK. Review of Chaosynth (http:/ / www. 59 Musical compositions Miranda's musical compositions have been broadcast and performed in a number of concerts and festivals worldwide. 1995. the Encompor (Porto Alegre. College showcases computer music. The Wire (magazine) [12] Electronic Engineering Times. (http:/ / beehive. including the Festival Latino-Americano de Arte e Cultura (Brasília. (2006). ac. Ten tors orchestra rise to the challenge. 36. and the Ciclo Acusmático (Bogotá. placed a vivid little string quartet by Eduardo Reck Miranda between music by 16th century composers. in his native town of Porto Alegre. 24. 54. 1995) and the Concorso Internazionale Luigi Russolo di Musica Elettroacustica (Italy. 2004). ac. uk/ [6] http:/ / www. inf. Alan. 1993). Orchestra teams up with opera star.Eduardo Reck Miranda synthesis. 1993–94). uk/ [2] The Living Composers Project. Scotsman (Edinburgh. the Concurso de Composição de Londrina (Brazil. plymouth. Musica Scotica Glasgow University. htm) [3] Cane. Pg. Scotland. the International Symposium for Electronic Arts (Minneapolis. Issue 1251. 1. Pg. Eduardo Reck Miranda (http:/ / composers21. Miller.

N. 2. (2006). E. editor. R. Montreal. Vol. 12. L. "Musique de la Vie Artificiel". 16(2):79-92. • Todd. pdf) Issue 1251. New Digital Musical Instruments: Control And Interaction Beyond the Keyboard. 2003). Eduardo Reck. In F. (To appear) Published research papers Miranda's papers have been published by many international journals. ISBN 0-89579-585-X Published book chapters (See Computer Music Research publications (http://cmr. Colin. Eduardo. • Miranda. and Matthias. (2006). pp. 38(4):331-336. Brain and Language. Eduardo Reck.43. A.Eduardo Reck Miranda [13] Johnson. "Putting some (artificial) life into models of musical creativity". ISBN 90-5755-094-6 • Miranda. No. R. • Miranda. (1998). (http:/ / cmr. E. E. Berlin: Springer-Verlag. (2000). Computer Music Journal. E. (2002). Lecture Notes in Computer Science 3449. and Miranda. R.ac. 49(1):75-76. J. Eduardo.uk/publications/)) • Miranda. Rothlauf et al. Poissant (Ed. and Wanderley. (2005). Inc. (2004). ISBN • Miranda. Evolutionary Computation. Samples of published journal papers • Miranda. ISBN 0-240-51567-6 • Miranda. Musical creativity: Current research in theory and practice. • Miranda.) EvoWorkshops 2005. "Interfacing the Brain Directly with Musical Systems: On developing systems for making music with brain signals ". (2005). Leonardo. R. ISBN 0-240-51693-1 • Miranda. ISBN 0-240-51517-X • Miranda. uk/ publications/ pp43EETimes. (2001). M. Publisher: A-R Editions. "Granular Sampling using a Pulse-Coupled Network of Spiking Neurons". (2005). P. R. Journal of the Audio Engineering Society. Digital Creativity. E. 15. Readings in Music and Artificial Intelligence. (1999). R. Electronic Engineering Times. Publisher: Routledge. and Brouse. (January 6. Roberts. and Organized Sound. including Evolutionary Computation. London. Computer Sound Synthesis for the Electronic Musician. 60 Published works Print (language) Published books • Miranda. R. and Miranda. Focal Press.. Marcelo. Contemporary Music Review. Publisher: Focal Press. Publisher: L’Angelot. I. Leonardo Music Journal. Eduardo Reck. E. Journal of New Music Research. (2005). (2005). Deliege and G. Leonardo Music Journal. Pg. R. Música y Nuevas Tecnologias: Perspectivas para le Siglo XXI. Art et Biotechnologies. Publisher: Focal Press. editor. (2004).plymouth. Wiggins (Eds. Computer Sound Design: Synthesis Techniques and Programming. • Miranda. "On Generating EEG for Controlling Musical Systems". Harnesses artificial life to evolve original music – Composer scores advance in high-tech tunes. R. Canada: Presses de l'Universite du Quebec. publisher. Biomedizinische Technik. E. E. Swarm Orchestras and the Origins of Melody". Second edition.).soc. and Stokes. UK: Psychology Press. plymouth. "Iterative Sound Synthesis by means of Cross-Coupled Digital Oscillators". "Artificial Phonology: On Synthesising Disembodied Humanoid Voice for Composing Music with Surreal Languages". S. (Eds. Leonardo.). soc. Eduardo Reck. • Valsamakis. Composing Music with Computers. Digital Creativity. 539–544. . ac. "At the Crossroads of Evolutionary Computation and Music: Self-Programming Synthesizers.

E. E. B. Kirby. (2005). 3.. E... E. BC. "Towards an intelligent rhythmic generator based on given examples: a memetic approach". 80–102. "Towards a Model for Embodied Emotions". • Coutinho. Brouse. "Evolving Emotional Behaviour for Expressive Performance of Music". R. "On the evolution of music in a society of self-taught digital creatures". (2005). A. R. and Barros. E. Kilborn. Sharman. and Miranda. R. E. Miranda. R. University of Glasgow. M. "Modelling the Development of Mirror Neurons for Auditory-Motor Integration".Towards Autonomous Robotic Systems.. Covilhã (Portugal). pp. • Miranda. • Gimenes. Proceedings of the International Computer Music Conference 2005. No. E. 91–111.. and Zhang. No. Martins. R. (2005). Proceedings of the 10th Brazilian Symposium of Musical Computation (SBCM). Contemporary Music Review. E. E. "Musical Composition by an Autonomous Robot: An Approach to AIBO Interaction". Miranda. Barcelona (Spain). and Maia Jr. Proceedings of the 5th International Conference on New Instruments for Musical Expression (NIME¹05). Gimenes. No. Brain and Language.. "A Memetic Approach to the Evolution of Rhythms in a Society of Software Agents". A. and Miranda.. • Coutinho. R. 55–58. "Granular Synthesis of Sounds Through Markov Chains with Fuzzy Control". and Cangelosi. .(2005). 1. pp. (2005). P. Q..2. J. K. (2005). E. "Toward Direct-Computer Musical Interfaces". 14. "EV Ontology: Multilevel Knowledge Representation and Programming". and Miranda. Canada. • Alvaro. Miranda. R. A. 31. Belo Horizonte (Brazil) • Gimenes. Computer Music Journal. V. E. Miranda. Proceedings of Intelligent Virtual Agents 2005 (LNCS 3661–0497). Proceedings of the International Computer Music Conference 2005. E. J. (2005). and Brouse. pp. Proceedings of TAROS 2005 . London (UK). Manzolli. Vol. Miranda. Belo Horizonte (Brazil). (2003).Eduardo Reck Miranda pp. and da Silva. 2. R. Vol. E. 1. (2005). (2003). No. (UK). (2005).. E. "Composition As Game Strategy: Making Music by Playing Board Games Against Evolved Artificial Neural Networks".. No. E.82.. (2005). • Miranda. pp. G. No. Proceedings of the 2nd Portuguese Workshop on Artificial Life and Evolutionary Algorithms Workshop. Digital Creativity. (2005). M. A. R. Vol. E. Vol. E. Miranda. E. Journal of New Music Research. Glasgow. A. "Plymouth Brain-Computer Music Interface Project: Intelligent Assistive Technology for Music-Making". R. 393–400. B. K. "On Computational Models of the Evolution of Music: From the Origins of Musical Taste to the Emergence of Grammars". Miranda.. Proceedings of the 10th Brazilian Symposium of Musical Computation (SBCM). Barcelona (Spain). Westerman. 36. Westerman. and Tikhanoff. 22. "A New Model of Sensorimotor Coupling in the Development of Speech". P. "Granular Synthesis of Sounds through Fuzzyfied Markov Chains". (2005). (2003). 29–42. Proceedings of the International Computer Music Conference 2005. 367–375. R. pp. Proceedings of the Workshop on Affective Computing: Towards Affective Intelligent Systems (AC 2005). "On Harnessing the Electroencephalogram for the Musical Braincap". • Miranda. São Paulo (Brazil). R. (2003). Duncan. E. Miranda. Proceedings of IX National Convention of the Audio Engineering Society. E. • Miranda. R. R. and Mullaney. and Johnson. (2003). R. Boskamp. • Miranda.. J. 4. E. 27. 137–158.. "On the Music of Emergent Behaviour: What can Evolutionary Computation Bring to the Musician?". S. Covilhã (Portugal). Kos (Greece). R. "Computational Musicology: An Artificial Life Approach". (2003). A. G. Vancouver. H. 61 • • • • • • Samples of published conference papers • Miranda. M. and Maia Jr. and Todd. Vol. C. Barcelona (Spain). • Coutinho. Vol. Miranda. R. Proceedings of the Digital Music Research Network Summer Conference. C. and Johnson. pp. Leonardo.

Grain-Streams. piano. and Miranda. Anátema. Suíte para Vibrafone. tape. Eduardo Reck. Requiem per una veu perduda. BC. Coimbra. R. string orchestra • Miranda. Vancouver. Miranda. tape. Miranda. • Burraston. (1994). prepared violin. (2001). (1989). Miranda. Proceedings of the International Computer Music Conference. Zenrinbau. (2004). Eduardo Reck. Goma Arábica. Deep Resonance. • Miranda. J. Noises. Proceedings of the 5th International Conference on New Instruments for Musical Expression (NIME'05).European Conference on Case-Based Reasoning (ECCBR). Eduardo Reck.Dept. Portugal. (1996). Proceedings of the Workshop on Computational Creativity (CC'04) . (1993). string quartet. (1989). 62 Musical compositions Orchestral music • Miranda. Entre o Absurdo e o Mistério. Eduardo Reck. Miranda. E. tape. live electronics. Belgium. Present and Future of Technology in Music. flute. A. E. Proceedings of the International Computer Music Conference. Eduardo Reck. and Miranda. tape. "Composition for Ubiquitous Responsive Environments". Ghent. (1991–1995). Miranda. (1996). E. tape. Miranda. (1989). Pereira. Atmos. mezzo-soprano. vibraphone. Miranda. • Martins. Eduardo Reck. Canada. 243–255. (1993). tape. berimbau ensemble. (1987). Le Jardin de Jérôme. xylophone. Eduardo Reck. Eduardo Reck. (2005). Eduardo Reck. Proceedings of Colloquium Past. percussion ensemble. tape. R. Miami (USA). pp. Miranda. and Miranda. Eduardo Reck. Eduardo Reck. Eduardo Reck. Eduardo Reck. tape. Eduardo Reck. and Cardoso. Efervescência em 2 Movimentos. R. Miranda. Eduardo Reck. Livingstone. • Miranda. Eduardo Reck. Miranda. . E. (2005). Universidad Complutense de Madrid (Spain). Miranda. Eduardo Reck. E. The Turning of the Tide. Electroacoustic music • • • • • • • • • • • • • Miranda. tape. (2004). Eduardo Reck. (2004). "Cellular Automata in MIDI based Computer Music". (1993). D. (1993). 40–53. (1987). D. oboe. "Orb3 Adaptive Interface Design for Real time Sound Synthesis & Diffusion within Socially Mediated Spaces". "Enhancing Sound Design with Conceptual Blending of Sound Descriptors". "ORB3 – Musical Robots within an Adaptive Social Composition System" Proceedings of the International Computer Music Conference 2005. P. "Musical Applications of Evolutionary Computing: From Sound Design to Evolutionary Musicology". Olivine Trees. E. Wee Batucada Scotica. tape. M. piano. Technical Report 142-04. clarinet. F. Ítalo Calvino takes Jorge Borges on a taxi journey in Berlin. R... Miranda. (1995). Eduardo Reck. D. Gestures. Miranda. Eduardo Reck. (1997). Miranda. Miami (USA). • Livingstone. "Artificial Life and the Evolution of Music". D. pp. Barcelona (Spain). tape. Electroacoustic Sambas I-X. (2004). and Miranda. Edmonds. (1986). small orchestra Chamber music • • • • • • Miranda. R. live electronics.Eduardo Reck Miranda • Livingstone. Mônadas. IPEM . (1992). Azteka. • Livingstone.. Miranda. (1991). tape. Ghent University. tape. Proceedings of International Symposium on Music & Science. Miranda. Eduardo Reck. (2003). (1999). E. Parábula. Miranda. (1988). of Musicology.. Miranda. D. E.

the same "vertical joysticks" can be used in more than one instance to enable simultaneous pressing of multiple keys at any given time like "W" and "Spacebar" for jumping forward or toggling between left and right strafing for running in a zigzag pattern. BCI devices attempt to move away from the classic input devices like keyboard and mouse and instead read electrical activity from the head. Electroacoustic Samba X. The current version of the NIA uses carbon-fibers injected into soft plastic as substrate for the headband and for the sensors and achieves sensitivity much greater than the original silver chloride-based sensors using a clip-on interface to the wire harness.uk/) Neural Impulse Actuator The Neural Impulse Actuator (NIA) is a brain-computer interface (BCI) device developed by OCZ Technology. (OOdiscs: 45). Eduardo Reck. Miranda. Audio CD. hold. (1999). Eduardo Reck. Short keys system Control over the computer in either desktop or gaming environments is done by binding keys to different zones within as many as three vertical joysticks. Eduardo Reck. electromyograms and electro oculograms. skin and nerve activity including sympathetic and parasympathetic components that have to be summarized as biopotentials rather than pure neural signals. The biopotentials are decompiled into different frequency spectra to allow the separation into different groups of electrical signals. (1996). Miranda. Miranda. Eduardo Reck. (Simpósio Brasileiro de Computação e Música: NUCOM01). Goma Arábica. (IMEB/UNESCO/CIME: LDC 278068/69). Label: Sargasso Records. Each joystick can be divided into several zones based on thresholds and each zone within each joystick can be bound to a keyboard key.Eduardo Reck Miranda 63 Discography • • • • • • • Miranda. preferably the EEG. Each key stroke can further be assigned to several modes. The name Neural Impulse Actuator implies that the signals originate from some neuronal activity. Electroacoustic Sambas II-III. Requiem per una veu perduda. (1998). ASIN: B00029LO8G External links • Faculty homepage (http://neuromusic. Mother Tongue. (1998). Electroacoustic Samba I. Miranda. (2004). Name The name Neural Impulse Actuator is still justifiable since also the secondary signals are under neuronal control. Miranda. Eduardo Reck (composer). (2000). including single keystroke. Miranda.soc.plymouth. Eduardo Reck. (Organised Sound: 3/3). (Sociedade Brasileira de Música Eletroacústica: SBME01). repeat and dwell which allows full plasticity with respect to configuration of the NIA for any application. what is actually captured is a mixture of muscle. Olivine Trees. however. (Leonardo Music Journal: 10). . Eduardo Reck. (1995). Individual signals that are isolated comprise alpha and beta brain waves. Moreover.ac.

no drivers needed" (http:/ / www. ocztechnologyforum. Patent 6636763 (http://www. for Microsoft Windows (XP and Vista). say it may be a HID device providing raw data from its sensors to the software.com/products/ocz_peripherals/ nia-neural_impulse_actuator/) • Help for using the NIA (http://www.techpowerup. [3] "NIA and linux" (http:/ / www. . The 3rd-party input remapping applications GlovePIE and PPJoy accept input from the nia according to GlovePIE. OCZ Forum.anandtech. Retrieved 13 Jan 2009.com/aboutocz/press/2008/273 . 32 and 64-bit.tcmagazine. ocztechnologyforum. References [1] http:/ / www. php?t=43298).ocztechnologyforum. php?option=com_content&task=view&id=32&Itemid=1) . net/ projects/ nia4linux/ ).html • Complete Review of NIA.htm) • OCZ preps neural headband controller for release (http://www. Phoronix Media. .Neural Impulse Actuator 64 Software support The only software available officially is proprietary.ocztechnology. Retrieved 13 Jan 2009. OCZ Forum.com/tradeshows/showdoc.x/13928) • U.com/patents?vid=6636763) Brain-body actuated system • U.hothardware. OCZ is planning to release an SDK that may have some support for Linux.techreport. com/ scan.com/54897/Price_of_OCZ_Neural_Impulse_Actuator_Confirmed_$159.[1] No specification has been published. External links • Official website (http://http://www. no plans for Linux support in the foreseeable future have been announced.com/patents?vid=5692517) Brain-body actuated system • http://www.com/OCZ+Mind+Controlled+ Gamer+Mouse+Nears+Production/article10379.google. .S. com/ products/ ocz_peripherals/ nia-neural_impulse_actuator [2] "nia4linux project page at SourceForge. (http://www. phoronix. [4] "nia is only a HID device.lostcircuits.php?t=38653) • OCZ Mind Controlled Gamer Mouse Nears Production (http://www. or create their own software for it for other reasons.aspx?i=3252&p=2 • http://www. including the practice it requires. ocztechnology.com/forum/showthread.org forums.com/mambo//index. com/ forum/ showthread. (http://www.OCZ Press release • http://www. com/ forum/ showthread. 10 Jan 2009.ocztechnology. Retrieved 13 Jan 2009.php?shownews=18456 • http://www. php?t=38441). Retrieved 13 Jan 2009.[3] [4] As of 10 Jan 2009. aspx?articleid=1178) • Complete Review including its development.dailytech.S.[3] [5] However. [5] Michael Larabel (13 Mar 2008). People who are trying to make use of the device on Unix-like platforms[2] .com/comments. php?page=news_item& px=NjM5Nw).google. Patent 5692517 (http://www. .net" (http:/ / sourceforge.com/printarticle. "OCZ Neural Impulse Actuator On Linux?" (http:/ / www.com/discussions.

“This technical breakthrough means we can track subtle changes in brain activity at the level of ion channels and synaptic potentials. This new technology has the potential to help scientists in a variety of fields and on a variety of research projects. allowing the analysis of several brain cells networking and performing automatic. member of the Hotchkiss Brain Institute and advisor to the Vice President Research on Biomedical Engineering Initiative of the U of C. Formation It is made of silicon that is doped in such a way that it contains EOSFETs (electrolyte-oxide-semiconductor FET) that can sense the electrical activity of the neurons (action potentials) in the above-standing physiological electrolyte solution. “This technology can likely be scaled up such that it will become a novel tool for medium throughput drug screening. Now. such as Alzheimer’s and Parkinson’s. The new neurochips are also automated. which are also the most suitable target sites for drug development in neurodegenerative diseases and neuropsychological disorders. Future applications (still in the experimental phase) are retinal implants or brain implants. Gerald Zamponi. professor and head of the Department of Cell Biology and Anatomy. It also contains capacitors for the electrical stimulation of the neurons. is published online this month in the journal. and member of the Hotchkiss Brain Institute.” says Syed. Developed with the National Research Council Canada (NRC).Neurochip 65 Neurochip A neurochip is a chip (integrated circuit/microprocessor) that is designed for the interaction with neuronal cells. meaning that anyone can learn to place individual brain cells on them. and it was only possible to monitor one or two cells simultaneously. Faculty of Medicine scientists who proved it is possible to cultivate a network of brain cells that reconnect on a silicon chip—or the brain on a microchip—have developed new technology that monitors brain cell activity at a resolution never achieved before. in addition to its usefulness for basic biomedical research”. the new silicon chips are also simpler to use. Applications Present applications are neuron research. says. Naweed Syed's lab cultivated brain cells on a microchip. Biomedical Devices. The University of Calgary. which will help future understanding of how brain cells work under normal conditions and permit drug discoveries for a variety of neurodegenerative diseases. professor and head of the Department of Physiology and Pharmacology. large-scale drug screening for various brain dysfunctions. larger networks of cells can be placed on a chip and observed in minute detail. The new technology from the lab of Naweed Syed. . Previously it took years of training to learn how to record ion channel activity from brain cells. in collaboration with the NRC.

NeuroSky only uses one. This makes headsets based on NeuroSky technology very low cost. Other emotions. Projects Utilizing NeuroSky Judecca Judecca is a first-person shooter game utilizing NeuroSky technology. Unlike competing products. chaired by Stanley Yang. then sell their components and headset to those licensed developers to bundle with their applications and place into the retail market. it can't detect conscious thoughts and treats facial expressions as a noise. NeuroSky has created a game to demonstrate their product. so the user could for example be attentive and meditative at the same time. Instead they license their technology (MindKit SDK license) to developers. and Eye tracking will be done with Eye-Com's eye tracking glasses. Neurosky are also working on a more advanced version of their headset. . but on another hand does not provide as much functionality as the Emotiv headset. Project Millennia In addition to their "Think-Gear" line. Project Millennia includes head and eye tracking plus stereo sound. the Think-Gear module. Neurosky's hardware. which allows players to push objects such as cars or furniture by concentrating on them (attention). including anxiety and drowsiness were also in the work.NeuroSky 66 NeuroSky NeuroSky. Nokia. United States. Head tracking will be by Memsic accelerometers. Mattel and Musinaut. The electrodes of standard medical electroencephalography use a conductive gel to facilitate the reading of the signals. It is likely to be integrated into toys or other devices and not just as a PC peripheral. is a company based in San Jose. but with gyros and EEG. and to levitate objects by relaxing (meditation). Uncle Milton. which both use many electrodes. uses their patented dry-active sensor technology to read the brain signals. small electrical neural impulses generated by thought and mental state. Technology NeuroSky does not market directly to the public. Capabilities Neurosky has publicly demonstrated two emotions reading with their brainwave sensors.[1] They are two independent readings. Electroencephalography uses electrodes attached to the head to read the output of brain signals. This will give the headset some of the same abilities as Emotiv's competing product which also features head and eye tracking. California. Square Enix. Attention meters is a reading of how attentive the user is feeling. currently under development by Japanese game developer Square Enix. Their technology is an example of a "brain-computer interface". Movement and view control would still be done using conventional game controls. and easy to put on. but it comes at a much cheaper price. Dry-active sensor technology does not need such a gel and unlike medical EEG or Emotiv's headset. The game is said to contain certain game functions which will be keyed to the device's ability to measure a player's level of attention. in addition to the EEG. Meditation meter is a reading of how relaxed the user is feeling. Companies which have publicly announced they are working with NeuroSky include Sega Toys. named "Project Millennia" (Emotiv's competing product was named "Project Epoc"). and announced at the 2008 Tokyo Game Show.

$199 • Mindball . Slashdot. March 17-23 2007 (http://www.Available . neurosky. end user version available since Dec 2009)[2] .neurosky. • Mind Games. slashdot. 2009-12-03.$299 • NeuroSky .com/) . The Economist.rather than EEG) • Emotiv Systems (Developer version available since June 2009 for $500. pl?sid=09/ 12/ 03/ 0616246).000 to groups.and PC-users: • Neural Impulse Actuator (July. 2008) . org/ article.com/science/displaystory.NeuroSky 67 Competitors The main commercial-competitors in this area (launch date mentioned in brackets) which are going to launch such devices primarily for gaming.$100 or less (uses EMG . References [1] http:/ / www.com/s/ap/20070430/ap_on_hi_te/mind_reading_toys) External links • Official website (http://http://www. cfm?story_id=8847846) • New toys read brain waves (http://news.yahoo. biz/ menu/ bottom/ faq/ [2] "Brain-Control Gaming Headset Launching Dec.economist. 21" (http:/ / games.The table can be rented for approximately $20. .

2011. 2008.Miguel Nicolelis 68 Miguel Nicolelis Miguel Angelo Laporta Nicolelis Born Citizenship Nationality Fields Institutions Alma mater São Paulo. Brazil Brazilian Brazilian Neuroscientist Duke University University of Sao Paulo Miguel Angelo Laporta Nicolelis. These signals were sent to the robot arm. After a while the monkey realised that thinking about moving the shape was enough and it no longer needed to move the joystick. After an hour the monkey's treadmill was turned off. Dr. MD. The monkey could see the robot. on a screen in front of him. On January 15. an important research facility in Brazil. named CB. indicating that a part of the brain not sufficient to induce a motor response in the monkey had become dedicated to controlling the robot. Nicolelis was appointed by the pope Benedict XVI ordinary member of the Pontifical Academy of Sciences. . This was possible by decoding signals of hundreds of neurons recorded in volitional areas of the cerebral cortex while the monkey played with a hand-held joystick to move a shape in a video game. Nicolelis's lab saw a monkey implanted with a new BCI successfully control a robot walking on a treadmill in Kyoto. A system in which brain signals directly control an artificial actuator is commonly referred to as brain-machine interface or brain-computer interface. is a Brazilian physician and scientist. Dr. but he was able to continue to direct the robot to walk normally for another few minutes. PhD. Japan. and was rewarded for walking in sync with the robot (which was under the control of the monkey). which then mimicked the monkey's movements and thus controlled the game. He and his colleagues implanted electrode arrays into a monkey's brain that were able to detect the monkey's motor intent and thus able to control reaching and grasping movements performed by a robotic arm. as if it were an extension of itself. On January 5. So it let go of the joystick and controlled the game purely through thought. best known for his pioneering work in "reading monkey thought". Nicolelis also played a fundamental role in the foundation of the International Institute for Neuroscience of Natal.

com/ doi/ abs/ 10. cfm?id=835EFB22-D4E1-ADD9-068213BE0712AA2C . J. [3] PLoS Biology. (2005) Cortical ensemble adaptation to represent actuators controlled by a brain machine interface. M. Srinivasan MA. pdf [9] http:/ / www.. M. Patil.. Stambaugh CR. Kralik. net [8] http:/ / www. Biggs SJ. 1: 193-208. O’Doherty. External links • • • • • • • Nicolelis Lab [7] CV and awards [8] New Scientist 2003 [9] New Scientist 2004 [10] International Institute for Neuroscience of Natal (IINN) [11] Oct 16. Dimitrov. Principe. 46.. net/ NLNet/ Load/ CVs/ Nicolelis_CV. 1460-9568. • Carmena. Chapin JK. • Nicolelis MA (2003) Brain-machine interfaces to restore motor function and probe neural circuits. com/ article. Scientific American. J. J. 04320.D.M. Nicolelis MA. [5] Nature 16: 361-365.L...E.S. org/ perlserv/ ?request=get-document& doi=10%2E1371%2Fjournal%2Epbio%2E0000042 [4] http:/ / www...M. J.S..M. 400 [11] http:/ / www. Nicolelis. J.L. Additional references 1. nicolelislab. "The Scientific American 50" [6]. D. 1111/ j. Lebedev . [1] J. com/ article. [2] Eur. M. R.. Laubach M. scientificamerican. 22: 1529-1540. Kim J. 2005. com [12] http:/ / www. 4: 417-422.C. newscientist. Neurosci. 25: 4681-4693.. C. jneurosci. newscientist.G. Beck PD. nature. 2008 References [1] http:/ / www.L. Zacksenhouse. charlierose. Nicolelis. Santucci. M. sciam. x [3] http:/ / biology.Miguel Nicolelis 69 Selected Publications on Brain-Machine Interface • Lebedev. blackwell-synergy. com/ nature/ journal/ v408/ n6810/ abs/ 408361a0. com/ podcast/ episode. J..A. Nicolelis. html...A. (2003) Learning to control a brain-machine interface for reaching and grasping by primates. Kralik JD. (2000) Real-time prediction of hand trajectory by ensembles of cortical neurons in primates. Henriquez. 2003 interview with Charlie Rose [12] Mindful Motion: Miguel Nicolelis and Mind-Powered Robots.jsessionid=6D87C4B29FF58C8DDB5ACF4E2A8560D3 [5] http:/ / www.F. [4] Nat Rev Neurosci.. pp.E. com/ nrn/ journal/ v4/ n5/ abs/ nrn1105_fs.. com/ article. html [6] http:/ / www. nicolelislab. ns?id=dn4262 [10] http:/ / www.A. C. December 2004... Crist. D. P. plosjournals. O’Doherty. M. cfm?articleID=000D5CA6-D59B-118F-91DD83414B7F0000& pageNumber=2& catID=9 [7] http:/ / www. and Creating Science Cities in Brazil and Beyond Scientific American podcast [13] January 16.A. D. Henriquez. com/ view/ interview/ 1761 [13] http:/ / www. org/ cgi/ content/ abstract/ 25/ 19/ 4681 [2] http:/ / www.E.. J.A. Carmena. natalneuro.M. M. M. • Santucci. nature. Neurosci. ns?id=mg18224412. (2005) Frontal and parietal cortical ensembles predict single-trial muscle activity during reaching movements. • Wessberg J.A. Lebedev.

Pages 35-53 • "OpenViBE: See Your Brain in Action" (http://medgadget. real-time diagnosis).com/archives/2007/03/openvibe_see_yo. to access and to manipulate.economictimes. filter.uk/2/hi/programmes/click_online/8108934. video games). neurofeedback. References [1] OpenViBE: Open-Source Software for Brain-Computer Interfaces (http:/ / ercim-news.stm) BBC News. real-time biofeedback.fr/) • "Now.indiatimes. OpenVibe is the first library of functions written in C++ of this type developed by INRIA . process. classify and visualize brain signals in real time. robotics and all other application fields related to brain-computer interfaces and real-time neurosciences. accessed March 2011 . accessed March 2011 • "Brainwaves put patients in touch" (http://news. multimedia (virtual reality.35) MIT Press Journal "Presence.org/doi/abs/10. Interface The user interface of OpenVibe is easy to use for creating BCI scenarios and saving them for later use.bbc.1162/pres. testing and using brain-computer interfaces.19. and Use Brain–Computer Interfaces in Real and Virtual Environments" (http://www. accessed March 2011 • "OpenViBE: An Open-Source Software Platform to Design. video game developers. Test.co. etc.html) Medgadget.inria. for real-time processing of brain signals)." February 2010. OpenViBE users can either be programmers or people not familiar with programming. It can be used to acquire. accessed March 2011 External links • Project homepage (http://openvibe. researchers in signal processing or robotics.mitpressjournals. along with several pre-configured and demo programs which are ready for use[1] .1. Vol. No.com/ 2011-01-08/news/28432722_1_brain-activity-software-scientists) The Economic Times. The package includes a Designer tool to create and run custom applications. 19. ercim. Applications The main OpenViBE application fields are medical (assistance to disabled people. eu/ en78/ rd/ openvibe-open-source-software-for-brain-computer-interfaces) ERCIM News.Institut national de recherche en informatique et automatique (France) .it can be integrated and applied quickly and easily . 1. OpenViBE is software for real-time neuroscience (that is. This includes medical doctors.OpenVibe 70 OpenVibe OpenViBE is a software platform dedicated to designing. you can control computer commands by thought" (http://articles.

optogenetics was chosen as the Method of the Year (MOTY) across all fields of science and engineering by the interdisciplinary research journal Nature Methods (MOTY primer [1]. optogenetics by definition must operate on the millisecond timescale to allow addition or deletion of precise activity patterns within specific cells in the brains of intact animals. a single-component light-activated cation channel from unicellular algae). in probing the causal role of specific action potential patterns in defined neurons). In 2010. The surprising experimental utility of this single-component “microbial opsin” approach was quickly proven with many additional microbial opsin classes and in a variety of animal models ranging from behaving mammals to classical model organisms such as flies. with the temporal precision (millisecond-timescale) needed to keep pace with functioning intact biological systems. the temporal precision of traditional genetic manipulations (employed to probe the causal role of specific genes within cells. Isacoff. MOTY commentary [3] ). via “loss-of-function” or “gain of function” changes in these genes) is rather slow. put forward between 2002 and 2005. these journals also referenced recent public-access general-interest video MOTY video [5] and textual SciAm [6] summaries of optogenetics. from hours or days to months. An example of this is voltage-sensitive fluorescent protein (VSFP2). using light to control optically-sensitized neurons) had been articulated by Francis Crick in his Kuffler Lectures at the University of California in San Diego (Crick 1999). Feng Zhang (2005)) at Stanford University brought the first single-component optogenetic system to neurobiology (beginning with channelrhodopsin. The other branch is called the actuator (or control) proteins. required multiple components to be introduced. even within freely moving mammals and other animals. At the same time. MOTY editorial [2]. The earliest genetically targeted photostimulation methods. Description Millisecond-scale temporal precision is central to optogenetics. to probe the neural code. required only one gene to be expressed in order to work. These include [[7]] proteins which are stimulated by light and are also known as light-gated ion channels/pumps. and responded to visible-spectrum light with a chromophore retinal that was already present and supplied to the channelrhodopsin (ChR) by the vertebrate tissues. In 2005. By comparison. and Miesenböck groups’ use of synthesized organic photoswitches or “caged” compounds that could interact with genetically-introduced ion channels (Zemelman 2002. The core tools of optogenetics can be divided into two branches. The theoretical utility of selectively controlling precise neural activity (action potential) patterns within subtypes of cells in the brain (for example.Optogenetics 71 Optogenetics Optogenetics is the combination of genetic and optical methods to control specific events in targeted cells of living tissue. who was also the first to control the behavior of an animal optogenetically (Lima 2005). Lima 2005). An example of this is channelrhodopsin-2. Zemelman 2003. where scientists have fused fluorescent proteins to detector proteins. worms. optogenetics was highlighted in the article on “Breakthroughs of the Decade” in the scientific research journal Science BotD [4]. the Deisseroth group ((Ed Boyden. These are engineered biosensors. which allows the experimenter to keep pace with fast biological information processing (for example. The “optogenetic” terminology was coined in 2006 (Deisseroth 2006). and since 2005 hundreds of laboratories around the world have employed microbial opsins to study complex biological systems (references below). Banghart 2004. which allowed millisecond-scale temporal control in mammals. History The use of photoreceptor proteins for controlling neural activity was conceived and demonstrated by Miesenböck (Zemelman 2002). and zebrafish. Indeed. One branch is called the reporter proteins. . including mammals. beginning with the Miesenböck group's use of invertebrate opsins and the Kramer.

to be controlled in freely behaving animals. To stimulate superficial brain areas such as the cerebral cortex.0). a family of chimeric single-component optogenetic tools was created that allowed researchers to manipulate within behaving mammals the concentration of defined intracellular messengers such as cAMP and IP3 in targeted cells (Airan 2009). The field of optogenetics has furthered the fundamental scientific understanding of how specific cell types contribute to the function of biological tissues such as neural circuits in vivo (see references from the scientific literature below). without involving consideration of their potential value in delivering insights into neuroscience and neuropsychiatric disease).. and monkeys).. Sohal 2009. Yazawa 2009. Schizophrenia.. Among the microbial opsins which can be used to investigate the function of neural systems are the channelrhodopsins (ChR2. and SFOs) to excite neurons (gain of function). optogenetics papers in 2009 have also provided insight into neural codes relevant to autism. fruit flies. the latter is now achieved using the fiberoptic-coupled diode technology introduced in 2007 (Aravanis et al. archaerhodopsin (Arch). Optogenetics also necessarily includes 1) the development of genetic targeting strategies such as cell-specific promoters or other customized conditionally-active viruses. enhanced halorhodopsins (eNpHR2. optogenetics also represents an important case study in the value of both ecological conservation (as many of the key tools of optogenetics arise from microbial organisms occupying specialized environmental niches).0 and eNpHR3.Optogenetics The hallmark of optogenetics therefore is introduction of fast light-activated channels and enzymes that allow temporally precise manipulation of electrical and biochemical events while maintaining cell-type resolution through the use of specific targeting mechanisms. Leptosphaeria maculans fungal opsins (Mac).g. Gradinaru 2009. Adamantidis et al. In invertebrates such as worms and fruit flies some amount of Retinal isomerase all-trans-retinal (ATR) is supplemented with food. rats. when optical control over small GTPases and adenylyl cyclases was achieved in cultured cells using novel strategies from several different laboratories (Levskaya 2009. Wu 2009. Witten 2010). For loss of function. optical fibers or LEDs can be directly mounted to the skull of the animal. 2007). Indeed. Moreover. ChR1. even deep within the brain.g. [6] 72 . including in freely-moving mammals (Witten 2010). A key advantage of microbial opsins as noted above is that they are fully functional without the addition of exogenous co-factors in vertebrates. Tsai 2009. integrated fiberoptic and solid-state light sources) to allow specific cell types. and depression (Cardin 2009. optogenetics-driven research has led to insights into Parkinson's disease and other neurological and psychiatric disorders. VChR1. Other biochemical approaches to optogenetics (crucially. Most commonly. 2007. Ryu 2010). optogenetic control of well-defined biochemical events within behaving mammals is now also possible. on the clinical side. This emerging repertoire of optogenetic probes now allows cell-type-specific and temporally precise control of multiple axes of cellular function within intact animals. and enhanced bacteriorhodopsin (eBR) have been employed to inhibit neurons. and in the importance of pure basic science (as these opsins were studied over decades for their own sake by biophysicists and microbiologists. halorhodopsin (NpHR). and 2) hardware (e. Moreover. Stierl 2011. anxiety. to deliver the light-sensitive probes to specific populations of neurons in the brain of living animals (e. drug abuse. Building on prior work fusing vertebrate opsins to specific G-protein coupled receptors (Kim 2005). Gradinaru et al. 2007. More deeply implanted optical fibers have been used to deliver light to deeper brain areas. mice. with tools that displayed low activity in the dark) followed soon thereafter. worms. It has been pointed out that beyond its scientific impact.

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. Florian Mormann. The translation of images which are perceived or conceived within the brain has not yet been fully achieved. References [1] Celeste Biever (18:05 12 December 2008). . nature. BBC News. com/ article/ dn16267-mindreading-software-could-record-your-dreams. Alexander Kraskov. html). [2] Pallab Ghosh (27 October 2010 Last updated at 13:01 ET). . Brainstorm (1983). the thoughts. Rodrigo Quian Quiroga.. Dr. the idea has received increased scientific currency since the development of the first BCI-enabled devices. voluntary control of human temporal lobe neurons" (http:/ / www. emotions. Final Fantasy: The Spirits Within (2001)). html). Nikhil Thiruvengadam. [3] Moran Cerf. "On-line. While currently residing within mostly fictional displays of the capacity of such devices (i.[2] [3] Current limitations BCI devices currently are able to translate a limited subset of neural signals into digital signals. most of which are utilized for motor-centric controls of attached devices. "Dream recording device 'possible' researcher claims" (http:/ / www.Thought recording and reproduction device 80 Thought recording and reproduction device A thought recording and reproduction device refers to any machine which is able to both directly record and reproduce. via a brain-computer interface. Christof Koch & Itzhak Fried (28 October 2010). "'Mind-reading' software could record your dreams" (http:/ / www. uk/ news/ science-environment-11635625). com/ nature/ journal/ v467/ n7319/ full/ nature09510.e. New Scientist. dreams or other neural/cognitive events of a subject for that or other subjects to experience. Nature. co. Strange Days (1995). Research In December 2008. Advanced Telecommunications Research Institute International's Department of Cognitive Neuroscience announced its own research into the translation of neural signals into images. bbc. .[1] In addition. newscientist. Moran Cerf of UCLA published a 2010 paper for Nature which claimed that he and other fellow researchers were on the cusp of being able to allow psychologists to interpret thoughts by corroborating people's recollections of their dream with an electronic visualization of their brain activity.

They are held in place by elastic bands. There is an initial sensation on the scalp but. The reason for this could be that the current flows mostly in the cerebrospinal fluid between the two cerebral hemispheres and enters the cerebral cortex from the forward part of the visual cortex.[1] [2] Visual cortex Transcranial alternating current stimulation applied over the visual cortex produces its effects depending upon frequency and illumination levels. it induces most effectively the perception of continuously flickering light (phosphenes) with frequencies in the beta wave. But when in the dark such perception of flickering lights is most effective when the stimulation frequency when done in alpha wave range. this fades. The size of the stimulation electrode is around 3 x 4 cm and the reference electrode has three times the surface area so as to reduce current density and limit stimulating the skin. and the hair and skin are saturated with saline solution for about 5-10 minutes. and a reference one elsewhere. after the initial few minutes. This suggests that tACS stimulates the anterior part of the visual cortex on its medial wall where the peripheral areas of the visual field are processed. such as on the top of the head or on the neck.[4] .[3] The brain waves led muscle EMG by 41.[3] Transcranial alternating current stimulation produces no effects upon motor evoked potentials or EEG power.6 ms suggesting that the synchronization with muscle activity is caused by the brain. When applied in an illuminated room. There is also a small but significant slowing of the reaction time when a person moves the joystick to a target.[1] The phosphenes are reported to be seen in the far peripheral areas of vision.[1] Motor cortex Transcranial alternating current stimulation applied over the motor cortex on one side brain at beta wave frequencies entrains activity in this range and increases the coherence between scalp-recorded electroencephalography (EEG) and electromyographic (EMG) activity in the first dorsal interosseous muscle of the opposite hand when it is held steady on a joystick.Transcranial alternating current stimulation 81 Transcranial alternating current stimulation Transcranial alternating current stimulation (tACS) is a noninvasive means by which alternating currents applied through the skull over the occipital cortex of the brain entrains in a frequency-specific fashion the neural oscillations of the underlying brain.[2] The alternating current applied is sinusoidal at a voltage of 5 to 15V.[1] No effects are produced by current alternations at the theta wave or gamma wave frequencies. The current density under the stimulation electrode is about 83μA per square cm.[1] Method Two electrodes are used: a stimulating one over the target cortex.

Curr Biol. doi:10.1016/j. and a Ph.07. He received a BSc in Physics in 1974. Poreisz. (http:/ / download. L. (2009).Comparatively weak after-effects of transcranial alternating current stimulation (tACS) on cortical excitability in humans. 18 [3] Pogosyan A. (2008). including a number of methods for doing wireless communication in CMOS integrated circuits. patents to his name.001 Neil Weste Neil H. and Paulus. E. Inventions Weste has 14 U. managed the project. The company was acquired by Cisco Systems in 2001. It has been translated into Japanese. Greek.1016/j.2007. Antal A. .cub. and participated in the design. a BE in 1976. including Bell Telephone Laboratories.. Walsh V. Weste produced a CMOS chipset for the IEEE 802. Boros.[1] After the acquisition. com/ current-biology/ mmcs/ journals/ 0960-9822/ PIIS0960982208013961. Terney.D. in 1978. Boosting cortical activity at Beta-band frequencies slows movement in humans.. a technology-investment and consulting firm that he continues to manage. (2008).2009. Curr Biol. Microelectronics Center of North Carolina..074 PMID 19800236 [4] Antal.. Symbolics. Frequency-dependent electrical stimulation of the visual cortex Supplemental Data.10. doi:10. is an Australian inventor and engineer. A. W. K. Agile Systems. Chaieb. Walsh V.. Frequency-dependent electrical stimulation of the visual cortex. C. all from the University of Adelaide. Gaynor LD. and Chinese. Weste worked at a number American technology firms. Weste remained with Cisco for 2 years and then founded NHEW R&D. He has worked in many aspects of integrated-circuit design and was a co-founder of Radiata Communications. 18(23):1839-43. cell. He did the conception.11a chip was designed. Life Weste grew up in the Riverland Region of South Australia. Brain Stimulation 1. Principles of CMOS VLSI Design (initially coauthored with Kamran Eshraghian[2] [3] but now coauthored with David Harris[4] [5] ) is a standard textbook in integrated-circuit design courses. mmc1. PMID 19026538 [2] Kanai R. Eusebio A. D. In 1997 he started Radiata Communications with David Skellern where the first 802. (2008). noted for having designed a 2-chip wireless LAN implementation and for authoring the textbook Principles of CMOS VLSI Design. Antal A. In 1995 he returned to Australia as a professor at Macquarie University. CMOS Textbook Weste's textbook. 97–105.brs. Chaieb L. and TLW. Paulus W. Weste (born 1951). Chaieb L. He was also at Duke University and the University of North Carolina.S. Paulus W. 19(19):1637-41. Brown P.Transcranial alternating current stimulation 82 References [1] Kanai R. In 1998.11a wireless LAN. pdf) Curr Biol.

they have three daughters and 4 grand-daughters. pp. "350 MHz opamp-RC filter in 0. L. June 1985. 1. html#W [7] http:/ / www.A Fill Method for Raster Scan Displays. 1993 Weste." IEEE Proc. S.S. T. au . 2003 IEEE International. J. Ryan. T. Skellern. Issue 10. 1977. MA. • Weste. 1981. Harsto." IEEE Transactions on Computers. and P." IEEE JSSC. A. Kamran. B. • Harrison." Solid-State Circuits Conference. MA. J. 3. • Weste. Miscellaneous • Weste is an IEEE fellow[6] as well as a fellow in the Australian Academy of Technological Sciences and Engineering (FTSE). 17. N. ASSP-32. Neil and Eshraghian. Amplifiers for Performing Peripheral Integrated-Circuit Functions. Dalton. cluniesross. Principles of CMOS VLSI Design . N. N. No. pp. Neil and Harris. org/ membership_services/ membership/ fellows/ chronology/ fellows_1996. IEEE..Neil Weste 83 Other Publications • Weste. IEEE. Weste. J. Vol. and B. Vol. "A 66-MHz DSP-Augmented RAMDAC for Smooth-Shaded Graphic Applications. pp.. Weste. Vol. Graham. Principles of CMOS VLSI Design . pp. References [1] [2] [3] [4] http:/ / www.18 um CMOS. Greenberg. No. Burr. Neil and Eshraghian. 799–804. No. No. Lee. Ackland. T.A Circuits and Systems Perspective. tvp. "MULGA-An Interactive Symbolic Layout System for the Design of Integrated Circuits. May 2004 [5] Weste. Vol.J. Digest of Technical Papers. pdf Weste. pp. C-30. Percival. J. Wong. 379–383. Jan. N. ieee.A Systems Perspective. Principles of CMOS VLSI Design . "A 500 MHz CMOS anti-alias filter using feed-forward op-amps with local common-mode feedback. and B. 4th Edition Addison-Wesley. and B. Jan. pp. com. 2003. 1983. N. "A Single Chip Video Ghost Canceller." Electronics Letters. Kamran. 40–47. Vol. David. Aug. 259–260. 36." IEEE Trans. 9-13 Feb. org.. SC-20. Ackland. N. • Weste. and J." in The Bell System Technical Journal. ISSCC. Weste. Vol. • Edwards. N. 1. pp. Vol.n and R. 2003. Myles. Weste. Weste. No. Ackland. Meaney. 2nd Edition Addison-Wesley. 3rd Edition Addison-Wesley. 1981..F. 132–483. "M. D. C-32. on Computers. 41–48. No. Vol.. • Weste.E. 823–857. Principles of CMOS VLSI Design . and P. MA. 165–172. J. and D. pp. "TOPOLOGIZER: An Expert System Translator of Transistor Connectivity to Symbolic Cell Layout" IEEE JSSC.-Feb. 3. No. 1985 Weste. "The Edge Flag Algorithm .J.H.D.T.D. L. March 1991. pp. Vol. D. 5. 38. Oct. 1998." IEEE JSSC. pp. 1997. Speech and Signal Processing. • Weste is the recipient of a 2010 Clunies Ross Medal [7]. Electronic Circuits and Systems.M. pp. David. McDermott. 3. Acoustics. and N. A." Micro. N. • Weste is married to Avril Weste. March 1993. 1. • Harrison.. 1.A Circuits and Systems Perspective. 2010 [6] http:/ / www. Bodony. MA. and N.D. "VLSI for OFDM. Issue 1. 26. Vol. • Weste." IEEE Journal on Circuits and Systems. • Leonard.O. and C. Mavor. Kollaritsch.P. "Array Configurations for Dynamic Time Warping. "Dynamic time warp pattern matching using and integrated multiprocessing array. 28. "A high-speed wireless LAN. 14 March 2002. 1984." Communications Magazine. • Weste.C. July-Aug. au/ portfolio/ news/ Emotiv-PR-March2007. 119–128. D. 127–131. 217–228.J. pp. N. Addison-Wesley. Issue 6. Corry. Vol.H.J. • Skellern.J.A Systems Perspective. 60. N. Burr. Neil and Harris. 731–734. Feb. Vol. 6. Sept.

while simulating the frequency analysis performed in the cochlea. Neuroprosthetics and neuro science have a very intertwined relationship. with approximately 100. The future holds an exciting prospect for the every day use of a variety of neural prostheses. and research in this field intends to resolve disabilities. The neuroprosthetic seeing the most widespread use is the cochlear implant. These devices substitute the functions performed by the ear drum and Stapes. the implant works on wireless power transmission through the skin. the use of cochlear implants and pacemakers has become an undeniable fact of life. Wireless electrical recording from the brain of awake. There is another side to the application of neural prostheses. . Any implanted device has to be very small to be to minimally invasive. Gradually as these devices become safer and the our understanding of how the brain works enhances the use of these devices will become more and more common and help people with severe disabilities live a normal life. freely behaving animals can open many important doors into understanding how the brain handles different functions. Instead. the less tissue reaction they will cause thus resulting less implant risk and longer implant period. The more biocompatible these materials are. In order to substitute sensory. The development of such devices has had a profound impact on the quality of human life. A microphone on an external unit gathers the sound and processes it.000 in use worldwide as of 2006. There are many challenges which must be overcome in order to develop these devices. Neuroprostheses contribute to better understanding of the neural system and this better understanding helps develop better. The tissue surrounding the implant is usually very sensitive to temperature rise so the implant must have very low power consumption in order to assure it won't harm the tissue.[1] Another very important issue is the bio compatibility of the material that the implants are coated with.[2] Today. Accurately probing and recording the electrical signals in the brain would help better understand the relationship among a local population of neurons that are responsible for a specific function. we need to first understand which part of the brain is responsible for those modalities and how those functions are performed. Neural prostheses are a series of devices that can substitute a motor. motor or cognitive modalities. this is a great challenge considering that this data link has to operate through the skin. more application-specific neural prostheses. These implantable devices can also be used in animal experiments as a tool for neuroscientists to develop a better understanding of how the brain works. sensory or cognitive modality that might have been damaged as a result of an injury or a disease. especially in the brain. eye or cochlea. Cochlear implants provide an example of such devices.Neuroprosthetics 84 Neuroprosthetics Neuroprosthetics (also called neural prosthetics) is a discipline related to neuroscience and biomedical engineering concerned with developing neural prostheses. This is just as challenging as the data transmission. Also this implant would have to communicate with the outside world wirelessly. This bidirectional wireless communication requires a high bandwidth for real-time data transmission. The minimal size of the implant means no battery can be embedded in the implant. the processed signal is then transferred to an implanted unit that stimulates the auditory nerves through a microelectrode array.

. Blindness can result from damage to the optical pathway (cornea. aqueous humor. and relatively minor impacts. Sensory prosthetics Visual prosthetics A visual prosthesis can create a sense of image by electrically stimulating neurons in the visual system. tethering would not resolve the problem in devices meant to be inserted deep into the brain. Power and data will be transmitted to the implant wirelessly by the external unit. The subjects demonstrated their ability to distinguish between three common objects (plate. cup. They are part of the retina. in 2000. This trial was implemented at Optobionics. CA) began a trial with a prototype epiretinal implant with 16 electrodes. such as those used in deep brain stimulation to alleviate the symptoms of Parkinson's Disease. The first clinical trial of a permanently implanted retinal prosthesis was a device with a passive microphotodiod [4] array with 3500 elements. A camera would wirelessly transmit to an implant. Recent systems utilize more advanced probes. and vitreous). The processed signal is sent to the brain through the optical nerve. or the visual cortex can be stimulated. In 2002. If any part of this path way is damaged blindness can occur. In 1968 Giles Brindley implanted an 80 electrode device on the visual cortical surface of a 52-year-old blind woman. As a result of the stimulation the patient was able to see phosphenes in 40 . The stimulation can also be done anywhere along the optic signal's path way. The optical nerve can be stimulated in order to create an image. The microphotodiods serve to modulate current pulses based on the amount of light incident on the photo diode. A visual prosthesis system consists of an external (or implantable) imaging system which acquires and processes the video. The problem with either approach is that the brain floats free in the skull while the probe does not. The array of electrodes has to effectively stimulate 600-1000 locations. originally done by inserting the electrodes with needles and breaking off the needles at the desired depth. have proposed tethering 'electrodes to be mounted on the exterior surface of the brain' to the inner surface of the skull. and knife) at levels statistically above chance.Neuroprosthetics 85 History The first cochlear implant dates back to 1957. Inc. are potentially damaging. such as Kensall Wise at the University of Michigan. This can happen as a result of accident or disease. Second Sight Medical Products. The implant uses the received power/data to convert the digital data to an analog output which will be delivered to the nerve via micro electrodes.[3] Paraplegics were helped in standing with a lumbar anterior root implant (1988) and in walking with Functional Electrical Stimulation (FES). An active sub retinal device developed by Retina Implant GMbH (Reutlingen. although clinical tests have proven most successful for retinal implants. the implant would map the image across an array of electrodes. An IC with 1500 microphotodiods was implanted under the retina. an early difficulty was reliably locating the electrodes. stimulating these optic neurons in the retina thus will create an image. a multilayer neural structure about 200 um thick that lines the back of the eye. Regarding the development of electrodes implanted in the brain. Some researchers. Inc. However. (Sylmar. such as a low speed car accident. The two most common retinal degenerative diseases that result in blindness secondary to photoreceptor loss is age related macular degeneration (AMD) and retinitis pigmentosa (RP). the first auditory brainstem implant in 1977 and a peripheral nerve bridge implanted into spinal cord of adult rat in 1981. even if successful. Germany) began clinical trials in 2006. crystalline lens. Other landmarks include the first motor prosthesis for foot drop in hemiplegia in 1961.[5] The seminal experimental work towards the development of visual prostheses was done by cortical stimulation using a grid of large surface electrodes. The subjects were six individuals with bare light perception secondary to RP. such as in the case of deep brain stimulation (DBS). Photoreceptors are the specialized neurons that convert photons into electrical signals.

and Miguel Nicolelis at Duke University. However. Modern signal processing represents the most important speech information while also providing the brain the pattern recognition information that it needs. and auditory midbrain implants (AMIs) are the three main categories for auditory prostheses. with the help of D. Eyries. The requirements for a high resolution retinal prosthesis should follow from the needs and desires of blind individuals who will benefit from the device. arguing that the basic research and design of the densely populated microscopic wire was not sophisticated enough to proceed.[6] This experiment showed that an implanted electrical stimulator device could restore some degree of vision. In 1957. Also this high amount of information must be received and processed by the implant without much power dissipation which can damage the tissue.[10] Since the early 2000s FDA has been involved in a clinical trial of device termed the "Hybrid" by Cochlear Corporation.S. Kayser. The microphone of the CI system receives sound from the external environment and sends it to processor. Any implant would be preferred to be minimally invasive. signal processing. provided the first detailed description of directly stimulation the auditory nerve in a human subject. cochlear implants acquire and process the sound and convert it into electrical energy for subsequent delivery to the auditory nerve. The "Hybrid" utilizes a shorter electrode than the standard cochlea implant. several scientists. In theory these devices would benefit patients with significant low-frequency residual hearing who have lost perception . biophysics. In 1972. In order for a good quality image to be mapped in the retina a high number of micro-scale electrode arrays are needed.Neuroprosthetics different positions of the visual field. Djourno and C. face recognition and reading are the main necessary enabling capabilities. Pattern recognition in the brain is more effective than algorithmic preprocessing at identifying important features in speech. started research on the design of a sophisticated visual prosthesis. A combination of engineering. the first portable cochlear implant system in an adult was implanted at the House Ear Clinic.[8] The individuals described hearing chirping sounds during simulation. The processor digitizes the sound and filters it into separate frequency bands that are sent to the appropriate tonotonic region in the cochlea that approximately corresponds to those frequencies. and AMIs stimulates auditory neurons in the inferior colliculus. This trial is aimed at examining the usefulness of cochlea implantation in patients with residual low-frequency hearing. French researchers A. and cognitive neuroscience was necessary to produce the right balance of technology to maximize the performance of auditory prosthesis. Interactions with theses patients indicate that mobility without a cane. John Chapin at SUNY. the challenges are grave. including Karin Moxon at Drexel. Recent efforts in visual cortex prosthesis have evaluated efficacy of visual cortex stimulation in a non-human primate. ABI electrode arrays stimulate the cochlear nucleus complex in the lower brain stem. In contrast to traditional hearing aids that amplify sound and send it through the external ear. the image quality is dependent on how much information can be sent over the wireless link. auditory brain stem implants (ABIs). 86 Auditory prosthetics Cochlear implants (CIs). Food and Drug Administration (FDA) formally approved the marketing of the House-3M cochlear implant in November 1984. The U. In this experiment after a training and mapping process the monkey is able to perform the same visual saccade task with both light and electrical stimulation. Other scientists have disagreed with the focus of their research.[9] Improved performance in cochlea implants not only depends on understanding the physical and biophysical limitations of implant stimulation but also on an understanding of the brain's pattern processing requirements. The size of the implant is also of great concern. Today Advanced Bionics and Medtronic are the major commercial providers of cochlea implants. since the electrode is shorter it stimulates the basil region of the cochlea and hence the high-frequency tonotopic region.[7] The results and implications of fully-functional visual prostheses are exciting. Cochlear implants have been very successful among these three categories. Also. CI electrode arrays are implanted in the cochlea.[7] With this new technology.

however. In ancient times the electrogenic fish was used as a shocker to subside pain. Bladder control implants Where a spinal cord lesion leads to paraplegia. number. changes in pain location. and suboptimal electrode placement.[13] In the mid-1960s. 1. In the somatic nervous system attempts to aid conscious control of movement include Functional electrical stimulation and the lumbar anterior root stimulator. and number of independent channels. The current devices use computerized equipment to find the best options for use. shape. most western physicians were offering their patients electrotherapy delivered by portable generator. controlled by an external transmitter. a fair level skill was required to deliver the therapy to the target for the proper amount of time. are the large dorsal column afferents. The design option for the pulse generator include the power source. arrangement.Neuroprosthetics in the speech frequency range and hence have decreased discrimination scores.[15] Motor prosthetics Devices which support the function of autonomous nervous system include the implant for bladder control. with successful human trials from the early 1980s onwards. which produce broad paresthesia covering segments caudally. This reprogramming option compensates for postural changes. By the nineteenth century.[16] This device is implanted over the sacral anterior root ganglia of the spinal cord. Pioneering physicians became interested in stimulating the nervous system to relieve patients from pain. it delivers intermittent stimulation which improves bladder emptying. It also assists in defecation and enables male patients to have a sustained full erection. The design options for electrodes include their size. pulse width. and assignment of contacts and how the electrode is implanted. target anatomic placement location. Pacemaker technology. because this overlap is necessary (but not sufficient) to achieve pain relief. current or voltage source. electrode migration. which proposed that the transmission of pain could be blocked by stimulation of large afferent fibers.[12] Paresthesia coverage depends upon which afferent nerves are stimulated. From 1969 onwards Brindley developed the sacral anterior root stimulator. close to the pial surface of spinal cord. (Including keeping the fish alive as long as possible) Electro analgesia was the first deliberate application of electricity. The most easily recruited by a dorsal midline electrode.[14] 3. became available. The technical goal of SCS for neuropathic pain is to mask the area of a patient's pain with a stimulation induced tingling. Because of the awkwardness of using a living shock generator. pulse rate.[17] . which had it start in 1950. Melzack and Wall published their gate control theory of pain. three things converged to insure the future of electro stimulation. Programming options are very numerous (a four-contact electrode offers 50 functional bipolar combinations). known as "paresthesia". including headache. The related procedure of sacral nerve stimulation is for the control of incontinence in able-bodied patients. 2.[11] 87 Prosthetics for pain relief The SCS (Spinal Cord Stimulator) device has two main components: an electrode and a generator. patients have difficulty emptying their bladders and this can cause infection. Healers had developed specific and detailed techniques to exploit the generative qualities of the fish to treat various types of pain.

Having a patient think about clenching a fist. Completing the translation. The second was implanted in a different motor region and was used to indicate the selection. and they are beginning to build robotic limbs and exoskeletons that patients can control by thinking about movement. The technology behind motor neuroprostheses is still in its infancy. . and in the future. (i. auditory cortex) can perform functions associated with another portion of the brain. a form of sensory feedback was provided via the implant by passing small electrical currents into the nerve. ill effects. The filters used in the prostheses are also being fine-tuned. Preliminary clinical trials suggest that the devices are safe and that they have the potential to be effective. Cognitive prostheses Cognitive prostheses seek to restore cognitive function to individuals with brain tissue loss due to injury. The recorded signals were used to control a robot arm developed by Warwick's colleague. transducing recorded information through a thin cable.g. Sensory/motor prosthetics In 2002 an array of 100 electrodes was implanted directly into the median nerve fibers of the scientist Kevin Warwick. and reportedly are slated to feature sensors for detecting pressure and temperature. After decades of research in monkeys. recent studies on brain plasticity suggest that the brain is capable of rewiring itself so that an area of the brain traditionally associated with a particular function (i. Todd Kuiken at Northwestern University and Rehabilitation Institute of Chicago has developed a method called targeted reinnervation for an amputee to control motorized prosthetic devices and to regain sensory feedback.e. for example.[18] Developments continue in replacing lost arms with cybernetic replacements by using nerves normally connected to the pectoralis muscles.[19] Dr.[23] Implants could take advantage of brain plasticity to restore cognitive function even if the native tissue has been destroyed. disease. neuroscientists have been able to decode neuronal signals into movements.e. auditory cortex processing visual information). Investigators and study participants continue to experiment with different ways of using the prostheses. finger representation area) and was used to move a cursor among a group of letters. or stroke by performing the function of the damaged tissue with integrated circuits. Peter Kyberd and was able to mimic the actions of Warwick's own arm.[20] Additionally. doctors hope to create an implant capable of transmitting signals from inside the skull wirelessly. This caused a contraction of the first lumbrical [20] muscle of the hand and it was this movement that was perceived.Neuroprosthetics 88 Motor prosthetics for conscious control of movement Researchers are attempting to build motor neuroprosthetics that will help restore movement and the ability to communicate with the outside world to persons with motor disabilities such as tetraplegia or amyotrophic lateral sclerosis. Prior to these advancements. Kennedy's device used two neurotrophic electrodes: the first was implanted in an intact motor cortical region (e.[21] The theory of localization states that brain functions are localized to a specific portion of the brain. as opposed to through a cable. researchers have built interfaces that allow patients to move computer cursors. scientists have developed microelectrode arrays smaller than a square centimeter that can be implanted in the skull to record electrical activity. To capture electrical signals from the brain.[22] However. produces a different result than having him or her think about tapping a finger. Philip Kennedy (Emory and Georgia Tech) had an operable if somewhat primitive system which allowed an individual with paralysis to spell words by modulating their brain activity. These arms allow a slightly limited range of motion. if any. Some patients have worn the devices for over two years with few.

[27] Orthosis for TBI patients to control limb movement via devices that read neurons in brain.[21] Degenerative hippocampal neurons are the root cause of the memory disorders that accompany Alzheimer's disease. Paralysis Paralysis Resource Center. Also. traumatic brain injury. Many patients would benefit from a prosthetic device that controls limb movement via devices that read neurons in brain. Even a small measure of success by cognitive implants would help keep Alzheimer's patients out of nursing homes. Cole at NIH . This technology is being developed at the Andersen Lab [32]. more and more people are being affected by Alzheimer's disease. to communicate with others. hippocampal pyramidal cells are extremely sensitive to even brief periods of anoxia. Traumatic Brain Injury More than 1. and stimulate needed motor pools to make movement. (Anderson Paper.[28] Deep Brain Stimulation relieves symptoms of Parkinson's Disease for numerous patients.[29] Parkinson's Disease patients could benefit from a cortical device that mimics the natural signals needed to promote dopamine production. Many of the more severe cases of Alzheimer's patients end up in nursing homes. The goal is to develop a device to enable locked in patients.[24] Due to increased life spans. Loss of hippocampal neurons in the dentate gyrus. calculate limb trajectory. approximately 6 million According to the Christopher and Dana Reeve Foundation's people are living with paralysis in the United States. Speech Deficits Approximately 7.[21] This demonstrates the wide scope of neural damage and neurodegenerative disease conditions for which a hippocampal prosthesis would be clinically relevant.specifically "Computer software as an orthosis for Brain Injury". located at the California Institute of Technology [33]. and stimulate the needed motor pools to make movement. stroke. like those that occur during stroke.[26] Hippocampal dysfunction has also been linked to epileptic activity. The success of cochlear implants suggest that cortical implants to the speech areas of the brain can be developed to improve speech in such patients. Paralysis results from many sources. neurodegenerative diseases like multiple sclerosis and Lou Gehrig's Disease.Neuroprosthetics 89 Applications Alzheimer's Disease Alzheimer's Disease is projected to affect more than 107 million people worldwide by the year 2050. Another possible avenue for mitigation of PD is a device that supplements dopamine when given specific neuronal inputs which would let the body regulate dopamine levels with its intrinsic sensors. calculate limb trajectory. Theodore Berger [25] at the University of Southern California is developing a prosthetic for treatments of hippocampal detriments including Alzheimer's. and congenital sources. an area associated with new memory formation has been attributed to blunt head trauma.) Parkinson's Disease Nearly 1 million people in the United States are affected by Parkinson's Disease. Alzheimer's disease renders individuals incapable of supporting themselves.5 million people in the United States have trouble speaking. [31] . those without the ability to move or speak. Hippocampal Deficits Dr.4 million people in the United States suffer traumatic brain injury.[30] Many of these can be attributed to aphasias.

Optimization of the implanted circuits reduces power needs. respectively).[21] Once the I/O parameters are modeled mathematically.[24] Just these two diseases indicate that there is already a large market for cognitive neural prosthetics. in the same way as normal tissue. Implanted devices currently need on-board power sources. More than 6. Longer battery life correlates to fewer surgeries needed to replace batteries. Another strategy is to convert electromagnetic energy into electrical energy. with more potential markestspace revealed in traumatic brain injury and speech problems (particularly damage to Broca's or Wernicke's areas). Power Consumption Power consumption drives battery size. These devices make of inductive coupling to recharge batteries.[34] Obstacles Mathematical Modeling Accurate characterization of the nonlinear input/output (I/O) parameters of the normally functioning tissue to be replaced is paramount to designing a prosthetic that mimics normal biologic synaptic signals. roughly the size of a quarter.[35] [36] Mathematical modeling of these signals is a complex task "because of the nonlinear dynamics inherent in the cellular/molecular mechanisms comprising neurons and their synaptic connections.[30] Many of these can be attributed to aphasias. One of the example of microimplantable electrode array is the Utah array. surgery is needed to replace the unit.Neuroprosthetics 90 Societal Impact/Market Information Nearly 1 million people in the United States are affected by Parkinson's Disease. it must process the input signals. More than 1. integrated circuits are designed to mimic the normal biologic signals. a process known as transformation.5 million people in the United States have suffered stroke. For the prosthetic to perform like normal tissue. (spatial and temporal properties. .4 million people in the United States suffer traumatic brain injury. as in radio frequency identification tags."[37] [38] [39] The output of nearly all brain neurons are dependent on which post-synaptic inputs are active and in what order the inputs are received.[27] Approximately 7. Once the battery runs out.[40] Wireless Controlling Devices can be mounted outside of the skull and should be smaller than a pager. One option that could be used in the medical field to recharge implant batteries without surgery or wires is being used in powered toothbrushes.[28] Alzheimer's Disease is projected to affect more than 107 million people worldwide by the year 2050.5 million people in the United States have trouble speaking. Size Implantable devices must be very small to be implanted directly in the brain.

The PRR encodes the targets for reaching in visual [45] Because it is coding the goal of the coordinates relative to the current direction of gaze AKA retinal coordinates. Methods of data transmission must be robust and secure. Perhaps the most astonishing possibility is utilizing these signals to provide 'locked in' individuals. those without the ability to move or speak. the PRR. the PPC is situated between sensory and motor areas in the brain. light weight device has been developed that allows constant recording of primate brain neurons at Stanford University. The PRR receives direct visual information. Andersen and colleagues placed electrode arrays onto the dorsal premotor cortex. Crossing the Blood Brain Barrier can introduce pathogens or other materials that may cause an immune response. or PRR for short. a phenomenon known as sensory – motor integration. Functionally speaking. the brain must learn how to use the implant. First. This allows physicians and clinicians to capture more data. Secondly. and electrode insulation must be chosen for long term implantation.Neuroprosthetics Bio Compatibility Cognitive prostheses are implanted directly in the brain. Materials used in the housing of the device.Active implantable medical devices Part 3: Implantable neurostimulators. the electrode material (such as iridium oxide[41] ). or relay this information to motor neurons. indicating that vision may be the primary sensory input.[42] This technology also enables neuroscientists to study the brain outside of the controlled environment of a lab. especially those with damage to areas of the brain that calculate limb movement variables. or PPC. Neurosecurity is a new issue. Within the PPC is an area known as the post parietal reach region. movement and not all the different variables required for the limb to contact the target. allowing better treatment and characterization of neural disease. Correct Implantation Implantation of the device presents many problems. the outputs from the device must be targeted correctly on the desired tissue. and medial interparietal area (MIP) of monkeys to record signals made by these regions while the monkeys looked at a computer . Decoding these signals is important to help paralyzed patients. the planning signals of the PRR are considered cognitive in nature. 91 Current Developments Andersen Lab The Andersen Lab [43] builds on research done previously by Musallam and show that high-level cognitive signals in the post parietal cortex. Implants for Surgery .[44] Signals like these could be used to directly control a prosthetic device. Makers of cognitive implants must prevent unwanted downloading of information or thoughts from and uploading of detrimental data to the device that may interrupt function. the correct presynaptic inputs must be wired to the correct postsynaptic inputs on the device. This area has been shown to be most active when an individual is planning and executing a movement. Questions to answer:How does this affect material choice? Does the brain have unique phages that act differently and may affect materials thought to be bio compatible in other areas of the body? Data Transmission Wireless Transmission is being developed to allow continuous recording of neuronal signals of individuals in their daily life. It is involved in converting sensory inputs into plans for action. Various studies in brain plasticity (int link) suggest that this may be possible through exercises designed with proper motivation. so biocompatibility is very important obstacle to overcome. The brain has its own immune system that acts differently than the immune system of the rest of the body. can be used to decode the target position of reaching motions. First. Subject to Standards: ISO 14708-3 2008-11-15. ensuring that short term events like epileptic seizures can be recorded. Thirdly. an avenue of communication. A small.

or first-in. the researchers used reach trials to decode intentions in healthy monkeys. currently the hippocampus. the researchers conducted brain-control trials using neural activity data recorded from 2 tenths of a second to 1 second of the memory period to decode the intended reach destination. along with the brain's plasticity. ensuring that motor and sensory information were not influencing the planning activity.5 seconds. making the system work better each time the patient uses it. The goal is to make an implantable device that replicates the way living hippocampal neurons behave and exchange electrical signals. the monkeys were much better at hitting the target. Adaptive databases overcome this scenario. it would be a large step towards a biomedical solution for Alzheimer's symptoms. first-out. and creates an opportunity for patients to improve how they operate the prosthesis with training. and perhaps even motorized wheel chairs. Next. After a month or two of training. in the future precision devices such as surgical tools could be controlled directly by the brain instead of controls manipulated by the motor system. providing visual reinforcement. If the number of database entries is kept constant. Finally. This learning is a testament to the brain's natural plasticity. but sitting motionless in the dark absent of eye movements. and then to stimulate neurons in other parts of the brain. about 1. another cue (green) popped up briefly then disappeared. essential for learning and memory. Furthermore. (a less successful one) must be deleted. hopefully just like the tissue did before damage or degeneration. Each time a reach decoding is successful. This process. Theodore Berger's research lab at the University of Southern California seeks to develop models of mammalian neural systems. 92 Technologies Involved Local Field Potentials Local field potentials (LFPs) are electrophysiological signals that are related to the sum of all dendritic synaptic activity within a volume of tissue. paralyzed patients cannot perform reach trials for the scientists to record reach intention data. without using their limbs. setup. This suggests a FIFO. Recent studies suggest goals and expected value are high-level cognitive functions that can be used for neural cognitive prostheses. The oldest data drops out first. A brain-machine interface used the decoded data to move a cursor to the spot on the screen where the monkeys planned to move. Each time the patient uses the prosthetic system. If successful. one trial. Hippocampal Prosthetic Dr. Complications from brain injury to motor areas of the brain like reduced coordination could be improved. calculate what the outgoing response of normal hippocampus neurons would be. However. should enable people to control a myriad of prostheses.[46] • explain how they are used • how they are better than other methods . Eventually the database will contain only successful decodes.Neuroprosthetics screen. Speech and language problems caused by stroke could be reversed. Monkeys were rewarded with juice if the correct target was decoded and the cue was flashed again. the brain could automatically make subtle adjustments to the input signal recorded by the system. After the monkeys touched a central cue spot on the screen and looked at a central fixation point (red). but with rigorous training and many trials. The recordings were made when the monkeys were planning movement. Initially filling the database will be difficult. To accomplish this. the system will be able to accurately discern the user's intentions. the device will listen for neuronal signals going to the hippocampus with implanted electrode arrays. it is added to the database. The monkeys were given a juice reward if they reached to where the newly vanished target was at the end of a short memory period.

" J. 2004 [5] M. Philadelphia. 4. (Lond. Humayun. E. Wilson. Retrieved February 6. Brackmann DE.Ophthalmol. Cochlear implants: My perspective [10] Fayad JN. and K. vol. Other future directions include devices to maintain focus. J. Physiol. Gantz. "History of cochlear implants. Retrieved May 5. PA: Lippincott Williams and Wilkins. 2. Development of automatically adjusting electrodes would mitigate this problem. B. J. McClure. 11 (suppl. H. V. J. Lawton. "The sensations produced by electrical stimulation of the visual cortex. Greenberg. K. 2007. vol. "Spinal cord stimulation for chronic. vol. pp. Peyman. 2006. . House. 63–68. [2] Laura Bailey. to help patients with damaged cortices feel and express emotions. 119–130." presented at the ARVO Annu. 479. Piantadosi." in Cochlear Implants:Principles and Practices. p. Packo. pp.. Memory/Brain off-loading and subsequent uploading to learn new information quickly. com/ content/ qjjwu2l4n363j278/ ). and R. "The artificial silicon retina microchip for the treatment of vision loss from retinitis pigmentosa. J. Anderson's group is currently collaborating with Yu-Chong Tai's lab and the Burdick lab (all at Cal Tech) to make such a system that uses electrolysis-based actuators to independently adjust electrodes in a chronically implanted array of electrodes.).. Present and Future" Indian Journal of Physical Medicine & Rehabilitation 17(1) [4] A. Lauderdale. and to enable true telepathic communication. The techniques used in the Potter Lab [48] can be used to study and enhance the activities of neural prosthetics devices.. North. Rev. no. Fishlock. May 2001 .[47] MRI Used for imaging to determine correct positionings 93 Imaged Guided Surgical Techniques Image-Guided Surgery is used to precisely position brain implants. Visual prosthesis. M. Niparko and B. "HUniversity of Michigan News Service" (http:/ / www." Audiol. 122.vol. 2008. Shannon RV. Pollack. Turner. Researchers at the Georgia Institute of Technology are researching mammalian memory cells to determine exactly how we learn. pp. Meeting. html?Releases/ 2006/ Feb06/ r020606a). Chow. 2000. "Acoustic plus electric speech processing: Preliminary results of a multicenter clinical trial of the Iowa/Nucleus hybrid implant. Lewin. W. 1968 [7] Weiland JD. not simply picking up visual/auditory cues and guessing emotional state or subject of thought from context. If the electrodes are moved by physical shock or the brain moves in relation to electrode position. M. p. Ft. intractable pain: Superiority of 'multi-channel' devices. Y. Elect. vol." Inst. 196. the electrodes could be recording different nerves. References [1] Daniel Garrison. Schuchard. C. 2006. Eng. Humayun MS. springerlink. S. Cochlear and brainstern auditory prostheses "neural interface for hearing restoration: Cochlear and brain stem implants". K. Gfeller.Dorn. K.Neuroprosthetics Automated Movable Electrical Probes One hurdle to overcome is the long term implantation of electrodes. E. 103–108 [9] W. McMahon. 2010. S. and R. Individually adjusting multi electrode arrays is a very tedious and time consuming process. Brindley and W. Y. to stabilize/induce mood. Caspi. Adjustment to electrodes is necessary to maintain an optimal signal. A. Chow. Vol 1 [12] R. pp. M. [6] G. Proceedings of the Ieee 96:1076-84 [8] J. F. A. [3] Handa G (2006) "Neural Prosthesis – Past. 2008. "Spatial vision in blind subjects implanted with the second sight retinal prosthesis. 23–28." Pain. Neurotol. 460. umich. ." Arch. FL. edu/ news/ index.[46] Future Directions Self-charging implants that use bioenergy to recharge would eliminate the need for costly and risky surgeries to change implant batteries. Ewend. 47. G. Otto SR. 1991 [13] D.). "Minimizing Thermal Effects of In Vivo Body Sensors" (http:/ / www. Proceedings of the Ieee 96:1085-95 [11] B. and S. Controlling complex machinery with thoughts instead of converting motor movements into commands for machines would allow greater accuracy and enable users to distance themselves from hazardous environments. D. "Doctor volts [electrotherapy].

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Nature 442:125-7 Velliste M. Neurotherapeutics 5:137-46 Liu WT. 25: 4681-4893. Proceedings of the Ieee 96:1073-4 Harrison RR. The design of integrated circuits to observe brain activity. 22(6): 1529-1540.453(7198):1098-101. 2006.com/) • CIMIT . The development of brain-machine interface neuroprosthetic devices. Nicolelis MA (2005) "Frontal and parietal cortical ensembles predict single-trial muscle activity during reaching movements in primates. Proceedings of the Ieee 96:1203-16 Abbott A. O'Doherty JE.net/doc/) and Programmable chip version (http://pceeg. 4: 417-422. Stambaugh CR. Cyberkinetics is the first venture capital funded neural prosthetic company.Neuroprosthetics 95 Commercial technology Medtronic and Advanced Bionics are significant commercial names in the emergent market of Deep Brain Stimulation. Berger's website (http://www.sourceforge." J Neurosci." Nature 16: 361-365. Liker MA. 2008.org/) . Further reading Santhanam G. External links (for a list of universities see Neural Engineering ." Eur J Neurosci. Lebedev MA. Humayun MS. Biggs SJ.Center For Integration Of Medicine And Innovative Technology . Carmena JM.cimit. Nicolelis MA (2003) "Brain-machine interfaces to restore motor function and probe neural circuits. Principe JC. Zacksenhouse M. Henriquez CS. Kralik JD. Nature 442:195-8 Patil PG. Spalding MC. Moran DW "Brain-controlled interfaces: movement restoration with neural prosthetics. Theodore W." Nature. Weber DJ. Nicolelis MA. 19. Wessberg J. Whitford AS.sourceforge. Srinivasan MA. A high-performance brain-computer interface. Kim J. Cui XT. Shenoy KV. Afshar A.neural-prosthesis. Ryu SI. 2008." (2006) Neuron 5. Turner DA.Advances & Research in Neuroprosthetics (http://www. 2008. Schwartz AB (2008) "Cortical control of a prosthetic arm for self-feeding. Schwartz AB. Sourceforge open source EEG projects • Dr. Laubach M.52(1):205-20 Santucci DM. Nicolelis MA (2005) "Cortical ensemble adaptation to represent velocity of an artificial actuator controlled by a brain-machine interface.net/). Yu BM. Kralik JD. Implantable biomimetic microelectronics systems. Lebedev MA. Beck PD. (2000) "Real-time prediction of hand trajectory by ensembles of cortical neurons in primates. 2006. Neuroprosthetics: In search of the sixth sense. Chapin JK. Perel S." Nat Rev Neurosci.Neural Engineering Labs) • The open-source Electroencephalography project (http://openeeg.

Others have multiple electrodes stimulating differing positions within the heart to improve synchronisation of the lower chambers of the heart. or there is a block in the heart's electrical conduction system. Modern pacemakers are externally programmable and allow the cardiologist to select the optimum pacing modes for individual patients.Artificial pacemaker 96 Artificial pacemaker A pacemaker (or artificial pacemaker. so as not to be confused with the heart's natural pacemaker) is a medical device which uses electrical impulses. the electrode measures between 50 and 60 centimeters (20 to 24 inches). The primary purpose of a pacemaker is to maintain an adequate heart rate. Some combine a pacemaker and defibrillator in a single implantable device. A pacemaker. either because the heart's native pacemaker is not fast enough. The body of the device is about 4 centimeters long. delivered by electrodes contacting the heart muscles. . to regulate the beating of the heart. scale in centimeters An artificial pacemaker with electrode for transvenous insertion.

William L. This effective control of postsurgical heart block proved to be a significant contribution to decreasing mortality of open heart surgery in this time period. Sydney whose heart continued "to beat on its own accord". He had a total of 26 devices during 'reviving the dead'. both among his fellow physicians.[7] The first implantable pacemaker. "at the end of 10 [2] [3] minutes" of stimulation.[6] In 1957. devised a portable apparatus which "plugged into a lighting point" and in which "One pole was applied to a skin pad soaked in strong salt solution" while the other pole "consisted of a needle insulated except at its point. For example. These studies demonstrated the restoration of heart rate.[1] In 1926.[3] An external pacemaker was designed and built by the Canadian electrical engineer John Hopps in 1950 based upon observations by cardio-thoracic surgeon Wilfred Gordon Bigelow at Toronto General Hospital . "The pacemaker rate was variable from about 80 to 120 pulses per minute. described an electro-mechanical instrument of his own.Artificial pacemaker 97 History In 1899. including Paul Zoll.[4] [5] An apparent hiatus in publication of research conducted between the early 1930s and World War II may be attributed In 1958. . made smaller but still bulky transcutaneous pacing devices in the following years using a large rechargeable battery as the power supply. Arne Larsson (1915-2001) became the first to receive to the public perception of interfering with nature by an implantable pacemaker. Dr. the term continuing in use to this day. and likewise the voltage variable from 1. cardiac output and mean aortic pressures in animal subjects with complete heart block through the use of a myocardial electrode. J A McWilliam reported in the British Medical Journal of his experiments in which application of an electrical impulse to the human heart in asystole caused a ventricular contraction and that a heart rhythm of 60-70 beats per minute could be evoked by impulses applied at spacings equal to 60-70/minute. and due to newspaper reporting at the time. supported by physicist Edgar H Booth of the University of Sydney. being powered from an AC wall socket. A number of innovators. adverse publicity. and was plunged into the appropriate cardiac chamber". working independently. A substantial external device using vacuum tube technology to provide transcutaneous pacing. Dr Mark C Lidwell of the Royal Prince Alfred Hospital of Sydney. American physiologist Albert Hyman. carried a potential hazard of electrocution of the patient by inducing ventricular fibrillation. Weirich published the results of research performed at the University of Minnesota. In 1932. powered by a spring-wound hand-cranked motor. it was somewhat crude and painful to the patient in use and. the apparatus was used to revive a stillborn infant at Crown Street Women's Hospital. Lidwell may have been aware of this and did not proceed with his experiments in humans". "Hyman did not publish his life and campaigned for other patients needing data on the use of his pacemaker in humans because of pacemakers.5 to 120 volts" In 1928. Hyman himself referred to his invention as an "artificial pacemaker".

Minnesota. A second device was then implanted which lasted for two days. including ARCO in the USA. The first patient lived for a further 18 months. A further impediment to reliability of the early devices was the diffusion of water vapour from the body fluids through the epoxy resin World's first Lithium-iodide cell powered encapsulation affecting the electronic circuitry. Sweden. Lithium-iodide or lithium anode cells became the standard for future pacemaker designs.Guidant. In 1958. went on to receive 26 different pacemakers during his lifetime. This phenomenon was pacemaker. which were charged by an induction coil from the outside. Implantable pacemakers constructed by engineer Wilson Greatbatch entered use in humans from April 1960 following extensive animal testing. Others who contributed significantly to the technological development of the pacemaker in the pioneering years were Bob Anderson of Medtronic Minneapolis. procedure involved incision of a vein into which was inserted the catheter electrode lead under fluoroscopic guidance. This transistorised pacemaker. housed in a small plastic box. 1972 overcome by encasing the pacemaker generator in an hermetically sealed metal case. produced the first wearable external pacemaker for a patient of Dr. The first use of transvenous pacing in conjunction with an implanted pacemaker was by Parsonnet in the USA. until it was lodged within the trabeculae of the right ventricle.G (Geoffrey) Davies of St George's Hospital London. That device lasted until the patient died of other ailments. using titanium as the encasing metal. engineer Earl Bakken of Minneapolis. Cardiac Pacemakers Inc. developed isotope powered pacemakers.Artificial pacemaker The development of the silicon transistor and its first commercial availability in 1956 was the pivotal event which led to rapid development of practical cardiac pacemaking. Janwillem van den Berg of Holland and Anthony Adducci of Cardiac Pacemakers Inc. The world's first implantable pacemaker patient. Arne Larsson. or pervenous. 9 months later. in which the catheter electrode was inserted via the patient's basilic vein. This technology. J. The preceding implantable devices all suffered from the unreliability and short lifetime of the available primary cell technology which was mainly that of the mercury battery. had controls to permit adjustment of pacing heart rate and output voltage and was connected to electrode leads which passed through the skin of the patient to terminate in electrodes attached to the surface of the myocardium of the heart. Geoffrey Wickham of Telectronics Australia. at the age of 86. outliving the inventor as well as the surgeon. The early Swedish-designed devices used rechargeable batteries.[8] In 1959. but this development was overtaken by the development in 1971 of the lithium-iodide cell by Wilson Greatbatch. He died in 2001. an improved version of the Swedish Elmqvist design was implanted in Montevideo. This method was to become the method of choice by the mid-1960s. Hans Thornander who joined previously mentioned Rune Elmquist of Elema-Schonander in Sweden. The Greatbatch innovation varied from the earlier Swedish devices in using primary cells (mercury battery) as the energy source. The device failed after three hours.[10] [11] [12] 98 Lagergren in Sweden[13] [14] and Jean-Jaques Welti in France[15] in 1962-63. The first clinical implantation into a human of a fully implantable pacemaker was in 1958 at the Karolinska Institute in Solna. temporary transvenous pacing was first demonstrated by Furman et al. Barouh Berkovits and Sheldon Thaler of American Optical. using a pacemaker designed by Rune Elmqvist and surgeon Åke Senning. became the standard by the mid-1970s. . connected to electrodes attached to the myocardium of the heart by thoracotomy. of Miami. Walter Keller of Cordis Corp. Uruguay in the Casmu Hospital by Doctors Fiandra and Rubio. initially by Telectronics of Australia in 1969 followed by Cardiac Pacemakers Inc of Minneapolis in 1972. Walton Lillehei. several companies. C. In the late 1960s. The transvenous.[9] In February 1960.

also called external pacing. Transvenous pacing is often used as a bridge to permanent pacemaker placement. The electrodes are placed in contact with the outer wall of the ventricle (epicardium) to maintain satisfactory cardiac output until a temporary transvenous electrode has been inserted. Pacing artifact on the ECG and severe muscle twitching may make this determination difficult. distortion results from muscle contractions due to a (short) hypoxic seizure. It is an emergency procedure that acts as a bridge until transvenous pacing or other therapies can be applied. pacemaker stimuli at 60 beats per minute result in a wide QRS complex with a right bundle branch block pattern. Because decreased pacemaker stimuli do not result in a ventricular escape rhythm. striking from a distance of 20 – 30 cm to induce a ventricular beat (the British Journal of Anesthesia suggests this must be done to raise the ventricular pressure to 10 15mmHg to induce electrical activity). The epicardial pacemaker leads were placed after the patient collapsed during aortic valve surgery.Artificial pacemaker 99 Methods of pacing Percussive pacing Percussive pacing. The procedure is performed by placing two pacing pads on the patient's chest. is recommended for the initial stabilization of hemodynamically significant bradycardias of all types. This is an old procedure used only as a life saving means until an electrical pacemaker is brought to the patient. It can be kept in place until a permanent pacemaker is implanted or until there is no longer a need for a pacemaker and then it is removed. either in the anterior/lateral position or the anterior/posterior position. The pacing wire is then connected to an external pacemaker outside the body. also known as transthoracic mechanical pacing. A pacemaker wire is placed into a vein. At the end of the tracing. In the first half of the tracing. Epicardial pacing (temporary) Temporary epicardial pacing is used during open heart surgery should the surgical procedure create atrio ventricular block. broad T wave on the ECG) is achieved. usually on the left lower edge of the sternum over the right ventricle in the vena cava. . when used for temporary pacing. the patient can be said to be pacemaker-dependent and needs a definitive pacemaker. Transvenous pacing (temporary) Transvenous pacing. ECG rhythm strip of a threshold determination in a patient with a temporary (epicardial) ventricular pacemaker. Progressively weaker pacing stimuli are administered. under sterile conditions. Transcutaneous pacing Transcutaneous pacing (TCP). Note the circle around one of the sharp electrical spike in the position were one would expect the P wave. External pacing should not be relied upon for an extended period of time. and gradually increases the pacing current (measured in mA) until electrical capture (characterized by a wide QRS complex with a tall. is an alternative to transcutaneous pacing. and then passed into either the right atrium or right ventricle. which results in asystole in the second half of the tracing. is the use of the closed fist. The rescuer selects the pacing rate. with a corresponding pulse.[16] An ECG in a person with an atrial pacemaker.

it will stimulate the ventricle of the heart with a short low voltage pulse. classified according to the number of chambers involved and their basic [17] operating mechanism: • Single-chamber pacemaker. When the pacemaker fails to sense a heartbeat within a normal beat-to-beat time period. usually a lithium battery. The more complex forms include the ability to sense and/or stimulate both the atrial and ventricular chambers. of the heart. which is inert in the body.[17] The pacemaker generator is a hermetically sealed device containing a power source. This type more closely resembles the natural pacing of the heart by assisting the heart in coordinating the function between the atria and ventricles.Artificial pacemaker 100 Permanent pacing Permanent pacing with an implantable pacemaker involves transvenous placement of one or more pacing electrodes within a chamber. One lead paces the atrium and one paces the ventricle. However. above the muscles and bones of the chest. in the same way a piercing is. The outer casing of pacemakers is so designed that it will rarely be rejected by the body's immune system. This pacemaker has sensors that detect changes in the patient's physical activity and automatically adjust the pacing rate to fulfill the body's metabolic needs. the placement may vary on a case by case basis. The whole thing will not be rejected. Here. • Dual-chamber pacemaker. The most basic form monitors the heart's native electrical rhythm. This sensing and stimulating activity continues on a beat by beat basis. only one pacing lead is placed into a chamber of the heart. . or chambers. Most commonly. and will be encapsulated by scar tissue. until positioned in the chamber. The atrial lead is the curved one making a U shape in the upper left part of the figure. It is usually made of titanium. In this type. the computer logic for the pacemaker and the output circuitry which delivers the pacing impulse to the electrodes. The procedure is performed by incision of a suitable vein into which the electrode lead is inserted and passed along the vein. either the atrium or the ventricle. the generator is placed below the subcutaneous fat of the chest wall. After satisfactory lodgement of the electrode is confirmed the opposite end of the electrode lead is connected to the pacemaker generator.[17] • Rate-responsive pacemaker. wires are placed in two chambers of the heart. The procedure is facilitated by fluoroscopy which enables the physician or cardiologist to view the passage of the electrode lead. through the valve of the heart.[17] Right atrial and right ventricular leads as visualized under x-ray during a pacemaker implant procedure. Basic function Modern pacemakers usually have multiple functions. There are three basic types of permanent pacemakers. a sensing amplifier which processes the electrical manifestation of naturally occurring heart beats as sensed by the heart electrodes.

unless it has already happened .2 seconds) trigger a ventricular beat. timing between the atrial and ventricular contractions. and (red arrow).Artificial pacemaker 101 The revised NASPE/BPEG generic code for antibradycardia pacing[18] I II III IV V Multisite pacing O = None Chamber(s) paced Chamber(s) sensed Response to sensing Rate modulation O = None A = Atrium V = Ventricle D = Dual (A+V) O = None A = Atrium V = Ventricle D = Dual (A+V) O = None T = Triggered I = Inhibited D = Dual (T+I) O = None R = Rate modulation A = Atrium V = Ventricle D = Dual (A+V) From this the basic ventricular "on demand" pacing mode is VVI or with automatic rate adjustment for exercise VVIR . also known as CRT (cardiac resynchronization therapy) is a type of pacemaker that can pace both the septal and lateral walls of the left ventricle. for patients in normal sinus rhythm. there is also a lead in the right atrium to facilitate synchrony with the atrial contraction.[19] [20] The DDDR mode is most commonly used as it covers all the options though the pacemakers require separate atrial and ventricular leads and are more complex. one in the right ventricle to stimulate the septum. Where the problem is atrioventricular block (AVB) the pacemaker is required to detect (sense) the atrial beat and after a normal delay (0. CRT devices have been shown to reduce mortality and improve quality of life in patients with heart failure symptoms. Thus. demonstrating a pacemaker and a cardi capable of delivering e dangerously fast abnorma . the pacemaker can resynchronize a heart whose opposing walls do not contract in synchrony. The corona around the outside of the l pacing of the left ventricl ventricular lead in this c aspects that represent con the generator is larger tha generators. a LV ejection fraction less than or equal to 35% and QRS duration on EKG of 120 msec or greater.[24] Three leads can be seen cardiac resynchronization lead (solid black arrow).1-0. a (dashed black arrow). The equivalent atrial pacing mode is AAI or AAIR which is the mode of choice when atrioventricular conduction is intact but the natural pacemaker the sinoatrial node is unreliable .sinus node disease (SND) or sick sinus syndrome. These modes AAIR and VDD are unusual in the US but widely used in Latin America and Europe.this is VDD mode and can be achieved with a single pacing lead with electrodes in the right atrium (to sense) and ventricle (to sense and pace). By pacing both sides of the left ventricle. which occurs in approximately 25-50 % of heart failure patients. as in atrial fibrillation. and another inserted through the coronary sinus to pace the lateral wall of the left ventricle.[21] [22] [23] CRT can be combined with an implantable cardioverter-defibrillator (ICD). Biventricular pacing (BVP) A biventricular pacemaker. as well as between the septal and lateral walls of the left ventricle can be adjusted to achieve optimal cardiac function.this mode is suitable when no synchronization with the atrial beat is required. CRT devices have at least two leads. requiring careful programming of their functions for optimal results. Often.

timing the contractions of the atria to precede that of the ventricles improves the pumping efficiency of the heart and can be useful in congestive heart failure. Many advancements have been made to improve the control of the pacemaker once implanted. Pacemakers that control both the atria and ventricles are called dual-chamber pacemakers. physical activity as determined by an accelerometer. The first dynamic pacemaker was invented by Dr. The Right Ventricular lead would be positioned away from the apex (tip) of the right ventricle and up on the inter ventricular septum. Anthony Rickards of the National Health Hospital. adrenaline. Many of these have been made possible by the transition to microprocessor controlled pacemakers.[26] In most cases the pacemaker is inserted in the left shoulder area where an incision is made below the collar bone creating a small pocket where the pacemaker is actually housed in the patient's body. in 1982. ATP levels. predetermined heart rate. every 1 or 2 years. a 'Dynamic Pacemaker'. [25] have shown that unnecessary pacing of the right ventricle can lead to heart failure and an The DAVID trials increased incidence of atrial fibrillation. UK. Instead of producing a static. There is a followup session during which the pacemaker is checked using a "programmer" that can communicate with the device and allows a health care professional to evaluate the system's integrity and determine the settings such as pacing voltage output. to make sure the that placement of the right ventricular lead has not lead to weakening of the left ventricle. The newer dual chamber devices can keep the amount of right ventricle pacing to a minimum and thus prevent worsening of the heart disease. Considerations Insertion A pacemaker is typically inserted into the patient through a simple surgery using either local anesthetic or a general anesthetic. or intermittent control. could compensate for both actual respiratory loading and potentially anticipated respiratory loading. Although these dual-chamber models are usually more expensive. Following surgery the patient should exercise reasonable care about the wound as it heals. Stem cells may or may not be of interest to transitional tissue welding. An antibiotic is typically administered to prevent infection. etc.pCO2 (dissolved oxygen or carbon dioxide levels) in the arterial-venous system. to prevent deterioration of the strength of the heart. such a pacemaker. The patient should have the strength of their heart analyzed frequently with echocardiography. pO2 . The actual surgery may take about 30 to 90 minutes. The patient may be given a drug for relaxation before the surgery as well. The lead or leads (the number of leads varies depending on the type of pacemaker) are fed into the heart through a large vein using a fluoroscope to monitor the progress of lead insertion. Pacemakers that control not only the ventricles but the atria as well have become common. Rate responsive pacing allows the device to sense the physical activity of the patient and respond appropriately by increasing or decreasing the base pacing rate via rate response algorithms. . London.Artificial pacemaker 102 Advancements in function A major step forward in pacemaker function has been to attempt to mimic nature by utilizing various inputs to produce a rate-responsive pacemaker using parameters such as the QT interval. Advances in transitional tissue welding would support this and other artificial organ/joint/tissue replacement efforts. body temperature. X-ray image of installed pacemaker showing wire routing Dynamic pacemaking technology could also be applied to future artificial hearts. below the outflow tract.

pacemaker center (doctor. The typical replacement requires a surgery in which an incision is made to remove the existing device. and the new device is inserted into the patient's body replacing the previous device. Large and/or sudden increases in impedance can be indicative of a lead fracture while large and/or sudden decreases in impedance can signify a breach in lead insulation. An additional aspect of the in-office check is to examine any events that were stored since the last follow-up. or Physician to program an output that recognizes an appropriate safety margin while optimizing device longevity. . the device can be checked as often as is necessary. Other factors affecting device longevity include programmed output and algorithms (features) causing a higher level of current drain from the battery. Routine pacemaker checks are typically done in-office every six (6) months. MFG. the device will be interrogated to perform diagnostic testing. Pacemaker patient identification card International pacemaker patient identification cards carry information such as.[27] [28] 103 Living with a pacemaker Periodic pacemaker checkups Once the pacemaker is implanted. patient data (between others. mode. the leads are attached to the new device. aetiology). Representative. • Impedance: A test to measure lead integrity. These tests include: Two types of remote monitoring devices used by pacemaker patients. though will vary depending upon patient/device status and remote monitoring availability. symptom primary. As modern pacemakers are "on-demand". The most basic preparation is that people who have body hair on the chest may want to remove the hair by shaving or using a depilatory agent as the surgery will involve bandages and monitoring equipment to be afixed to the body. These are typically stored based on specific criteria set by the physician and specific to the patient. IPG (rate. Since a pacemaker uses batteries. Determining the threshold allows the Allied Professional. Device replacement is usually a simpler procedure than the original insertion as it does not normally require leads to be implanted. it is periodically checked to ensure the device is operational and performing appropriately. • Sensing: the ability of the device to "see" intrinsic cardiac activity (Atrial and ventricular depolarization). Some devices have the availability to display intracardiac electrograms of the onset of the event as well as the event itself. the device itself will need replacement as the batteries lose power. device longevity is affected by how much it is utilized. This is especially helpful in diagnosing the cause or origin of the event and making any necessary programming changes. hospital).Artificial pacemaker The patient may want to consider some basic preparation before the surgery. Depending on the frequency set by the following physician. • Threshold: this test confirms the minimum amount of energy (Both volts and pulse width) required to reliably depolarize (capture) the chamber being tested. date of implantation. type) and lead. meaning that they only pace when necessary. At the time of in-office follow-up. the leads are removed from the existing device. ECG.

The proof of concept exploit helps demonstrate the need for better security and patient alerting [34] measures in remotely accessible medical implants. Cellphones available in the United States (less than 3 watts) do not seem to damage pulse generators or affect how the pacemaker works. The patient should inform all medical personnel that they have a pacemaker. to deactivate implanted cardiac devices. Any kind of an activity that involves intense magnetic fields should be avoided. Some standard medical procedures such as the use of Magnetic resonance imaging (MRI) may be ruled out by the patient having a pacemaker. or reprogram the devices.[29] or maintaining heavy equipment that may generate intense magnetic fields (such as an MRI (Magnetic Resonance Imaging Machine)). may cause interference. debilitating conditions like strokes. A patient has a right to refuse or discontinue treatment. There are several limitations to its use including certain patients qualifications. The pacemaker patient may find that some types of everyday actions need to be modified. as has been demonstrated by a team of researchers. but they should refer the patient to a physician who will. can cause so much suffering to themselves and their families that they would prefer not to prolong their lives with supportive measures. This includes activities such as arc welding possibly.S. study has found[30] that the magnets in some portable music players. A 2008 U. some home devices have a remote potential to cause interference by occasionally inhibiting a single beat. There are a few activities that are unwise such as full contact sports and activities that involve intense magnetic fields. and scan settings. Some medical procedures may require the use of antibiotics to be administered before the procedure. the shoulder harness of a vehicle seatbelt may be uncomfortable if the harness should fall across the pacemaker insertion site. it is legal and ethical to honor requests by patients. In addition.[32] Some patients believe that hopeless. when placed within an inch of pacemakers. However. with certain types of equipment.[34] The demonstration worked at short range. such as cardiac devices. For instance.[33] 104 Privacy and security Security and privacy concerns have been raised with pacemakers that allow wireless communication. body parts.Artificial pacemaker Lifestyle considerations A patient's lifestyle is usually not modified to any great degree after insertion of a pacemaker. including a pacemaker that keeps him or her alive. in February 2011 the FDA approved a new pacemaker device called the Revo MRI SureScan which is the first to be proven safe for MRI use. or by those with legal authority to make decisions for patients. Physicians have a right to refuse to turn it off. Unauthorized third parties may be able to read patient records contained in the pacemaker. in combination with dementia. . they did not attempt to develop a long range antenna. Lawyers say that the legal situation is similar to removing a feeding tube.[31] Turning off the pacemaker According to a consensus statement by the Heart Rhythm Society. according to the American Heart Association.

1136/bmj. 2-7 1929.tb02226.+ Arne) . com/ successstories/ successstory. NASPE / BPEG Defibrillator (NBD) code . . Sept. com/ openurl?genre=article& sid=nlm:pubmed& issn=0147-8389& date=2005& volume=28& issue=5& spage=446). called implantable cardioverter-defibrillators (ICDs) are implanted. doi:10.1540-8159. [8] Success Stories : Larsson. "Cardiac Disease in Relation to Anaesthesia" in Transactions of the Third Session. p 160. or defibrillation. to try to break the tachycardia before it progresses to ventricular fibrillation.x. Heart Rhythm Society.[35] Treatment of PMT typically involves reprogramming the pacemaker. Images Paediatr Cardiol 27 (2006). impaedcard. Accessed May 11. Gott V. [3] Mond H. Australia.x.[35] Other devices with pacemaker function Sometimes devices resembling pacemakers. aspx?name=Larsson. hrsonline. ATP is only effective if the underlying rhythm is ventricular tachycardia.348. Jude Medical (http:/ / www.2005. org/ News/ ep-history/ timeline/ 1800s. These devices are often used in the treatment of patients at risk from sudden cardiac death.. and may try to pace the heart faster than its intrinsic rate in the case of VT. 2007. "The treatment of complete heart block by the combined use of a myocardial electrode and an artificial pacemaker". In PMT. cardioversion. Sydney. [4] Aquilina O. pp. the artificial pacemaker forms the anterograde (atrium to ventricle) limb of the circuit and the atrioventricular (AV) node forms the retrograde limb (ventricle to atrium) of the circuit. html) [7] Weirich W. Sloman J. doi:10. "Reconstruction of Hyman's second pacemaker" (http:/ / www. sjm.1899" (http:/ / www. Lillehei C (1957). Edwards R (1982). " A brief history of cardiac pacing (http:/ / www. overdrive pacing. An ICD has the ability to treat many types of heart rhythm disturbances by means of pacing. "The first pacemaker". Partial quote in "Electrical Stimulation of the Heart in Man . harvard.1982.1111/j. a form of reentrant tachycardia. Pacing and clinical electrophysiology : PACE 5 (2): 278–82.17-81.1468.1540-8159. com/ issue/ issue27/ aquilinao2/ AquilinaO. [6] Harvard Gazette: Paul Maurice Zoll (http:/ / news.1993[36] I Shock chamber O = None A = Atrium V = Ventricle II III IV Antitachycardia pacing chamber Tachycardia detection Antibradycardia pacing chamber O = None A = Atrium V = Ventricle E = Electrogram H = Hemodynamic O = None A = Atrium V = Ventricle D = Dual (A+V) D = Dual (A+V) D = Dual (A+V) Short form of the NASPE/BPEG Defibrillator (NBD) code[36] ICD-S ICD with shock capability only ICD-B ICD with bradycardia pacing as well as shock ICD-T ICD with tachycardia (and bradycardia) pacing as well as shock References [1] McWilliam JA (1899).1. Arne : St. [2] Lidwell M C. This is known as fast-pacing. Australasian Medical Congress.09542. [5] Furman S. blackwell-synergy. htm)". PMID 13529629. PMID 15869680. Br Med J 1 (1468): 348–50. 19/ 12-zoll. Szarka G. or anti-tachycardia pacing (ATP). Pacing Clin Electrophysiol 28 (5): 446–53. doi:10. Layvand D (2005). "Electrical stimulation of the heart in man".Artificial pacemaker 105 Complications A possible complication of dual-chamber artificial pacemakers is pacemaker-mediated tachycardia (PMT). and is never effective if the rhythm is ventricular fibrillation.1111/j. Surg Forum 8: 360–3. Some ICD devices can distinguish between ventricular fibrillation and ventricular tachycardia (VT). edu/ gazette/ 2001/ 04. cfm#elec). PMID 6176970.

"Efficacy of antibiotic prophylaxis prior to the implantation of pacemakers and cardioverter-defibrillators: Results of a large. [31] http:/ / www. nejm.1540-8159. Pacing Clin Electrophysiol 21 (1): 246–9. double-blinded.1:285. org/ News/ InResearch/ 2008/ November/ MP3PlayerStudy. 10 (2): 261–5. Circ Arrhythmia Electrophysiol 2 (1): 29–34. New York Times. . "An intracardiac bipolar electrode for interim treatment of complete heart block". wiley. PMID 1749727. Fletcher R. "Percussion pacing in a three-year-old girl with complete heart block during cardiac catheterization" (http:/ / bja. gov/ pubmed/ 1279591). PMID 11916002.1111/j. Epstein AE.1111/j. . Bleckmann A.2006. www. Will Morgan. Carson P. "How it happened: my recollection of early pacing". . [25] Wilkoff BL. Thomas S. doi:10. Pacemakers .PubMed Result" (http:/ / www.1001/jama. et al. [30] "MP3 Headphones Interfere With Implantable Defibrillators. Shane S. DeMets D. htm) Physicians can deactivate implanted defibrillators and pacemakers when terminally ill patients request it. (2009). PMID 19808441.1111/j. JAMA 288 (24): 3115–23. Erdmann E. [14] Lagergren H. 1992) . com/ journal/ 119941339/ abstract). Szekely A. bidmc.org. [24] Bristow M. Mark DB. doi:10. aspx). Am. Pacing Clin Electrophysiol 14 (11): 1742–4. 2010 [34] Halperin. PMID 12495391. 2010. Heart Rhythm Foundation [16] Eich C. com/ openurl?genre=article& sid=nlm:pubmed& issn=0147-8389& date=2006& volume=29& issue=5& spage=453). Lüderitz B.bidmc.1978. prospective. PACE. "Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure". et al. . org/ cgi/ content/ full/ 352/ 15/ 1539). Br J Anaesth 95 (4): 465–7. com/ 2010/ 06/ 20/ magazine/ 20pacemaker-t. Sutton R (2002).Beth Israel Deaconess Medical Center" (http:/ / www. PMID 16051649.x.1016/0002-9149(62)90305-3. (December 2002). DeVries D. Zucker I R. "The effect of cardiac resynchronization on morbidity and mortality in heart failure".1991. PMID 14484083. "Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure" (http:/ / content.nih. Benjamin Ransford.tb03451. June 14. htm) [28] Eucomed (http:/ / www.1111/j. Parsonnet V. PMID 9474681.ncbi.3115. et al. N Engl J Med 352 (15): 1539–49. Clin. doi:10. com/ ) [29] "Testing of work environments for electromagnetic interference (Pacing Clin Electrophysiol.1056/NEJMoa050496. org/ cgi/ content/ full/ 288/ 24/ 3115). J. Patient and Public Information Center : Heart Rhythm Society" (http:/ / www. [15] Jean Jaques Welti:Biography. doi:10. www. 352 (15): 1539–49. Schoenfeld M. Johansson L (1963). xs4all. "Clinical Observations with Long-term Atrial Pacing" (http:/ / www3. hrspatients. 1978 [11] "Preliminary Investigation of the Development of a Permanent Implantable Pacemaker Using an Intracardiac Dipolar Electrode". Clark. and multisite pacing. J. html) By KATY BUTLER. wiley.1093/bja/aei209. Kevin B. org/ icd-study/ icd-study. [20] Pitts Crick JC for the European Multicenter Study Group (1991). Engl. "An intracardiac pacemaker for Stokes-Adams seizures" (http:/ / www. Pacing Clin Electrophysiol 25 (2): 260–4.Artificial pacemaker [9] Furman S. (2005).795906.002 Implants of a Single Lead VDD Pacing System" (http:/ / www3.tb01097. J. doi:10. Daniel. oxfordjournals. et al. pdf) (PDF).1998. Med. doi:10. nl/ ~fbaart/ aktueel/ pm. De Marco T. Daubert JC. May 31. org/ presenter. . [19] Bohm A. Cardiol. Hayes D.x.1540-8159. 106 .x. interscience. amednews. [21] Cleland JG. "Intracardiac stimulation for complete heart block". PMID 83610. ncbi. [27] European Pacemaker Patient Identification card (http:/ / www. (2005). [26] de Oliveira JC. Daubert J. [13] Lagergren H (1978). Retrieved 2008-08-10. doi:10. com/ journal/ 119992153/ abstract).gov.1540-8159. Retrieved 2008-11-10. . ama-assn. . Benessa Defend. Krueger S. Retrieved 2008-11-10. Kevin Fu. doi:10.00399. North American Society of Pacing and Electrophysiology/British Pacing and Electrophysiology Group". [33] What Broke My Father’s Heart (http:/ / www. asp).1056/NEJMoa032423. . N. Erdmann E. Tavazzi L (2005). Gras D. [22] Bardy GH. Cook JR. jhtml?identifier=4676 [32] Heart devices can be turned off near end of life. "Pacemakers and Implantable Cardiac Defibrillators: Software Radio Attacks and Zero-Power Defenses" (http:/ / www. secure-medicine. Heydt-Benjamin. nejm.1056/NEJMoa043399. according to new guidelines from the Heart Rhythm Society. org/ patients/ treatments/ pacemakers. eucomed. . Zucker IR. [10] "Permanent Transvenous Pacing in 1962". doi:10. (http:/ / www. Boehmer J. . randomized. [17] "Pacemakers. Freemantle N. Pinter A. PMID 13928055. PMID 16689837. [23] Cleland J.108. Lee KL. "The revised NASPE/BPEG generic code for antibradycardia. White B. doi:10.1056/NEJMoa050496. . Med.x.24. 352 (3): 225–37. nytimes. Asa M M. ama-assn. Saxon L.tb02757. Pacing Clin Electrophysiol 1 (1): 140–3. Maxim Asa M (1962). O'Reilly.nlm. Res. "European Multicenter Prospective Follow-Up Study of 1. Kass D. N. N. org/ amednews/ 2010/ 05/ 31/ prsa0531. PMID 15753115. org/ cgi/ pmidlookup?view=short& pmid=15659722& promo=ONFLNS19). Engl. nlm. Reynolds D. Schwedel JB (1959). org/ cgi/ content/ full/ 95/ 4/ 465). "The effect of cardiac resynchronization on morbidity and mortality in heart failure" (http:/ / content. Tadayoshi Kohno.288. [18] Bernstein A. "Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator: the Dual Chamber and VVI Implantable Defibrillator (DAVID) Trial" (http:/ / jama. IEEE Symposium on Security and Privacy. placebo-controlled trial". Acta Chir Scand 125: 562–6.1161/CIRCEP. 1962 [12] Parsonnet V. blackwell-synergy. nih. Kappenberger L. J. adaptive-rate. doi:10. D'Orio Nishioka SA. Preda I (1998). DiCarlo L. and William H. PMID 15152059. N Engl J Med 350 (21): 2140–50. Daubert J. doi:10. 261 (5): 943–8. 10:391.1540-8159. Engl. PMID 15659722. Med. Parsonnet V. Martinelli M. Paul T (October 2005). interscience. americanheart. Feldman A (2004).. PMID 15753115. Maisel (May 2008).

medscape. and so precluding the use of a cochlear implant). In Europe.com/multimedia/Podcasts/displayPod.escardio. NASPE/BPEG defibrillator code". The processor for both the eight and 20 electrode implants used Nucleus 22 ABI (Cochlear Limited) external speech processors. Nathan A. PhD. where 25 people had received the ABI . Only about a thousand recipients have been implanted with an auditory brain stem implant.Artificial pacemaker [35] eMedicine > Pacemaker-Mediated Tachycardia (http:/ / emedicine. com/ article/ 159645-overview) Author: Brian Olshansky. Speech perception in non-NF2 patients on average has been reported to be higher than that of NF2 patients[3] . This original ABI consisted of two ball electrodes which were implanted near the surface of the cochlear nucleus. Parsonnet V. In the US in 1992 an eight electrode implant developed by Cochlear Limited. and in patients with NF2 as other auditory complications. ABIs have been used in children and adults. BCh. Camm A. Mead R. A change from a percutaneous connection to a wireless transcutaneous connection. Implant history The auditory brainstem was first implanted in humans in 1979 at the House Ear Institute. such as auditory nerve aplasia and cochlea ossification [2] . 107 External links • Implantable Cardioverter Defibrillator from National Heart. The auditory brain stem implant uses similar technology as the cochlear implant. 2008 [36] Bernstein A. Rickards A.aspx) Auditory brainstem implant An Auditory Brain Stem Implant (ABI) is a surgically implanted electronic device that provides a sense of sound to a person who is profoundly deaf. USA[4] [5] . gov/health/dci/Diseases/icd/icd_whatis. the House Ear Institute and Huntington Medical Research Institute [7] . MD. Noel G Boyle. .nih. Fisher J. Updated: Jun 17. "North American Society of Pacing and Electrophysiology policy statement. due to the nature of the surgery required to implant the device (as it requires brain surgery to implant the device) and the reduced effectiveness of the implant (most auditory brain stem implant recipients only have an awareness of sound recipients won't be able to hear musical melodies. An electrode array with 21 electrodes developed by Cochlear Limited was developed for the European market at the same time [8] . Smyth N. but instead of electrical stimulation being used to stimulate the cochlea. MD. due to sensorineural hearing impairment (due to illness or injury damaging the cochlea or auditory nerve.[1] In the United States ABIs are only approved for adults (18 & over) and only for patients with NF2. Coauthor(s): Chirag M Sandesara.2 cochlear implant (Advanced Bionics)[10] have also been developed. MB. Lung and Blood Institute (http://www. and from ball electrodes to flat [6] electrodes were the only changes to the implant until 1991. PMID 7692407. CA. Sutton R (1993). A 12 electrode array implant with a speech processor based on the C40+ cochlear implant (Med-El)[9] and a 16 electrode array implant with the Clarion-1.nhlbi. Since 1999 a 21 electrode array implant has been used with the Nucleus 24 ABI (Cochlear Limited) speech processor. Pacing Clin Electrophysiol 16 (9): 1776–80. MD.org/communities/EHRA/education/webinars/Pages/welcome.muschealth. it is instead used to stimulate the brain stem of the recipient.aspx?podid=293& autostart=false&groupid=6) • Current indications for CRT-P and CRT-D: Webinar from the European Heart Rhythm Association (EHRA) (http://www. only the beat).html) • Biventricular Pacemaker: What is Cardiac Resynchronization Therapy? Podcast from the Medical University of South Carolina (http://www. Fletcher R.

• Elvsåshagen T. 1998. 2002.sciencedirect.mcgill. doi:10. Am J Audiol [10] Lenarz et al. Solyga V. Otol Neurotol Further reading • Colletti V. Hearing by cochlear nucleus stimulation in humans. PMID 15564834. Open Set Speech Perception with Auditory Brainstem Implant? The Larongoscope. in/ newspapers?id=u1slAAAAIBAJ& sjid=raIFAAAAIBAJ& pg=4329. "Cochlear and Auditory Brainstem Implants in the Management of Acoustic Neuroma and Bilateral Acoustic Neurofibromatosis" (http://www. Auditory Brainstem Implant: Part 1.karger.cochlear. Heiberg A.co.medicine.pdf). Ann Otol Rhinol Laryngol [6] Brackmann et al.uk/products/670. Golfinos JG. "Auditory brainstem implantation in patients with neurofibromatosis type 2". European Arch Otol Rhinol Laryngol [9] Jackson et al. McGill Journal of Medicine (3): 115–120. MacDougall JC (Fall/Winter 1997). Miorelli V.1016/S0165-5876(01)00465-7. PMID 16891833. [4] Edgerton et al. Roland JT Jr (Dec 2004). Shapiro WH. Laryngoscope 114 (12): 2135–2146. Tidsskr Nor Laegeforen 129 (15): 1469–1473. co. 2004.at/english/30_Products/01_MAESTRO/Cochlear_Implants/ 08_Advanced_Electrode_Design. 2001. Ann Otol Rhinol [5] House and Hitselberger 2001. Adv Otorhinolaryngol. Kerty E (Aug 2009). 64: 1–10.pdf). "Neurofibromatosis type 2 and auditory brainstem implantation". ca/mjm/v03n02/v03p115/v03p115. Feb 25. Fiorino F.asp) Brief description of the Nucleus Auditory Brainstem Implant (the Nucleus ABI24M) • Picture & brief description (http://www. "History of Cochlear Implants and Auditory Brainstem Implants" (http://content. com/ProdukteDB/Katalogteile/isbn3_8055/_81/_57/Implants_02. Issues in surgical implantation. • Møller AR (2006).Otolarangol head neck surg [3] Colletti and Shannon 2005. 1993 [2] Colletti et al. PMID 11518586. 1991. Cohen NL.Auditory brainstem implant 108 References [1] (http:/ / news.medel. External links • Nucleus ABI24M (http://www. Sacchetto L. PMID 19690597. Carner M (Aug 2001). Twenty year report of the first auditory brain stem nucleus implant. An auditory Brainstem Implant System. google. Otol Head Neck Surg [8] Laszig et al.php) of the MedEl ABI electrode array . Bakke SJ. The Multichannel Auditory Brainstem Implant: Performance in Twenty Patients. Rappaport JM. Otol Head Neck Surg [7] Otto et al. 1982. • Davis NL. • Kanowitz SJ. Auditory brainstem implant: I. Int J Pediatr Otorhinolaryngol 60 (2): 99–111. "Hearing habilitation with auditory brainstem implantation in two children with cochlear nerve aplasia" (http://www.3959014& dq=auditory+ brainstem+ implant+ cochlear+ similar& hl=en) Reading Eagle. 1993. The Hanover Auditory Brainstem Implant: A Multiple-electrode prosthesis. ISSN 0165-5876. Performance and its Evolution Over Time. Auditory Brainstem Implant (ABI): New frontiers in adults and Children.com/science/ article/B6T7V-43RYV11-1/2/e51502b808ed71cdc585ef6fc97ac7b5).

Gene therapy: Biological pacemaker created by gene transfer. The first successful experiment with biological pacemakers was carried out by Arjang Ruhparwar's group at Hannover Medical School in Germany using transplanted fetal heart muscle cells. Tebbenjohanns J. Nuss HB. Eduardo Marban's group from Johns Hopkins University published the first successful gene-therapeutic approach towards the generation of pacemaking activity in otherwise non-pacemaking adult cardiomyocytes using a guinea pig model[2] . Eur J Cardiothor Surg. Orlando. Again. 419: 132-133 [3] Plotnikov AN. Research Despite the successes of artificial pacemakers several limitations and problems have emerged during the past decades such as electrode fracture or damage to insulation. 2002. Circulation. Biological safety Until this young field of research finds access to the clinic. Niehaus M et al. Nature 2002. Meanwhile other genes and cells have been discovered. Florida. 21: 853-857 [2] Miake J. first introduced at the scientific sessions of the American Heart Association in Anaheim in 2001 and published in 2002[1] . The need for an alternative is most obvious in children including premature newborn babies where size mismatch and the fact that pacemaker leads do not grow with children are a problem. Scientific Sessions of the American Heart Association 2007. Ruhparwar's group demonstrated that by injection of the "Adenylate Cyclase" gene into the heart muscle a biological cardiac pacemaker can be created)[4] . 109: 506-512 [4] Ruhparwar A. including heart muscle cells derived from embryonic stem cells. the durability and potential ability of transplanted cells or transfected genes to cause arrhythmia must be excluded in long-term studies with cardiac mapping experiments at various time points and with a large population of animals. 2004. Sosunov EA. . If these cells are damaged by disease. Qu J et al. By specific inhibition of Ik1 below a certain level. Transplanted fetal cardiomyocytes as cardiac pacemaker. mimicking overexpression of HCN2 genes in cardiac myocytes[3] . spontaneous activity of cardiomyocytes was observed with resemblance to the action potential pattern of genuine pacemaker cells. "HCN" genes which encode the wild type pacemaker current I(f). Klein G et al. A few months later. Michael Rosen's group demonstrated that transplantation of HCN2-transfected human mesenchymal stem cells (hMSCs) leads to expression of functional HCN2 channels in vitro and in vivo. Adenylate-Cyclase VI Transforms Ventricular Cardiomyocytes Into Biological Pacemaker Cells. The investigators postulated latent pacemaker capability in normal heart muscle cells. re-operations for battery exchange and venous thrombosis. the implantation of an artificial pacemaker becomes necessary. References [1] Ruhparwar A. This potential ability is suppressed by the inward-rectifier potassium current Ik1 encoded by the gene Kir2 which is not expressed in pacemaker cells. Kallenbach K. Biological pacemaker implanted in canine left bundle branch provides ventricular escape rhythms that have physiologically acceptable rates. Marban E. infection.Biological pacemaker 109 Biological pacemaker The heart is endowed with specialized excitatory and conducting cells that are responsible for the generation and conduction of rhythmic impulses and contractions throughout the heart.

People with depression have abnormally high levels of activity in CG25.[3] Instead. [2] McIntyre CC. Rezai AR. is speculated to play a role in depression. Electrical stimulation has been shown to eliminate chronic depression in some patients. sensory. PMID 12739751. ventralis intermedius nucleus of the thalamus (Vim) or the subthalamic nucleus and electric pulses are used to block the abnormal activity. PMID 16810722.20959.Y: Marcel Dekker. Parkinson's disease The deep brain stimulation used in pacemakers to treat Parkinson's disease can help reduce symptoms such as tremors. surgical ablation of the globus pallidus) or thalamotomy (i. After the pacemaker is surgically implanted into the brain. Clinical depression Pacemakers are also being used to treat depression. a neurological movement disorder. 133–51. Pacemakers may also be implanted outside the brain. Brain stimulation may be used both in treatment and prevention. Mov. a thin electrode with four contacts is implanted in the globus pallidus. In Markov. References [1] Mogilner A. The pacemaker is a medical device that is implanted into the brain to send electrical signals into the tissue. This causes an indirect regulation of the neuronal output by activating axon terminals with synaptic connections to neurons near the stimulating electrode. The procedure also treats essential tremor. and around cranial nerves such as the vagus nerve (vagus nerve stimulation). CG25. [3] Machado A. Bioelectromagnetic medicine.e. The lead from the implant is extended to the pacemaker under the skin in the chest area. N. Sharan AD.1002/mds. Gross RE.. or cortical stimulation. Paul J. Epilepsy Epilepsy refers to a wide variety of neurological disorders characterized by sudden recurring attacks of motor. or psychic malfunction with or without loss of consciousness or convulsive seizures. ISBN 0-8247-4700-3. Current Clinical Indications. electrical impulses are sent to the stimulator and into the brain. and neural modeling". Electrical currents block the neuronal output at or near the electrode site. Parkinson's disease. Marko. a brain region involved in somatovisceral control. Kopell BH. (2) Synaptic inhibition. Thakor NV (2002).. . (3) De-synchronization of abnormal oscillatory activity of neurons.. neural recording. surgical ablation of the thalamus).R.2095910. doi:10. "Deep brain stimulation for Parkinson's disease: surgical technique and perioperative management". Rezai A. the treatment is called deep brain stimulation. Depending on the area of the brain that is targeted. "Uncovering the mechanisms of deep brain stimulation for Parkinson's disease through functional imaging. and Future Prospects". pp. Disord. Crit Rev Biomed Eng 30 (4-6): 249–81.e. 21 (Suppl 14): S247–58..1002/mds. on or near the spinal cord (spinal cord stimulation).L. "Chronic Therapeutic Brain Stimulation: History. The procedure is generally only used for patients whose symptoms cannot be controlled with medication.Y. and walking problems. stiffness.Brain pacemaker 110 Brain pacemaker "Brain pacemakers" are used to treat people who suffer from epilepsy. Benabid A. The implantation of pacemakers in the brain may control or eliminate epileptic seizures with programmed or responsive stimulation. Benabid AL (June 2006). rigidity.[1] There exist three hypotheses to explain the mechanisms of DBS[2] : (1) Depolarization blockade. and on or near peripheral nerves. Some patients report an immediate improvement in mood and in their sleeping habits after implantation. Rosch. major depression and other diseases. The exact mechanism of action of DBS is not known. New York. slowed movement. Deep brain stimulation represents an advance on previous treatments which involved pallidotomy (i. (2004).

com/ content/ l2v5v78897555416/ ) [2] (http:/ / alignmap. GBE (born circa 1926). He is also a pioneer in visual prosthetics. an alpha blocker. Rosch. Jankovic J (May 2006). (2004). org/ cgi/ content/ abstract/ 196/ 2/ 479) [5] (http:/ / www. html) [6] (http:/ / at. ISBN 0-8247-4700-3. Marko. Shahed J. idrs.Y: Marcel Dekker. wiley. in his hotel room before the presentation. including Variations on a Theme by Schoenberg. 21 (5): 692–5. a triennial Royal Society prize lectureship. 1111/ j. He held the 1986 Ferrier Lecture. org/ publications/ TWBassoonist/ TWB.[1] but is perhaps best known for an unusual scientific presentation at the 1983 Las Vegas meeting of the American Urological Association. In Markov. htm) .O. Disord. uk/ consorts/ 7oaks. but given the technology of the day further development was impractical.[4] The device was tested on four blind patients.20767. Paul J. 05797.[2] [3] He had injected himself with phenoxybenzamine. He made important contributions to the treatment of erectile dysfunction. "Globus pallidus deep brain stimulation in dystonia". It was easier to play than a normal bassoon. Mov.M.[6] Notes [1] (http:/ / www. 2005. 265–76. V1. Lozano A.[5] an electronically controlled version of the bassoon. springerlink. 1464-410X. • Richter E. doi:10.1002/mds. musicologist and composer. PMID 16342255. Bioelectromagnetic medicine. His knighthood was given for his research in bioengineering. the logical bassoon. "Deep Brain Stimulation for Parkinson's Disease in Movement Disorders". com/ 2006/ 11/ 06/ presentation-is-not-really-everything-the-giles-brindley-show/ ) [3] BJUI Volume 96. November 2005: How (not) to communicate new scientific information: a memoir of the famous Brindley lecture by Laurence Klotz (http:/ / onlinelibrary. N. Issue 7. pages 956–957. Brindley invented a musical instrument in the 1960s. pp. He was doctoral advisor to David Marr (neuroscientist) who later developed computational theories of vision that had great impact in the neuroscience of vision and computer vision. He spent most of his career at the University of London and London Hospital. giving them some basic visual sensation. where he removed his trousers to show the audience his chemically-induced erection and invited them to inspect it closely. x/ full) [4] (http:/ / jp. developing one of the first visual prosthesis in the 1960s. com/ doi/ 10.. is a British physiologist. authoring more than 100 scientific papers in a variety of subjects. Dat-Vuong K. 111 Giles Brindley Sir Giles Skey Brindley. New York.Brain pacemaker • Diamond A. physoc. co. He has also composed music for wind instruments. Azher S. but was never marketed. orpheusweb. 2/ toward-future.

Education Jorge Cham received his Bachelor's degree from Georgia Tech in 1997. Cham began an invited speaking tour of over 80 major universities delivering his talk titled "The Power of Procrastination". where he started drawing PhD Comics as a graduate student at Stanford University.[5] Heathrow detention incident According to the PHD Comics webpage. Born Jorge Cham May 1976 Webcomics Area(s) Notable works Piled Higher and Deeper Jorge Cham (born in May 1976) is a Panamanian cartoonist and roboticist best known for his popular newspaper and web comic strip Piled Higher and Deeper (PhD Comics).[4] Jorge Cham at EPFL. the authorities were convinced to allow him to enter the country and give his lectures as planned. In this lecture. Finally he was released but was bound to be deported the next day. 2007. He also explores the guilt and the myths associated with procrastination and argues that in many cases it is actually a good thing. thanks to the many letters of support from his colleagues.[1] He was featured on NPR on December 20th. However. 2008 PhD Comics In 2005. He has since been syndicated in several university newspapers and in four published book collections. 2010.[6] . Cham lives in the United States.[3] He subsequently worked at Caltech as an instructor and as a researcher on neural prosthetics. Cham talks about his experiences creating the comic strip and examines the sources of grad students' anxieties.Jorge Cham 112 Jorge Cham Jorge Cham Jorge Cham at UIUC.[2] and earned a PhD in mechanical engineering from Stanford. Cham was detained at the Heathrow airport for several hours on the 26th of October 2009.

Retrieved 2010-01-20. (see also the forum thread (http:/ / www. victims of paralysis due to peripheral nerve injury could achieve a full recovery by directly recording the output of their motor cortex. This document will review the current state of research into electrode failure. htm). php?t=5845& view=next& sid=86ecd692168c0ce6c47c61b4b8dfc09a)) [8] "Using Humor to Survive Graduate School" (http:/ / www. but the technology is immature and arosarenalebedev There are numerous examples in the literature unreliable. com/ comics. htm). Georgia Tech Alumni Association. . html). a few months at kipkemarzullonicolelisrouschesanthanamschwartzvetterwilliams best. . stating that he had "successfully cloned half of his DNA". Retrieved 2006-08-13. php?comicid=1243). . com/ speaking. Clinical applications and direction Clinical applications for brain computer interfaces (BCI) The potential for neural interfacing technology to restore lost sensory or motor function is staggering." (http:/ / www. likely announcing that he had become a father and therefore having a good excuse to procrastinate on updating his PHD Comics webpage. Retrieved 2009-11-02. htm). 2010 post in the PHD Comics webpage. External links • Piled Higher and Deeper (http://www. phdcomics. com/ about. focusing on recording electrodes as opposed to stimulating electrodes. phdcomics. [7] "Recent News" (http:/ / www. Example of chronic electrode implant of intra-cortical electrode recording used to a variety of ends that fail after a few weeks. .Detention incident.[7] During the 2010 SACNAS National Conference Cham identified Nissin as his favorite instant noodle brand and MSG as his favorite flavor. . [3] "About PhD Comics" (http:/ / www. Retrieved 2007-02-26. . Jorge Cham sent a cryptic message to all of his fans.com/) • Cham's personal site at Stanford (http://www-cdr. phdcomics.phdcomics.stanford. sacnas. com/ comics/ archive. html). [2] "Pacesetters: Piled High" (http:/ / gtalumni. [5] "Jorge Cham's Speaking Tour" (http:/ / www.Jorge Cham 113 Personal life In a January 8. php). [6] "PHD comics . . Retrieved 2007-02-27. org/ Publications/ magazine/ win06/ pacesetters. stanford. com/ proceedings/ viewtopic. phdcomics. [4] "Jorge Cham's Research" (http:/ / www-cdr. edu/ ~jgcham/ research. phdcomics. org/ confNew/ confClient/ current/ agenda/ #1214).edu/~jgcham/) Chronic electrode implants Chronic Electrode Implants are electronic devices implanted into the brain. . phdcomics. . Retrieved 2010-10-01. com/ book. They may record electrical impulses in the brain or they may stimulate neurons with electrical impulses from an external source. Retrieved 2007-07-08. Retrieved 2006-08-13.[8] Notes [1] "The "Piled Higher and Deeper" Book Collections" (http:/ / www.

mechanical tissue compression. Recording electrodes. Short term effects of electrode insertion on surrounding tissue have been documented extensively. • 4) Advances in prosthetic technology to create artificial limbs capable of reproducing the full range of motion. In addition to the variety of materials used.biran The overall observed tissue response is caused by a combination of the traumatic injury of electrode insertion and the persistent presence of a foreign body in the neural tissue. and cannot easily be made more sensitive. polyimide.lebedevnicolelis This review will focus on techniques pursued in the literature that are relevant to achieving the goal of consistent. • 2) Efficient computational processing of recorded data. Lebedev & Nicolelis discuss in their 2006 review the specific needs for research in the field to truly improve the technology to the level of clinical implementation. but stimulating interfaces can overcome this problem by increasing signal strength. In principle these systems are susceptible to the same tissue Schematic of the "Utah" chronic electrode array response that causes failure in implanted electrodes. research into minimizing this is focused on the geometry of the electrode and the proper technique for insertion. simple uniform microwires. as well as cheungmoffitvinceweilandwestbymoxon1moxon2 others. Implantable electrode research also employs many different techniques for surgically implanting the electrodes. stimulating and recording. and collection of debris resulting from cell death.” (see 2.Chronic electrode implants 114 Direction for development of Chronic BCI Chronic brain-computer interfaces come in two varieties. severed neuronal processes and blood vessels. Common materials for electrode or probe construction include silicon. Interaction between electrode and tissue As mentioned above. however. Defining and minimizing acute term effects of electrode insertion Damage caused by electrodes in the short term is caused by the insertion into the tissue. Consequently. including planar shanks.bjornsson They include cell death (both neuronal and glial). an important step is documenting the response of living tissue to electrode implantation in both the acute and chronic timelines. if there is to be significant progress towards long-term implantable electrodes. It is ultimately this tissue response that causes electrodes to fail by encapsulating the electrode itself in a protective layer called a “glial scar.2). Current implantable microelectrodes are unable to record single. long-term recordings. ceramic. • 3) Incorporation of feedback into the user’s body image using native plasticity.or multi-unit activity reliably on a chronic scale. the most critical differences are whether or not the implant is anchored across the skullkim and the speed of insertion. the 4 requirements outlined in their review are: • 1) Consistent long term (over the course of years) recording of large neuronal populations residing in multiple brain areas. electrodes are constructed hoogerwerf in many different shapes. Applications for stimulating interfaces include sensory prosthetics (cochlear implants. . iridium. gold. platinum. One serious impediment to understanding the tissue response is the lack of true standardization of implantation technique or of electrode materials. are the most successful variety of sensory prosthetics) and deep brain stimulation therapies. for example. Research towards this end can be divided into two primary categories: characterizing the specific causes of recording failure. while recording interfaces can be used for research applicationsberger and to record the activity of speech or motor centers directly from the brain. and techniques for preventing or delaying electrode failure. In short. and probes that taper to a thin tip from a wider base. must rely on whatever signals are present where they are implanted.

or creates an inhibitory environment for neurite extension. gliosis. insulates the electrode from nearby neurons. and each is also ‘activated’ by injury related mechanisms that result in changes in morphology. thereby hindering diffusion and increasing impedance. and was observed in a densely packed region within approximately 50 um of the electrode surface. The fluorescent dextran filled the blood vessels.Chronic electrode implants In the Bjornsson et al. the tethering forces aggravate the injury caused by the electrode’s insertion and sustain the tissue response. extends the distance between the electrode and its nearest target neurons.weldon Activated astrocytes form the major component of the encapsulating tissue that forms around implanted electrodes. 90o for medium. To facilitate direct visualization of vascular deformation. as in the case of implanted electrodes whose material composition is resistant to such enzymatic dissolution. being more prevalent at medium and slow insertion speeds. but did not correlate with tip geometry. Fluorescent microbeads lodged throughout the tissue. Analysis of the images prompted the division of tissue damage into 4 categories: • • • • 1) fluid displacement. a control population was treated with the same surgical procedures. Severing and dragging were consistently present along the insertion track. i. thus repelling regenerating neural processes polikovgriffith Either activated astrocytes or buildup of cellular debris from cell death away from recording sites”. . this ‘frustrated phagocytosis’ contributes to the failure of recordings. 0.5 mm/s. 115 Fluid displacement by device insertion frequently resulted in ruptured vessels. releasing necrotic substances into the immediate vicinity and contributing to cell death around the electrode. It has been proposed that when the foreign body cannot be degraded. Tissue response to chronic-term electrode implantation When implanted in neural tissue in the long term.e. around the electrode would act to insulate the recording sites from other. Electrodes were constructed from silicon wafers to have three different sharpnesses (interior angle of 5o for sharp. expression profile. 2 mm/s. microelectrodes stimulate a sort of foreign body response. providing discrete coordinates that aided in computerized calculations of strain and deformation. Qualitative assessments of vascular damage were made by taking real-time images of electrodes being inserted into 500 um thick coronal brain slices. Each cell-type performs many functions in supporting healthy. as electrodes must be within 100 um to get a signal. primarily effected by astrocytes and microglia. Rather. Another recent study addresses the problem of the tissue response. Samples were stained for ED1 and GFAP presence. tissue was labeled with fluorescent dextran and microbeads before viewing. uninjured neural tissue. “Current theories hold that glial encapsulation. allowing initial geometry to be visualized along with any distortions or breakages. active neurons. 3) vessel severing.biran Michigan-type electrodes (see article for detailed dimensions) were surgically inserted into the brains of Adult male Fischer 344 rats. and 4) vessel dragging. Insertion speed was also presented at three speeds. ED1+ reading is indicative of the presence of macrophages. 2006 study.kim One function taken on by microglia when activated is to cluster around foreign bodies and degrade them enzymatically. and function. these features were correlated with insertion speed. but the electrode was implanted and immediately removed so that a comparison could be made between tissue response to acute injury and chronic presence. Faster insertion of sharp probes was the only condition resulting in no reported vascular damage.125 mm/s. and 0. 2) vessel rupture. 150o for blunt). an ex vivo apparatus was constructed explicitly to study the deformation of and damage to neural tissue during electrode insertion. Tissue response has also been shown to be greater in situation where the electrodes are anchored through the subject’s skull.gray Even very small increases in the separation between the electrode and local nerve population can insulate the electrode completely. Animal subjects were sacrificed at 2 and 4 weeks after implantation to quantify the tissue response with histological and immunostaining techniques.

Studies have demonstrated that surfaces functionalized with sequences taken from adhesive peptides will decrease cellular motility and support higher neuronal olbrichstauffer It has also been shown that peptides can be selected to specifically support neuronal growth populations.ludwig Protein functionalization Another body of research dedicated to improving the biocompatibility of electrodes focuses on functionalizing the electrode surface with relevant protein sequences. As a result.Chronic electrode implants ED1+ cells were present at both 2 and 4 weeks after implantation. Thus far. 116 Developing methods to alleviate chronic effects Techniques for combating long-term failure of electrodes are understandably focused on disarming the foreign body response. Descriptions of the research are limited to a brief summary of the theory and technique. and not the acute injury. Biological coating Research focusing on bioactive coatings to alleviate the tissue response is conducted primarily on silicon-based electrodes. Improving biocompatibility of recording electrodes This section loosely categorizes different approaches to improving biocompatibility seen in the literature. or glial growth. This can most obviously be achieved by improving the biocompatibility of the electrode itself. which are presented in detail in the original publications.zhong • coating electrodes with alternating layers of polyethylimine (PEI) and laminin (LN). It is difficult to effectively evaluate progress towards improved electrode biocompatibility because of the variety of research in this field. of implanted microelectrodes is primarily a result of chronic implantation.he1he2 • coating electrodes with a conductive polymer film to improve electrical characteristics. with the objective of the outer LN layer decreasing the tissue response by helping to disguise the electrode as native material. Presence of GFAP indicates presence of reactive astrocytes. however signals were significantly lower in intensity than those found in chronic test subjects. with no significant difference between the time points. Stab controls showed signs of inflammation and reactive gliosis as well. electrode failure should be minimized. .kamlusaneinejad If populations of neurons can be induced to grow onto inserted electrodes. and eventual isolation. and that peptides can be deposited in patterns to guide cellular outgrowth. thus reducing the tissue’s perception of the electrode as a foreign substance. much of the research towards alleviating the tissue response is focused on improved biocompatibility. not the results. Techniques include the following: • storing anti-inflammatory neuropeptide α-MSH under a layer of nitrocellulose or within a nitrocellulose matrix to be released gradually into the local tissue post-implantation. overcoming the encapsulation barrier by increasing electrode sensitivity. and was seen at 2 and 4 weeks after implantation. extending more than 500 um from the electrode surface. and diminished noticeably from 2 weeks to 4 weeks. no technique has achieved results drastic and sweeping enough to change the fact of the encapsulation response. This is strong evidence that glial scarring and the encapsulation.

Chronic electrode implants Electrode design Kennedy’s research details the use of a glass cone electrode which contains a microwire built inside of it.kennedy The microwire is used for recording, and the cone is filled with neurotrophic substances or neural tissue in order to promote growth of local neurons into the electrode to allow for recording. This approach overcomes tissue response by encouraging neurons to grow closer to recording surface.

117

Microfluid delivery
Some notable success has also been made in developing microfluid delivery mechanisms that could ostensibly deliver targeted pharmacological agents to electrode implantation sites to alleviate the tissue response.rathnasingham

Research tools being developed
Just as in other fields, some effort is devoted explicitly to the development of standardized research tools. The goal of these tools is to provide a powerful, objective way of analyzing the failure of chronic neural electrodes in order to improve the reliability of the technology. One such effort describes the development of an in vitro model to study the tissue response phenomenon. Midbrains are surgically removed from day 14 Fischer 344 rats and grown in culture to create a confluent layer of neurons, microglia, and astrocytes. This confluent layer can be used to study the foreign body response by scrape-injury or depositing electrode microwires on the monolayer, fixing the culture at defined time points after insertion/injury and studying tissue response with histological methods.polikov2 Another research tool is a numerical model of the mechanical electrode-tissue interface. The goal of this model is not to detail the electrical or chemical characteristics of the interface, but the mechanical ones created by electrode-tissue adhesion, tethering forces, and strain mismatch. This model can be used to predict forces generated at the interface by electrodes of different material stiffnesses or geometries.subbaroyan For studies requiring a massive quantity of identical electrodes, a bench-top technique has been demonstrated in the literature to use a silicon shape as a master to produce multiple copies out of polymeric materials via a PDMS intermediate. This is exceptionally useful for material studies or for labs who need a high volume of electrodes but can’t afford to buy them all.russo

References
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Chronic electrode implants 9. Vetter, R.J., Chronic Neural Recording Using Silicon-Substrate Microelectrode Arrays Implanted in Cerebral Cortex. IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, 2004. 51(6): p. 9. 10. Williams, J.C., Long-term neural recording characteristics of wire microelectrode arrays implanted in cerebral cortex. Brain Research Protocols, 1999. 4: p. 11. 11. Berger, T.W., G. Chauvet, and R.J. Sclabassi, A Biologically-Based Model of Functional Properties of the Hippocampus. Neural Networks, 1994. 7(6-7): p. 1031-1064. 12. Cheung, K.C., et al., Flexible polyimide microelectrode array for in vivo recordings and current source density analysis. Biosensors & Bioelectronics, 2007. 22(8): p. 1783-1790. 13. Moffitt, M.A. and C.C. McIntyre, Model-based analysis of cortical recording with silicon microelectrodes. Clinical Neurophysiology, 2005. 116(9): p. 2240-2250. 14. Vince, V., et al., Biocompatibility of platinum-metallized silicone rubber: in vivo and in vitro evaluation. Journal of Biomaterials Science-Polymer Edition, 2004. 15(2): p. 173-188. 15. Weiland, J.D. and D.J. Anderson, Chronic neural stimulation with thin-film, iridium oxide electrodes. Ieee Transactions on Biomedical Engineering, 2000. 47(7): p. 911-918. 16. Westby, G.W.M. and H.Y. Wang, A floating microwire technique for multichannel chronic neural recording and stimulation in the awake freely moving rat. Journal of Neuroscience Methods, 1997. 76(2): p. 123-133. 17. Moxon, K.A., et al., Nanostructured surface modification of ceramic-based microelectrodes to enhance biocompatibility for a direct brain-machine interface. Ieee Transactions on Biomedical Engineering, 2004. 51(6): p. 881-889. 18. Moxon, K.A., et al., Ceramic-based multisite electrode arrays for chronic single-neuron recording. Ieee Transactions on Biomedical Engineering, 2004. 51(4): p. 647-656. 19. Hoogerwerf, A.C., A Three-Dimensional Microelectrode Array for Chronic Neural Recording. IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, 1994. 41(12): p. 11. 20. Kim, Y.-T., Chronic response of adult rat brain tissue to implants anchored to the skull. Biomaterials, 2004. 25: p. 9. 21. Biran, R., Neuronal cell loss accompanies the brain tissue response to chronically implanted silicon microelectrode arrays. Experimental Neurology, 2005. 195: p. 12. 22. Bjornsson, C.S., Effects of insertion conditions on tissue strain and vascular damage during neuroprosthetic device insertion. Journal of Neural Engineering, 2006. 3: p. 12. 23. Weldon, D.T., et al., Fibrillar beta-amyloid induces microglial phagocytosis, expression of inducible nitric oxide synthase, and loss of a select population of neurons in the rat CNS in vivo. Journal of Neuroscience, 1998. 18(6): p. 2161-2173. 24. Polikov, V.S., Response of brain tissue to chronically implanted neural electrodes. Journal of Neuroscience Methods, 2005. 148: p. 18. 25. Griffith, R.W. and D.R. Humphrey, Long-term gliosis around chronically implanted platinum electrodes in the Rhesus macaque motor cortex. Neuroscience Letters, 2006. 406(1-2): p. 81-86. 26. Gray, C.M., Tetrodes markedly improve the reliability and yield of multiple single-unit isolation from multi-unit recordings in cat striate cortex. Journal of Neuroscience Methods, 1995. 63: p. 12. 27. Zhong, Y. and R.V. Bellamkonda, Controlled release of anti-inflammatory agent a-MSH from neural implants. Journal of Controlled Release, 2006. 106: p. 10. 28. He, W., Nanoscale laminin coating modulates cortical scarring response around implanted silicon microelectrode arrays. Journal of Neural Engineering, 2006. 3: p. 11. 29. He, W. and R.V. Bellamkonda, Nanoscale neuro-integrative coatings for neural implants. Biomaterials, 2005. 26(16): p. 2983-2990. 30. Ludwig, K.A., Chronic neural recordings using silicon microelectrode arrays electrochemically deposited with a poly(3,4-ethylenedioxythiophene) (PEDOT) film. Journal of Neural Engineering, 2006: p. 12.

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Chronic electrode implants 31. Olbrich, K.C., et al., Surfaces modified with covalently-immobilized adhesive peptides affect fibroblast population motility. Biomaterials, 1996. 17(8): p. 759-764. 32. Stauffer, W.R. and X. Cui, Polypyrrole doped with 2 peptide sequences from laminin. Biomaterials, 2006. 27: p. 9. 33. Kam, L., et al., Selective adhesion of astrocytes to surfaces modified with immobilized peptides. Biomaterials, 2002. 23(2): p. 511-515. 34. Lu, S., Receptor-Ligand-Based Specific Cell Adhesion on Solid Surfaces: Hippocampal Neuronal Cells on Bilinker Functionalized Glass. Nano Letters, 2006. 6(9): p. 5. 35. Saneinejad, S. and M.S. Shoichet, Patterned glass surfaces direct cell adhesion and process outgrowth of primary neurons of the central nervous system. Journal of Biomedical Materials Research, 1998. 42(1): p. 13-19. 36. Kennedy, P.R., S.S. Mirra, and R.A.E. Bakay, The Cone Electrode - Ultrastructural studies following long-term recording in rat and monkey cortex. Neuroscience Letters, 1992. 142(1): p. 89-94. 37. Rathnasingham, R., Characterization of Implantable Microfabricated Fluid Delivery Devices. IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, 2004. 51(1): p. 8. 38. Polikov, V.S., In Vitro model of glial scarring around neuroelectrodes chronically implanted in the CNS. Biomaterials, 2006. 27: p. 9. 39. Subbaroyan, J., A finite-element model of the mechanical effects of implantable microelectrodes in the cerebral cortex. Journal of Neural Engineering, 2005. 2: p. 11. 40. Russo, A.P., Microfabricated Plastic Devices from Silicon using Soft Intermediates. Biomedical Microdevices, 2002. 4(4): p. 7.

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Cochlear implant
A cochlear implant (CI) is a surgically implanted electronic device that provides a sense of sound to a person who is profoundly deaf or severely hard of hearing. The cochlear implant is often referred to as a bionic ear. As of April 2009, approximately 188,000 people worldwide had received cochlear implants;[1] in the United States, about 40,000 adults and over 30,000 children are recipients.[2] The vast majority are in developed countries due to the high cost of the device, surgery and post-implantation therapy. A small but growing segment of recipients have bilateral implants [3] (one implant in each cochlea). Cochlear implants can restore hearing in patients suffering deafness due to loss of sensory hair cells in their cochlea. In those patients, they can often restore Cochlear implant sufficient hearing to allow unaided understanding of speech in a quiet background, but the restored, electrical hearing is much less rich than natural hearing, and offers only very limited appreciation of musical melody, or speech understanding in noisy environments. A sound example of what speech would sound like through a cochlear implant can be found here [4], and here is an example of what music would sound like. [5]

Inc. not at UC San Francisco. In 1964. was ultimately implanted in some thousand or so recipients and paved the way for future clinical development of multichannel CIs. importantly. Initially he teamed with Mel Bartz. Eyriès refused to implant a third device. Orthodox auditory theory was in confusion at the time. and it was not thought possible for direct electrical stimulation of neural tissue to convey meaningful sound to the brain. it demonstrated that by stimulating in different areas of the cochlea different pitch percepts could be produced. In one case a five-wire electrode was used but the same signal was applied to all contacts. audiologists. MD. Michelson's implantation of humans before animal physiology experiments caused consternation among physiologists. until electrical (sound-amplifying) hearing aids began to be developed in earnest in the 20th century.Cochlear implant 120 History The discovery that electrical stimulation in the auditory system can create a perception of sound occurred around 1790. This device failed after a short time and another device was implanted. An otolaryngology resident. The first direct stimulation of an acoustic nerve with an electrode was performed in the 1950s by the French-Algerian surgeons André Djourno and Charles Eyriès. Francis Sooy. his veracity and professional ethics were questioned. and the matter became a concern to the ENT department. House’s work continued in the 1970s in collaboration with engineer Jack Urban. . the speech was modulated onto a carrier of 16 kHz. and told the older surgeon of his dream since college of a multi-channel electrode resembling a hairbrush. as were the original implants. reported preliminary results of cochlear implantation in three deaf adults implanted with gold wire electrodes. He ran to the Coleman Laboratory. Michelson's report to the American Academy of Otolaryngology and Ophthalmology created a tempest. They placed wires on nerves exposed during an operation. manufactured by 3M. it did not require a break in the skin after implantation. In 1961 Dr William House (an otologist). Their implant was also a single-channel device but. Unprocessed sounds were transmitted via a pair of solenoid-like coils. Roger Maspétiol. a foundation funded by the wealthy ENT department chairman at UCSF. experiencing a jolt and hearing a noise "like a thick boiling soup". The first attempt to develop a clinical CI was in 1957 by Djourno and Eyriès. M. Djourno found another surgeon.[6] The House/3M unit was the first approved by the FDA (Food and Drug Administration of the USA) for implantation in adults in 1984. John Doyle (a neurosurgeon) and James Doyle (an electrical engineer) commenced work on a single-channel device in Los Angeles. The device. Michelson said so many stimulus points were not necessary and that his patients were hearing "in stereo" with a two-channel electrode he had designed.[7] In 1970. Robin Michelson. who implanted a second patient in 1958. Blair Simmons at Stanford University implanted some recipients with a six-channel device. He urged Djourno to collaborate with an industry partner to build a more reliable device. in this case. C.D. Other experiments occurred sporadically. The reimplantation procedures were carried out in Redwood City Community Hospital. it helped with lipreading by providing the rhythm of the speech. and many otologists. Although these recipients were unable to understand speech with the device alone. Robert Pettit. This device used a percutaneous plug to enable the electrodes to be individually stimulated. Recipients could still not understand speech through the device but. an electrical engineer working with Storz. After this second device failed. and reported that the patient heard sounds like "a roulette wheel" and "a cricket" when a current was applied. Michelson conducted some work in San Francisco. in the Coleman Laboratory at the University of California. A recipient was implanted with a single channel device. where Michelson spent one half-day per week away from his Redwood City private ENT practice. when Alessandro Volta (the developer of the electric battery) placed metal rods in his own ears and connected them to a 50-volt circuit. heard Michelson describe the results of his cochlear implantations at a department educational meeting. Michelson and Pettit teamed to build the bipolar electrodes embedded in silastic which replaced the broken gold electrodes in Michelson's three patients. The link was therefore transcutaneous. Djourno refused because he believed that academia should not be tainted by commerce.

Merzenich had constructed an advanced electronic bank of signal generating and monitoring equipment for use for in his mapping experiments and a carefully shielded soundproof booth for testing. a young PhD. recruited Michael Merzenich. but differ greatly in the details of each final design. finding both auditory stimuli similar. Harrell also advised exposure to another person capable of understanding the concept. in 1972. in July. 1977. Henry Ford’s Model “T” automobile of the early 1900s. on December 13. One was congenitally deaf and had never heard sound. 1982. An equal number of proclamations and claims of being "firsts" in cochlear implantation were also made. Soon.[8] [9] Cochlear Implants that operate successfully. incorporate the same basic design. Patent Counsel to NASA's John F. to carry out his research interests in neurophysiology. and thus 121 . Merzenich became convinced that the electrical signal from the cochlear implant was entering the brain and was "phase-locked. That is why implants from all (three) major manufacturers work equally well in functionality. many important advances in cochlear implantation were accomplished during the 1960s and 70s. Jr and was first exposed to the public when it was revealed to James O. and electrical input from a cochlear implant in the other ear. The successful cochlear implant must also be capable of converting the pattern of the detected intelligence into an appropriate electronic format for application to the acoustic (eighth cranial) nerve. in 1971. Subsequent Patent Office search and patent application for letters patent was completed in May. Jr. including those produced by all three major manufacturers (Cochlear Americas. Reissue 31031. the UCSF department chairman. Michelson could not bring his brainchild to the university setting yet. 1977.) prior to the mid-1970s. He agreed to monitor electrical activity in inferior colliculus cells of cats stimulated by normal sound in one ear. when tested on the operating room table. Jr. Pettit was incensed when he witnessed Michelson's humiliation at the meeting. He had assisted in the reimplantation surgeries and witnessed the fact that the patients. and new pitch and loudness-scaling tests were devised. was issued on September. Esquire. 1974. where the information is interpreted as meaningful intelligence. When the film was shown to a meeting of otologists later in 1972 it convinced the scientific community that meaningful sound could be conveyed to the brain by electrical stimulation of the auditory nerve.Cochlear implant When Michelson reported initial results of the reimplantation. New tests were devised for implanted patients. Indeed. which in turn further transmits the encoded pattern to the hearing center of the brain. Over the months of animal testing. Design of this basic conversion process was first described by Adam Kissiah. He decided to document on film the results of testing on the reimplanted patients to prove to the scientific community that electrical stimulation could result in meaningful sound perception. could hear something meaningful. and provided some aid to lip reading. and to investigate the potential of cochlear implantation. Likewise." Understanding what humans heard with the cochlear implant was another matter. another hue and outcry arose: He was accused of lying about results and of unethical human experimentation. Some cochlear implant designs and intra-cochlear implantations were made by others (see Cochlear Technology by Adam M. Kissiah. and the Cadillac of the modern era have the same basic design. The camera caught the patient humming the melody and tapping a pencil to the tempo of the tune. Patent 4063048 was issued to Adam M. Kennedy Space Center. Pettit employed a music professor to synthesize simple tunes and sounds in various sound envelopes. a version of "Where Have All the Flowers Gone" played on a Moog Synthesizer was presented to the patient through the cochlear implant. Mr. mapping the inferior colliculus. Merzenich was skilled at constructing micro-electrode needles capable of penetrating single nerve cells without rupturing the cell membranes and spilling cell contents. all cochlear implants MUST incorporate the same BASIC design to be capable of the ultimate goal of "detecting" or "demodulating" intelligence from the human voice when that intelligence is residing within an electronic signal. and were considered "successful" from a surgical and medical point of view. These earlier implants were capable of providing background sounds. Harrell. That sequence convinced the department chairman to support the cochlear implant project. Kissiah. Advanced Bionics and Med-El). but are quite different in final design enhancements. which further improved design. Merzenich was enormously skeptical of the cochlear implant project but agreed to test cats Michelson and Pettit had implanted. This was done on August 1. 1974. When one of the reimplanted patients was tested by the team under carefully controlled laboratory conditions.

the Australian cochlear implant was approved by the United States Food and Drug Administration to be implanted in adults in the United States. By 2006. producer of hearing implants. it will be many years before a commercial product becomes available. Greater understanding of voice intelligence was accomplished as the designs described in this first patent for the Cochlear Implant (4063048. barrette or elsewhere. In 1972 the House 3M single-electrode implant was the first to be commercially marketed. then 18 months in 1998. seven patients were implanted with an eight-channel device. the large external components which had been worn strapped to the body grew smaller and smaller thanks to developments in miniature electronics. The device was developed by the scientists Ingeborg and Erwin Hochmair. who in turn participated (also by contractual agreement) with Stanford University. which was implanted into the first patient. including the prototype multi-channel cochlear implant received by Rod Saunders in 1978 (subsequently removed when it was replaced by an updated model). Michelson's patents and ultimately device which are thought of as the first cochlear implants. University of Melbourne Department of Otolaryngology under the umbrella of CRC HEAR to be the first cochlear implant system capable of functioning for sustained periods with no external components. in the six months before the paper being submitted. The system is capable of providing hearing via the TIKI device in stand-alone mode (invisible hearing) or via an external sound processor.Cochlear implant enabled patients to attain a most welcome sense of "attachment" to the world of sound. Although these recipients continue to use their devices successfully today. Australia. Although Adam Kissiah was a full time employee with NASA at the Kennedy Space Center. in 1989. this has not been supported by audiological data in the literature. These earlier implants were incapable. in 1978. Dr. Austria and Melbourne.C. In 1976 a paper (received Feb 1975) was published by Pialoux.[13] Professor Graeme Clark A. 1977) were utilized in subsequent cochlear implants. Younger children have small ears and might mishandle behind-the-ear speech processors.[17] 122 . White and Dr.. On October 5. Australia.[12] Parallel to the developments in California. led the team that developed the Australian prototype bionic ear. F Blair Simmons. of providing the ultimate level of comprehension of the intelligence of the spoken human voice enjoyed by the implant users of today. during their program of cochlear implants (See Stanford University Cochlear Implant Program). in the 1970s there were two other groups working on the development of the cochlear implant in Vienna. December 13. however. It is part of a collection acquired by the National Museum in 2009 and includes key elements that figured in the development of the bionic ear. The prototype for the bionic ear developed by Professor Clark can be seen at the National Museum of Australia in Canberra. it was Dr. therefore. In 1990 the FDA lowered the approved age for implantation to two years. Australia. 2005. principal investigators.[11] However. and finally 12 months in 2000. in Melbourne. who founded MED-EL. Robert L. On December 16. Rod Saunders. a totally implantable [16] This was part of a research project conducted by Cochlear Ltd. the first of three recipients was implanted with Cochlear's TIKI device. 1977 professor Kurt Burian implanted a multichannel cochlear implant. and the cochlear implant. Inc. then Foundation Professor of the Department of Otolaryngology at the University of Melbourne in 1970. Throughout the 1990s. Chouard and McLeod that stated that.. This fact can be supported by review of the many volumes of quarterly reports provided by many researchers under contract to the National Institutes of Health.[14] In December 1984.[15] although off-label use has occurred in babies as young as 6 months in the United States and 4 months internationally. most school-age children and adults used a small behind-the-ear (BTE) speech processor about the size of a power hearing aid. he participated as a consultant in an implantation program during the early 1980s through license agreement granted by Kissiah to Biostim. they often wear the sound processor on their hip in a pack or small harness or wear the BTEs pinned to their collar.[10] Although it was reported that about 50% of ordinary words were understood without lipreading.

There are 4 manufacturers for Cochlear implants. [20] Nearly 3.[19] Additionally. Users generally report better hearing with two implants. A prime candidate is described as: • • • • having severe to profound sensorineural hearing impairment in both ears. amount of residual hearing. Advanced Bionics produces implants with 16 electrodes and uses a technique The internal part of a cochlear implant (model called current steering in which two electrodes are stimulated Cochlear Freedom 24 RE) simultaneously with different current levels to produce intermediate virtual channels. • an array of up to 24 electrodes wound through the cochlea.Cochlear implant Since hearing in two ears allows people to localize sounds (given synchronised AGCs) and to hear better in noisy environments. As of 2006. speech recognition ability. having a family willing to work toward speech and language skills with therapy . and tests show that bilateral implant users are better at localizing sounds and hearing in noise. and transmits power and the processed sound signals to the internal device by electromagnetic induction. Internal: • a receiver and stimulator secured in bone beneath the skin. the signal processing algorithm is also another important block. and each one produces a different implant with a different number of electrodes. having a functioning auditory nerve having lived at least a short amount of time without hearing (approximately 70+ decibel hearing loss.[21] 123 Parts of the cochlear implant The implant is surgically placed under the skin behind the ear. cause of hearing loss. language.[18] However. or in the case of infants and young children. • a transmitter.000 people worldwide are bilateral cochlear implant users. and communication skills.600 children. Cochlear implant centers determine implant candidacy on an individual basis and take into account a person's hearing history. The number of channels is not a primary factor upon which a manufacturer is chosen. the world's youngest recipient of a bilateral implant was just over 5 months old (163 days) in Germany (2004). on average) having good speech. The basic parts of the device include: External: • one or more microphones which picks up sound from the environment • a speech processor which selectively filters sound to prioritize audible speech splits the sound into channels and sends the electrical sound signals through a thin cable to the transmitter. bilateral (both ear) implants are being investigated and used. health status. which send the impulses to the nerves in the scala tympani and then directly to the brain through the auditory nerve system. Candidates There are a number of factors that determine the degree of success to expect from the operation and the device itself. there is also evidence to suggest that the combination of one implant with an FM system provides better speech recognition in noise than two implants alone. which is a coil held in position by a magnet placed behind the external ear. including 1. dynamic FM technology has been proven to outperform traditional FM when used with cochlear implants. and family commitment to aural habilitation/rehabilitation. which converts the signals into electric impulses and sends them through an internal cable to electrodes.

Additionally. form three distinct groups of potential users of cochlear implants with different needs and outcomes. including latest models of high power hearing instruments and FM systems • having no medical reason to avoid surgery • living in or desiring to live in the "hearing world" • having realistic expectations about results • having the support of family and friends • having appropriate services set up for post-cochlear implant aural rehabilitation (through a speech language pathologist.Cochlear implant • not benefitting enough from other kinds of hearing aids. though the critical period for utilizing auditory information does not close completely until adolescence. the brain may begin using the area of the brain typically used for hearing for other functions. pre-lingually deaf children and post-lingually impaired people (usually children) who have lost hearing due to diseases such as meningitis. 124 Type of hearing impairment People with mild or moderate sensorineural hearing loss are generally not candidates for cochlear implantation. Their needs can often be met with hearing aids alone or hearing aids with an FM system. Thus. So it’s really important that they get recognized and evaluated early. The presence of auditory nerve fibers is essential to the functioning of the device: if these are damaged to such an extent that they cannot receive electrical stimuli. which they can get an implant and learn to speak. And by age nine. From the ages of two to four. In contrast. The risk of surgery in the older patient must be weighed against the improvement in quality of life. Those who have lost their hearing as adults were the first group to find cochlear implants useful. Young children (under five years) in these cases often make excellent progress after implantation because they have learned how to form sounds. the implant will not work. or auditory verbal therapist). there is zero chance that they will learn to speak properly. most candidates have been diagnosed with profound sensorineural hearing loss. Research shows that congenitally deaf children who receive cochlear implants at a young age (less than 2 years) have better success with them than congenitally deaf children who first receive the implants at a later age.[22] Another group of customers are parents of children born deaf who want to ensure that their children grow up with good spoken language skills. sound no longer travels via the ear canal and middle ear but will be picked up by a microphone and sent through the device's speech processor to the implant's electrodes inside the cochlea. After the implant is put into place. that ability diminishes a little bit. If an individual has been deaf for a long period of time. As the devices improve. A small number of individuals with severe auditory neuropathy may also benefit from cochlear implants. deaf educator. If such a person receives a cochlear implant. Age of recipient Post-lingually deaf adults. and the brain often will struggle to readapt to sound. particularly for the newly deaf elderly patient. regardless of when they received it. the benefit is often judged to be worth the surgical risk."[24] The third group who will benefit substantially from cochlear implantation are post-lingual subjects who have lost hearing: a common cause is childhood meningitis. even if the second one was implanted as late as 9 years old. children who got their implants at age 2½ years or later did not respond as well to the [23] One doctor has said "There is a time window during later second implant. particularly the sound processor hardware and software. a 2010 study into bilateral implantation showed that children who receive their first cochlear implant before the age of 1½ responded well to the second one. the sounds can be very disorienting. . in regaining some comprehension of speech and other sounds. and only need to learn how to interpret the new information in their brains.

These professionals include. post-implantation therapy and ongoing effects The device is surgically implanted under a general anesthetic. The operation also destroys any residual hearing the patient may have in the implanted ear. Results are typically not immediate. only about 5. and encouraging the child to make sounds and form words. There is also the risk of device failure. some doctors advise single-ear implantation.[25] A story in 2000 stated that one in ten deaf children in the United States had a cochlear implant. although some cochlear implant recipients stay in the hospital for 1 to 2 days. and post-implantation therapy is required as well as time for the brain to adapt to hearing new sounds. The patient normally goes home the same day or the day after the surgery.000 worldwide. though infants can become age appropriate able to speak and understand at the same level as a hearing child of the same age in a matter of months. as well as subsequent therapy. or.and continually . and damage to facial nerves that can cause muscle weakness. After 1–4 weeks of healing (the wait is usually longer for children than adults) during which the wound must be kept dry. The participation of the child's family in working on spoken language development is considered to be even more important than therapy. These cochlear implants are a donation by the Taiwanese organization[27] [28] In India. however it is far more common for the process to take years. In the case of congenitally deaf children. Taiwan and China announced an approximately $270 million order for cochlear implant devices for children in 2006. onset of (or change in) tinnitus. As with every medical procedure. there are an estimated 1 million profoundly deaf children. as a result. saving the other ear in case a biological treatment becomes available in the future. talking about objects and actions. This occurs in 2% of cases and the device must be removed. the risks include skin infection. This minuscule number is due to the high costs for the implant.000 have cochlear implants. By the end of 2008. impaired facial sensation.in the child's therapy. First a small area of the scalp directly behind the ear is shaved and cleaned. the implant is turned on or "activated".[26] Mexico had performed only 55 cochlear implant operations by the year 2000 (Berruecos 2000). It is considered outpatient surgery. making hearing and listening interesting. and that the projection was the ratio would rise to one in three in ten years. and the operation usually takes from 1½ to 5 hours. usually where the incision does not heal properly. damage to the vestibular system. disfiguring facial paralysis. but are not limited to: • Speech-Language Pathologists (SLP) . which are being paid for by major healthcare organization based in Taipei. the surgery involves a certain amount of risk. the total number of cochlear implant recipients has grown to an estimated 150. in the worst cases. audiological training and speech therapy typically continue for years.000 children in the US and an additional 49.Cochlear implant 125 Number of users It was estimated in 2002 that around 10. because the family can aid development by participating actively .[29] The operation.000 people worldwide had received Cochlear implants. Then a small incision is made in the skin just behind the ear and the surgeon drills into the mastoid bone and the inner ear where the electrode array is inserted into the cochlea. Professionals trained to work with children who have received cochlear implants are a major part of the parent-professional team when addressing the task of teaching children to use their hearing to develop speech and spoken language. in this Cochlear implant as worn by user case.

but is a prosthetic substitute for hearing. hardware (device). especially if they have only lost their hearing for a short time.000 to US$125. It may provide them with more information for safety. A study by Johns Hopkins University determined that for a three-year-old child who receives cochlear implants can save $30. Some recipients find them very effective. the estimated total cost is $60. and surgeons also report that when there is an ear infection causing fluid in the middle ear. Individuals who have acquired deafblindness (loss of hearing and vision combined) may find cochlear implants a radical improvement in their daily lives. orientation and mobility and promote interaction within their environment and with other people. However. although he might have difficulty with a new voice or with a busy conversation. He described the robotic sound of human voices perceived through the cochlear implant as "a croaking dalek with laryngitis". and still had to rely to some extent on lip reading. Bell [30] • Pediatric Audiologist (AuD) • Teacher of the Deaf (ToD) with a specialization in Oral Deaf Education Many users. cochlear implants can be a great help in restoring functional comprehension of speech. balance. Having more auditory information than they may be familiar with may provide them with sensory information that will help them become more independent. Large amounts of static electricity can cause the device's memory to reset. and thus cannot be used with certain diagnostic tests such as magnetic resonance imaging (MRI). communication. reducing isolation. the sound quality delivered by a cochlear implant is often good enough that many users do not have to rely on lip reading in quiet conditions. as does Medicare in Australia.[31] The electronic stimulation the implant creates appears to have a positive effect on the nerve tissue that surrounds it. In noisy conditions however. the NHS covers cochlear implants in full. For this reason. the surgery itself. it can affect the cochlear implant. others somewhat effective and some feel worse overall with the implant than without. speech understanding often remains poor. audiologists. In the United Kingdom.[36] .000 to $50. this includes evaluation.000. but the depths found in normal recreational diving appear to be safe.[35] Even modern cochlear implants have at most 24 electrodes to replace the 16.[33] Efficacy A cochlear implant will not cure deafness or hearing impairment. The external components must be turned off and removed prior to swimming or showering. children with cochlear implants are also advised to avoid plastic playground slides. leading to temporarily reduced hearing. Another recipient described the initial sounds as similar to radio static and voices as being cartoonish.Cochlear implant • Certified Auditory-Verbal Therapists (LSLS Cert. AVT) A. Seguridad Social in Spain and Israel. and reported that he has no trouble speaking to people he knows.000 per person implanted.000 delicate hair cells that are used for normal hearing. British Member of Parliament Jack Ashley received a cochlear implant in 1994 at age 70 after 25 years of deafness. but some are now FDA approved for use with certain strengths of MRI machine.G.000 in special-education costs for elementary and secondary schools as they are more likely to be mainstreamed in school and thus use fewer support services than similarly deaf children. Manufacturers have cautioned against scuba diving due to the pressures involved. though after a year with the implant she said everything sounded right. hospitalization and rehabilitation.[32] 126 Cost In the United States. The implant has a few effects unrelated to hearing. Some brands of cochlear implant are unsafe in areas with strong magnetic fields. medical costs run from US$45. whether one on one or even on the telephone.[34] For people already functional in spoken language who lose their hearing. According to the US National Institute on Deafness and Other Communication Disorders. Some or all of this may be covered by health insurance.

some patients suffer from deafness medial to the cochlea typically acoustic neuromas.which are crucially important to speech perception. the Centers for Disease Control and Prevention and the Food and Drug Administration both recommend that would-be implant recipients be vaccinated against meningitis prior to surgery. Patients without a viable auditory nerve are usually identified during the candidacy process.[43] [44] Hyperbaric oxygen has been shown to be a useful adjunctive therapy in the management of cochlear implant flap necrosis.265 American children who received implants between 1997 and 2002 concluded that recipient children had a risk of pneumococcal meningitis more than 30 times greater than that for children in the general population. UK-based.[37] 127 Risks and disadvantages Some effects of implantation are irreversible. This relates to the specific pathology of deafness and the time frame. Cochlear implants cannot overcome such a problem.[41] As a result. study found that while the incidence of meningitis in implanted adults was significantly higher than the general population. . those born profoundly deaf who receive an implant as an adult can only distinguish simple sounds. the risk and extent of damage still varies. this does not mean the brain can learn to process and distinguish speech if the recipient has passed the critical period of adolescence. Still. the implantation process inevitably results in shaving of the hair cells within the cochlea.[46] There are strict protocols in choosing candidates to avoid risks and disadvantages.[42] Necrosis has been observed in the skin flaps surrounding cochlear implants.Cochlear implant Adults who have grown up deaf can find the implants ineffective or irritating. promise to minimize such damage. The main problem is with the age of recipient. there is a risk that the nerve may be damaged during the operation. as the perception of sound was maintained through use of the hearing aid. As a result. although the results may not be optimal. it is not as good as the quality of sound processed by a natural cochlea. as the artificial signal does not have a healthy nerve to travel along.[39] A study of 4. It is quite possible that the surgery does not restore hearing. With careful selection of candidates. while the device can help the recipient better hear and understand sounds in their environment. Fewer than 1% of deaf individuals have a missing or damaged auditory nerve. most critically the age of recipient but also the technology used and the condition of the recipient's cochlea. The incidence of the damage is infrequent. Children without a working auditory nerve may be helped with a cochlear implant. the incidence in children was no different than the general population. Adults who are born with normal hearing and who have had normal hearing for their early years and who have then progressively lost their hearing tend to have better outcomes than adults who were born deaf. This is due to the neural patterns laid down in the early years of life .[40] A later.[45] As the location of the cochlea is close to the facial nerve. a doorbell. While cochlear implants restore physical ability to hear. the risks of implantation are minimized. In addition. For example. such as a ringing phone vs. The success rate depends on a variety of factors. the cause of deafness is not always identified before the surgery. while the device promises to provide new sound information for a recipient. A battery of tests is performed to make the decision of candidacy easier. Some who were orally educated and used amplifying hearing aids have been more successful with cochlear implants. Recent research has suggested that children and adults can benefit from bilateral cochlear implants in order to aid in sound localization and speech understanding. While recent improvements in implant technology. Implantation into the cochlea has a low success rate with these people. while others who receive implants early can understand speech.[38] which can results in a permanent loss of most residual natural hearing because sometimes the cause of deafness is the auditory nerve or other part of the body. The United States Food and Drug Administration reports that cochlear implant recipients may be at higher risk for meningitis. which today can be treated with an auditory brainstem implant. and implantation techniques.

research shows that patients can understand speech with at least 4 electrodes. The transmitter attaches to the receiver using a magnet that holds through the skin. is the way the ear sorts out different frequencies so that our brain can process that information. Radio frequency is used so that no physical connection is needed. in which number of maxima (n) from the available maxima in sound are selected. Feature extraction strategies used features which are common to all vowels. "Tonotopic organization". the fine timing aspects are as yet poorly perceived and this is the focus of much current research. Advanced Bionics uses other techniques like CIS. SAS and HiRes. Each vowel has a fundamental frequency (the lowest frequency peak) and formants (peaks with higher frequencies). The algorithm chooses a number of the strongest outputs from the filters. Feature extraction strategies are no longer widely used. Receiver This component receives directions from the speech processor by way of magnetic induction sent from the transmitter. ACE is mainly used. also referred to as a "frequency-to-place" mapping. In individuals with sensorineural hearing loss. These strategies emphasize the transmission of spectral aspects of speech. but low frequency sounds pass farther in. sound vibrations in the air lead to resonant vibrations of the basilar membrane inside the cochlea. they stimulate the full spectrum. creates an electrical disturbance that can be picked up by the surrounding nerve cells. The movement of hair cells. or simply damaged over time by excessively loud noises. which reduces the chance of infection and pain. Filterbank strategies use Fast Fourier Transforms to divide the signal into different frequency bands. These algorithms try to recognize the vowel and then emphasize its features. The pattern of the fundamental and formant frequencies is specific for different vowel sounds. Hair cell loss or absence may be caused by a genetic mutation or an illness such as meningitis. the exact number depending on the number of implanted electrodes and other factors.for example uses the Speak-ACE strategy. Processing Sound received by the microphone must next be processed to determine how the electrodes should be activated. located all along the basilar membrane. Hair cells may also be destroyed chemically by an ototoxic medication. In a normal ear. where it returns that fine structure stimulation is an important issue. The cochlear implant bypasses the hair cells and stimulates the cochlear nerves directly using electrical impulses. High-frequency sounds (i. (The receiver also receives its power through the transmission. Some strategies used in Advanced Bionics and MED-EL strategies make use of fine structure presentation by implementing the Hilbert Transform in the signal processing path.Cochlear implant 128 Functionality The implant works by using the tonotopic organization of the basilar membrane of the inner ear. but the obstacle is in music perception. Each Cochlear implant manufacturer tries to use a different strategy. This allows the brain to interpret the frequency of sound as it would if the hair cells of the basilar membrane were functioning properly (see above). Cochlear 70% market share. and therefore what sound frequency is being heard. high pitched sounds) do not pass very far along the membrane.e. These strategies emphasize transmission of the spectral aspects of speech. while ACE strategies depends mainly on the Short Time Fourier Transform. Although coarse temporal information is presented. hair cells are often fewer in number and damaged. Transmitter This is used to transmit the processed sound information over a radio frequency link to the internal portion of the device. The processing strategy is a main block upon which one has to choose the implant manufacturer.) The receiver is also a sophisticated computer that translates the processed sound information and controls the electrical current sent to the electrodes in . The brain is able to interpret the nerve activity to determine which area of the basilar membrane is resonating.

due to some physical limitation. When an electrical current is routed to an intracochlear electrode. but the distance between the electrodes is about 2. of La Trobe University. where it codes the sound accordingly. It is hoped that the increased number of electrodes will enable users to perceive music and discern specific voices in noisy rooms. Melbourne. Today's tiny processors can often take the place of bulky body-worn processors. In the devices manufactured by Cochlear Ltd. 129 Electrode array The electrode array is made from a type of silicone rubber. while in the Nucleus Freedom from Cochlear Ltd is about 0. in 2008.one is a ball electrode that sits beneath the skin. an area of the midbrain that acts as a bridge between the inner ear and the auditory cortex.C. The audiologist also selects the appropriate speech processing strategy and program parameters for the user. It is a small processor that is worn on the ear. two electrodes sit outside the cochlea and act as grounds-. while the electrodes are platinum or a similar highly conductive material. The coding strategies programmed by the user's audiologist are stored in the processor. (The cochlea winds its way around the auditory nerve. which was more common in previous years. Australia. Programming the speech processor The audiologist sets the minimum and maximum current level outputs for each electrode in the array based on the user's reports of loudness. MED-EL produces deep insertion implants that can be inserted up to a tonotopical frequency of 100 Hz (according to Greenwood frequency to position formula in normal hearing). The mean length of human being cochlea is 33–36 mm. Speech processors Speech processors are the components of the cochlear implant that transforms the sounds picked up by the microphone into electronic signals capable of being transmitted to the internal receiver. where it is picked up by radio signal and sent along the electrode array in the cochlea. while the other is a plate on the device. or BTE.7 mm. It is embedded in the skull behind the ear. It is connected to the internal receiver on one end and inserted into the cochlea deeper in the skull.Cochlear implant the cochlea. This equates to 24 electrodes in the Cochlear-brand 'nucleus' device. Insertion depth is another important factor. There are primarily two forms of speech processors available. This is the kind of processor used by most adults and older children. 22 array electrodes within the cochlea and 2 extra-cochlear electrodes. There is a strong research in this direction and the best sounding implant can be subjective from patient to patient. announced beginning the development of a prototype "hi fi" cochlear implant featuring 50 electrodes. which is tonotopically organized as is the basilar membrane). Scientific and technical advances Professor Graeme Clark A. The laser stimulation produced more precise signals in that brain region than the electrical stimulation commonly used in cochlear implants.[47] Researchers at Northwestern University have used infrared light to directly stimulate the neurons in the inner ear of deaf guinea pigs while recording electrical activity in the inferior colliculus. The most common kind is called the "behind-the-ear" processor. Babies and small children wear either a "baby" BTE (pinned or clipped to the collar) or the body-worn processor. MED-EL and Cochlear brands both carry a "baby BTE" configurations.[48] Laser stimulation is a promising . an electrical field is generated and auditory nerve fibers are stimulated. typically together with the microphone. the implants don't reach to the apical tip when inserted but it may reach up to 25 mm which corresponds to a tonotopical frequency of 400–6000 Hz.5 mm. The signal produced by the speech processor is sent through the coil to the internal receiver.

an additional device manufactured by Neurelec. four people have undergone a trial of a internal microphone system.[52] 130 Manufacturers Currently (as of 2007). However. MED-EL. including the Hybrid "short-electrode" cochlear implant. have been developed that combine a cochlear implant with a sound amplifying hearing aid. 2003). The sound amplifying component helps users to perceive lower frequency sounds through their residual natural hearing while the cochlear implant allows them to hear middle and higher frequency sounds. US [54]. going back as far as the 18th century with the argument of manualism vs. cochlear implants have been one of the technological and social factors implicated in the decline of sign languages in the developed world. There have been news reports of other organizations working to develop cochlear implants. For some in the Deaf community. the familiarity of the user's surgeon and audiologist with the particular device. and claim that measuring the child's success only by their mastery of hearing and speech will lead to a poor self-image as "disabled" (because the implants do not produce normal hearing) rather than having the healthy self-concept of a proudly Deaf person. in South Korea by the Seoul National University Hospital[56] and in India by a branch of the Defence Research and Development Organisation. mapping strategies. the three cochlear implant devices approved for use in the U. Users of all four devices display a wide range of performance after implantation.[51] Additionally. which as they view it. In the EU. Australia. As of April 2011. work is ongoing in developing a fully internal cochlear implant. Austria [53] and Advanced Bionics. According to Johnston (2004). and anatomical concerns. are manufactured by Cochlear Limited. There is no clear-cut consensus that any one of these implants is superior to the others. They are often isolated from other deaf children and from sign language (Spencer 2003). which consists largely of pre-lingually deaf people whose first language is a signed language. customer service from the manufacturer. in the standard fashion.[26] Andrew Solomon of the New York Times states that "Much National Association of the . Some of the more extreme responses from Deaf activists have labeled the widespread implantation of children as "cultural genocide". usability of external components. reliability of the internal and external components.[49] [50] EAS devices have the potential to make cochlear implants suitable for many people with partial hearing loss. and without access to sign language (Spencer et al. MRI compatibility. battery life. other criteria are often considered when choosing a cochlear implant: FM system compatibility. cochlear implants are an affront to their culture. on the assumption that deafness is a disability. Each manufacturer has adapted some of the successful innovations of the other companies to its own devices.[58] This is an old problem for the Deaf community.[24] Hence they are implanted before the recipients can decide for themselves. Children do not always receive support in the educational system to fulfill their needs as they may require special education environments and Educational Assistants. Deaf culture critics argue that the cochlear implant and the subsequent therapy often become the focus of the child's identity at the expense of a possible future Deaf identity and ease of communication in sign language. oralism.[59] Children with cochlear implants are more likely to be educated orally. Cochlear implants for congenitally deaf children are considered to be most effective when implanted at a young age. of France [55] is available. Cochlear implants are rarely used in ears that have a functional level of residual hearing.Cochlear implant technology for improving the auditory resolution of implants but further research using fiber optics to stimulate the neurons of the inner ear is required before products using the technology can be developed. is a minority threatened by the hearing majority. Electric Acoustic Stimulation (EAS) devices. cosmetic factors.S. Since the devices have a similar range of outcomes. during the critical period in which the brain is still learning to interpret sound. The combination enhances speech perception in noisy environments.[57] Controversy in Deaf culture Much of the strongest objection to cochlear implants has come from the Deaf community. with two more yet to come.

J Dalton. University of Wisconsin-Madison News."[60] Opposition continues today but is softening. "What are Cochlear Implants?" (http:/ / www. PMID 17898671. edu/ smo/ avandeven/ MGT6050/ CIP Team 4 Slides. Pebble Beach. Schafer. faster. American Journal of Audiology 15: 114–126. au/ news/ business/ cochlear-heads-for-earnings-record/ 2007/ 02/ 13/ 1171128974085. . The Age. KL Plant. "Speech Recognition in Noise in Children With Cochlear Implants While Listening in Bilateral. February 2. html#c [16] Briggs. Peoria Journal Star. . "Peoria’s first cochlear implant surgery has grandfather rediscovering life" (http:/ / www. PM Seligman. ac. com. ppt).000 people worldwide have received implants as of April 2009. Schafer. [21] Mary Ann Moon. doi:10. 2nd edition.F. RJ. Roland. uk/ drupal/ ?q=prosthetics/ music [6] W. [8] References: Michelson RP. 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"Complication rate of minimally invasive cochlear implantation" (http:/ / linkinghub.24817307-5014239. Duncan (2011-04-04). . Shelli. com/ au/ corporate/ announces-order-china). "International consensus on bilateral cochlear implants and bimodal stimulation". PMID 16949968. com/ lifestyle/ cont28. New Hybrid Hearing Device Combining Advantages Of Hearing Aids. July 24. B. (http:/ / pdfserve.Biernath et al. Am.. . 2008. Retrieved 2009-11-04.1080/00016480510044412. 125 (9): 918–919. doi:10. April 28). ISBN 1-56368-129-3. Retrieved 14 July 2010. Implants. [29] Priyanka Golikeri (2010-07-14). drury. C. 2002. com/ medtech/ health/ news/ 2006/ 06/ 70937).tech .. Retrieved 2008-04-27. King SM. C. cochlear. org/ cgi/ content/ abstract/ 117/ 2/ 284). html). 10. [52] Graham-Rowe. "Speech recognition abilities of adults using CIs interfaced with FM systems". shtml). sciencedaily.Pediatrics" (http:/ / pediatrics. 900-light-opens-up-a-world-of-sound-for-the-deaf. Andrew (1994-08-28). [38] http:/ / www. Retrieved 2008-11-09. "City clerk outsmarts heredity" (http:/ / www. The Chaldron Record. Boyle." (http:/ / archive. Williams (2000-05-05). [37] Offeciers E. [35] Rempp.00. Soc. org/ cgi/ content/ short/ fdh188v1). com/ Ce-Fi/ Cochlear-Implants. 1729-1735. Retrieved 2008-04-27. Retrieved 2008-04-27. newscientist.W. [44] Stratigouleas ED.023.New Scientist" (http:/ / www. asp). surgeryencyclopedia. Reefhuis. Schwaber MK (January 1992). "Defiantly deaf" (http:/ / query. Retrieved December 22. neurelec. Laryngol. nationalreviewofmedicine. [34] Delost. "The Cochlear Implant Controversy" (http:/ / www. edu/ otolaryngology/ cochlear. and Turner. Retrieved 2008-11-09. University of Maryland Medical Center.Journal of Public Hea. "Not everyone is sold on the cochlear implant" (http:/ / www. com/ money/ report_costly-cochlear-implants-beyond-reach-of-masses_1409419). 44.

. (1997). Washington. 2006. Cochlear Implants.. 39. Chouard. . John B." Acta Oto-Laryngologica. [59] NAD Cochlear Implant Committee. • Lane. html). Retrieved 2010-04-30. In 'deaf History Unveiled'. Speech Perception Skills of Children with Multichannel Cochlear Implants or Hearing Aids.):334-337 • Officiers.Robbins. Archived from the original (http:/ / www.T.K.. Arch Otolaryng. "Defiantly deaf" (http:/ / query. 918-919. ed. The Cochlear Implant Controversy. Issues in Protocol Design for Cochlear Implant Trials in Children: The Clarion Pediatric Study. cbsnews. zeenews. Ann Otol Rhinol Larynogol 1976.M. 133 Further reading • Berruecos. Vol 84. 2010-03-05. 125.63. and Kessler. co. F. Electrical Stimulation of the Auditory Nerve in Man. com/ gst/ fullpage. De l'excitation électrique du nerf cochléaire chez l'homme. Trevor. (2004). and M. S. [57] "Cheaper. [58] "The Cochlear Implant Controversy. Cochlear implants: An international perspective . 272-291.L. • Osberger M. Andrew (1994-08-28). P. 'Djourno. Otolaryngology: Head and Neck Surgery 119:297-308.Todd. July 1966 • Pialoux. • Christiansen. asp?c=foINKQMBF& b=138140). html?res=9A00E2D91639F93BA1575BC0A962958260& sec=health& pagewanted=10).Kirk. and the first implanted electrical neural stimulator to restore hearing. Cochlear Implants in Children: Ethics and Choices. "Bilateral Cochlear Implants in Children: Localization Acuity Measured with Minimum Audible Angle. archive. J. Rebuilt: How Becoming Part Computer Made Me More Human. Zee News. 1976." Ear & Hearing. . Ethical Issues in Cochlear Implant Surgery: An Exploration into Disease.Van Cleve.. Retrieved 2008-11-09. . lighter biomedical equipment using Def-tech" (http:/ / www. NEW YORK: CBS News. P. D. Audiology. (2006). nad.Osberger. Annals of Otology.. Kennedy Institute of Ethics Journal 7:231-251. Huw R. 85 (suppl 27): 1 – 93. et. 27. . Ruth Y. et al.):337-339. Issues And Debates" (http:/ / www. (1995). 1957. A. Harlan (1993). M. "Procedure Gives Hearing to Auditory Disabled" (http:/ / www. à l'aide d'un micro-bobinage inclus à demeure. . org/ site/ pp. Leigh (2002. D. 2005. (1998). • Djourno A. Annals of Otology. 'Prothèse auditive par excitation électrique à distance du nerf sensoriel à l'aide d'un bobinage inclus à demeure. Gallaudet University Press. Cochlear Implants:Their Cultural and Historical Meaning. Retrieved 2010-03-05. asp?c=foINKQMBF& b=138140) on 2007-02-20. Louise C.' in: Otology and Neurotology. C. 5). Vol. (2005). Retrieved 2010-03-05. and MacLeod. "Cochlear Implants" (http:/ / web. (1957) 'Vallencien B. Boston: Houghton Mifflin. nytimes. 2003 May.' CR de la société. B. koreatimes. The Korea Times. • Lane. Physiological and clinical aspects of the rehabilitation of total deafness by implantation of multiple intracochlear electrodes. • Lane. 423-4. a. • Johnston. 4:221-225 • House. Acta Oto-Laryngologica 81: 436-441 • Chorost.24(3):500-6. (2005). The New York Times. W(h)ither the deaf Community? In 'American Annals of the deaf' (volume 148 no. (2006)Cochlear Implants A Practical Guide.Latin American countries and Spain.Cochlear implant [56] Bae Ji-sook (2010-02-28).J. and Craddock.C. H. • Grodin. F. September 4. World Federation of the deaf News 2 (3):22-28. H. kr/ www/ news/ art/ 2010/ 02/ 147_61550. Washington. Disability.J. "International Consensus on bilateral cochlear implants and bimodal stimulation. P. DC: Gallaudet University Press.. Michael.de biologie. Harlan (1994). • Eisen MD (2003). • Cooper. (1995). B. and Irene W. 1957. . • Djourno A. 2001. Hamilton: Jul/Aug 2000. W.E. (2000). March 9.2005). R. nad.I. 43-59. London and Philadelphia: Whurr Publishers. html). and Bahan. com/ stories/ 1998/ 06/ 02/ sunday/ main10794. and the Best Interests of the Child. org/ site/ pp. • Simmons. Rhinology and Laryngology 9 (Suppl. [60] Solomon. (1957). Rhinology and Laryngology 105 (Suppl. par induction à distance.. Effects of Cochlear Implantation in Young Children: A Review and a Reply from a DEAF-WORLD Perspective.' In: La Presse Médicale 65 no. org/ web/ 20070220131900/ http:/ / www. com/ news608563. Pedro. • Miyamoto. shtml). • Litovsky. Eyriès C. Eyriès C. Eyries.

nasa.ppt). ed.gov/20030099659_2003114614. New England Journal of Medicine.org/saf/1205/features/Interactive/intro1.nih. Cochlear Implants: Issues and Implications. (2003) Risk of Bacterial Meningitis in Children with Cochlear Implants.html) 134 External links • Cochlear Implants (http://www.php?storyId=4961269) Includes simulations of what someone with implants might hear. pdf) on engineer Adam Kissiah's contribution to cochlear implants beginning in the 1970s.htm) Information from the National Institutes of Health (NIH).org/templates/story/ story. USA 1997-2002. Patricia Elizabeth and Marc Marschark. . November 2005): Author Michael Chorost writes about his own implant and trying the latest software from researchers in a quest to hear music better. (http://www.com/family_resource_center. In 'Oxford Handbook of deaf Studies. • Tuning In (http://www.nidcd.kidshearnow.npr. University of Miami School of Medicine (http://www. • Barton G.pbs.edu/smo/avandeven/ MGT6050/CIP Team 4 Slides.11/bolero. • NASA Spinoff article (http://ntrs. (2003). 2003.gov/archive/nasa/casi.htm) PBS article about advances in cochlear implant technology with simulations of what someone with each type of implant would hear.wired.dmoz.gov/health/hearing/coch. • My Bionic Quest for Boléro (http://www. 2003. 434-450. • Spencer. Language and Education'. • NPR Story about improvements to improve the processing of music. Kids Hear Now Cochlear Implant Family Resource Center.ntrs. 349:435-445.csom. • 3M Power Point Presentation on the Cochlear Implant (http://webpages. Oxford: Oxford University Press.com/wired/archive/13.html?tw=wn_tophead_4) (Wired. et al.nasa. Marc Marschark and Patricia Elizabeth Spencer.umn.Cochlear implant • Reefhuis J.org/Business/Healthcare/Products_and_Services/Disability/ Hearing_and_Listening_Aids/Cochlear_Implants//) at the Open Directory Project • Cochlear Implants (http://www.

there is potential for serious complications and side effects. The IPG is a battery-powered neurostimulator encased in a titanium housing. behind the ear to the IPG.[8] The right side of the brain is stimulated to address symptoms on the left side of the body and vice versa. For non-Parkinsonian essential tremor the lead is placed in the ventrointermedial nucleus (VIM) of the thalamus. tremor and dystonia. its effects are reversible (unlike those of lesioning techniques) and is one of only a few neurosurgical methods that allows blinded studies.[2] its underlying principles and mechanisms are still not clear.Deep brain stimulation 135 Deep brain stimulation Deep brain stimulation (DBS) is a surgical treatment involving the implantation of a medical device called a brain pacemaker. nurse or trained technician to optimize symptom suppression and control side effects. the abdomen. with feedback from the patient for optimal placement.[6] DBS leads are placed in the brain according to the type of symptoms to be addressed.[5] The IPG can be calibrated by a neurologist. The lead is a coiled wire insulated in polyurethane with four platinum iridium electrodes and is placed in one of three areas of the brain. The Food and Drug Administration (FDA) approved DBS as a DBS-probes shown in X-ray of the skull treatment for essential tremor in 1997. Parkinson's disease. DBS directly changes brain activity in a controlled manner. which is placed subcutaneously below the clavicle or in some cases. Components and placement The deep brain stimulation system consists of three components: the implanted pulse generator (IPG). the lead. an insulated wire that runs from the head. The lead is connected to the IPG by the extension. DBS in select brain regions has provided remarkable therapeutic benefits for otherwise treatment-resistant movement and affective disorders such as chronic pain.[7] All three components are surgically implanted inside the body. which sends electrical impulses to specific parts of the brain. down the side of the neck. which sends electrical pulses to the brain to interfere with neural activity at the target site. . While DBS has proven helpful for some patients. for Parkinson's disease in [3] [4] 2002. Under local anesthesia.[1] Despite the long history of DBS. including major depression. a hole about 14 mm in diameter is drilled in the skull and the electrode is inserted. and the extension. and dystonia in 2003. the lead may be placed in either the globus pallidus or subthalamic nucleus. DBS is also routinely used to treat chronic pain and has been used to treat various affective disorders. For dystonia and symptoms associated with Parkinson's disease (rigidity. The installation of the IPG and lead occurs under general anesthesia. bradykinesia/akinesia and tremor).

. a precursor to adenosine (through a catabolic process).[3] DBS carries the risks of major surgery.[15] DBS is approved in the United States by the Food and Drug Administration for the treatment of Parkinson's. The goal is to provide stimulating pulses only when they are needed.[5] Its direct effect on the physiology of brain cells and neurotransmitters is currently debated.[14] Insertion of electrode during surgery using a stereotactic frame Research is being conducted as of 2007 to predict the onset of tremors before they occur by monitoring activity in the subthalamic nucleus. rigidity.[11] At present. with a complication rate related to the experience of the surgical team. or making a medication regimen more tolerable. and a site will be chosen based on their needs.[13] allowing a decrease in medications. are being evaluated and showing promise. to stop any tremors occurring before they start. adenosine A1 receptor activation depresses excitatory transmission in the thalamus. bradykinesia and postural instability. Traditionally. or whose medications have severe side effects. so each patient must be assessed individually. the two most common sites are the subthalamic nucleus (STN) and the globus pallidus interna (GPi). There are a few sites in the brain that can be targeted to achieve differing results. but other sites. but by sending high frequency electrical impulses into specific areas of the brain it can mitigate symptoms[12] and/or directly diminish the side effects induced by Parkinsonian medications.[10] DBS does not cure Parkinson's. Applications Parkinson's disease Parkinson's disease is a neurodegenerative disease whose primary symptoms are tremor. such as the caudal zona incerta and the pallidofugal fibers medial to the STN.Deep brain stimulation 136 Biochemistry It has been shown in thalamic slices from mice[9] that DBS causes nearby astrocytes to release adenosine triphosphate (ATP). the procedure is used only for patients whose symptoms cannot be adequately controlled with medications. In turn. but it can help manage some of its symptoms and subsequently improve the patient’s quality of life. thus causing an inhibitory effect that mimicks ablation or "lesioning".

seven for treatment-resistant depression. and one for both. it may not always be clear how to apply DBS for a particular patient. Tourette syndrome Deep brain stimulation has been used experimentally in treating a few patients with severe Tourette syndrome.Deep brain stimulation 137 Major depression There is insufficient evidence to support DBS as a therapeutic modality for depression. and requires long-term expert care.[16] Researchers reported in 2005 that electrical stimulation of a small area of the frontal cortex brought about a "striking and sustained remission" in four out of six patients suffering from major depression.[17] A systematic review of DBS for treatment resistant depression and obsessive–compulsive disorder identified 23 cases—nine for OCD. Their symptoms had previously been resistant to medication. Benefits for severe Tourette's are not conclusive.[20] As of 2006. and the significant time and effort involved in optimizing stimulation parameters". tending to remit in adulthood. it is important to note that DBS has not been approved as an evidence-based therapy for depression or OCD in North America. the researchers had noticed that activity in the subgenual cingulate—the lowest part of a band of tissue that runs along the midline of the brain—seemed to correlate with symptoms of sadness and depression. The changes reversed when the current was switched off. the procedure may be an effective treatment modality in the future.[18] However.[17] Using brain imaging. The procedure is invasive and expensive.[21] . and became more alert and interested in their environments. Despite widely publicized early successes."[20] There may be serious short. and more study is needed to determine whether long-term benefits outweigh the risk. They implanted electrodes into six patients while they were locally anesthetised.and long-term risks associated with DBS in persons with head and neck tics. all experienced reduction in tics and the disappearance of obsessive-compulsive behaviors. psychotherapy and electroconvulsive therapy. hypomanic or manic conversion. debilitating.[19] The procedure is well tolerated. Tourette's is more common in pediatric populations.[17] The effects of continuous subgenual cingulate stimulation have produced sustained remission from depression in the four patients for six months. Because diagnosis of Tourette's is made based on a history of symptoms rather than analysis of neurological activity. while those with severe personality disorders and substance abuse problems should be excluded. While the current was switched on. When reporting the results. the team did caution that the trial was so small that the findings must be considered only provisional. the Tourette Syndrome Association convened a group of experts to develop recommendations guiding the use and potential clinical trials of DBS for TS. four of the patients reported feeling a black cloud lifting. abrupt symptom worsening upon cessation of stimulation. but complications include "short battery life. and treatment-refractory illness should be considered. but alert. "Only patients with severe. considering less robust effects of this surgery seen in the Netherlands. DBS remains a highly experimental procedure for the treatment of Tourette's. there were five published reports of DBS in patients with TS. Due to concern over the use of DBS in the treatment of Tourette syndrome. It found that "about half the patients did show dramatic improvement" and that adverse events were "generally trivial" given the younger psychiatric patient population than with movements disorders. however. so this would not generally be a recommended procedure for use on children.

[29] Results of DBS in dystonia patients. This may cause more profound complications such as personality changes.[28] Although the clinical efficacy is not questioned. such as bleeding within the brain. mild disorientation and sleepiness are normal. However. Owen SLF. DBS has been used in the treatment of obsessive-compulsive disorder[27] and phantom limb pain. the previously non-verbal patient became capable of naming objects and using objects with his hands—for example. After further stimulation. S181–187. Notes [1] Kringelbach ML.S. Department of Health and Human Services. Nature reported that scientists in the US had stimulated a 38-year-old man who had been in a minimally conscious state for six years using DBS. April 22. where positive effects often appear gradually over a period of weeks to months. he could swallow food and take meals by mouth.[23] This result follows research carried out over 40 years. there is a follow-up to remove sutures. PMID 11948775. "Introduction to the programming of deep brain stimulators". fda. Jenkinson N. 2006. there is also the potential for neuropsychiatric side effects. FDA approves implanted brain stimulator to control tremors. com/ index. 2003. 2006. which has analyzed the effects of deep brain stimulation in the thalamus (and elsewhere) in patients with post-traumatic coma.Deep brain stimulation 138 Other clinical applications In August 2007. cognitive dysfunction. Deuschl G. . After surgery. Retrieved October 18. There may also be complications of surgery.[31] DBS has been tried for patients with Lesch-Nyhan syndrome in Japan. indicate a role of functional reorganization in at least some cases. hallucinations. ninds. Stereotact Funct Neurosurg. but electrode misplacement is relatively easy to identify using CT. (http:/ / knbc-tvhealth. About 9% of patients had psychiatric events. and there was an improvement in their physical functioning. html) Retrieved October 18. as well as rapid bilateral head-turning to voice. [3] U. [4] 'Brain pacemaker' treats dystonia. and depression. 8:623–635. bringing a cup to his mouth. swelling of the brain tissue. 2006. "Evolution of neuromodulation". Kopper F. the mechanisms by which DBS works are still debated. Herzog J. PMID 16006778. Most patients in this trial reported an improvement in their quality of life following DBS. Aziz TZ (2007). nih. 2002 17. which ranged in severity from a relapse in voyeurism to a suicide attempt. Nature Reviews Neuroscience.[33] Because the brain can shift slightly during surgery. given that interruption of stimulation reverses its effects. cfm?pt=itemDetail& item_id=97349& site_cat_id=470) KNBC TV. turn on the neurostimulator and program it.[29] Long-term clinical observation has shown that the mechanism is not due to a progressive lesion. ip2m. deep brain stimulation is not yet a reliable cure for patients in post-traumatic coma. Deep brain stimulation for Parkinson's Disease information page. htm) Retrieved November 23.[24] [25] [26] While this research has shown some potential. gov/ bbs/ topics/ NEWS/ NEW00580. these may be temporary and related to correct placement and calibration of the stimulator and so are potentially reversible.[30] The procedure is being tested for effectiveness in patients with severe epilepsy. meaning he was no longer dependent on a gastrostomy tube. hypersexuality. attention and learning. [5] National Institute of Neurological Disorders and Stroke. "Translational principles of deep brain stimulation".[22] The patient initially had increased arousal and sustained eye-opening. (http:/ / www. accompanied by problems with word generation. [2] Gildenberg PL (2005). 71–79. compulsive gambling. Moreover. 83(2–3). [6] Volkmann J. After 2–4 weeks.[32] A recent trial of 99 Parkinson's patients who had undergone DBS suggested a decline in executive functions relative to patients who had not undergone DBS. (http:/ / www. Potential complications and side effects While DBS is helpful for some patients. there is the possibility that the electrodes can become displaced or dislodged. gov/ disorders/ deep_brain_stimulation/ deep_brain_stimulation. Reports in the literature describe the possibility of apathy. Switzerland and France. PMID 17637800. Mov Disord.

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Editor-in-Chief. Encyclopedia of Bioethics. Jenkinson N.Deep brain stimulation 140 References • Appleby BS. Grill WM (2000).youtube. html) . Annals of Biomedical Engineering 38:219–233. Owen SLF. 8:623–635. Nature Medicine. Textbook of stereotactic and functional neurosurgery.ege.1. Stereotact Funct Neurosurg. • Gildenberg Philip L and Tasker.14. Takano T. (2005) Adams and Victor's Principles of Neurology (8th Edition). Nature Reviews Neuroscience. Volume 2. McGraw-Hill Medical Publishing. Schnermann J. "Selective microstimulation of central nervous system neurons". 629–634. Tian G. Rabins PV (2007). Post. Robert H. 75–80. Aziz TZ (2007). "Cellular effects of deep brain stimulation: model-based analysis of activation and inhibition". PMID 10784087 • McIntyre CC. Grill WM. pp. Libionka W. Regenberg A. Xu Q. Journal of Neurophysiology 91:1457–1469. Duggan PS. Movement Disorders 22:1722–1728 PMID 17721929 • Bekar L. PMID 14668299 • Ropper Allan H and Brown.med. Deep Brain Stimulation (2004) In. Wang X. "Translational principles of deep brain stimulation". McGraw-Hill Publishing. New York: MacMillan Reference. "Psychiatric and neuropsychiatric adverse events associated with deep brain stimulation: A meta-analysis of ten years' experience".edu. "Adenosine is crucial for deep brain stimulation–mediated attenuation of tremor". Bakos R. Thakor NV (2004). 3rd Edition. PMID 16006778 • Kringelbach ML. Torres A. • Fins JJ. Sherman DL. • Gildenberg Philip L (2005). SG. PMID 17637800 • McIntyre CC. n. Lovatt D. ISBN 007141620X External links • Video: Deep brain stimulation therapy for Parkinson's disease (http://www. v. 83(2–3). Williams E. Ronald R (1998). 71–79. Nedergaard M (2008).tr/~norolbil/2001/NBD15501. pp. "Evolution of neuromodulation".com/ watch?v=9phXvB077Dw) • Deep brain stimulation for movement disorders (http://www.

The pacing is performed according to a reconditioning program in which the duration and frequency of electrode stimulation is gradually increased until full-time diaphragm pacing is achieved. Following a recovery period of a week or so. the diaphragm relaxes and air moves out of the lungs (expiration).com -Diaphragm Pacing [1] References [1] http:/ / www. Mechanism In patients with a diaphragmatic pacemaker. asp?articlekey=22654 . External links • MedicineNet. For the procedure to work. The device works through pacing of the diaphragm. Wires from the electrodes in the diaphragm run to and from a control box worn outside the body. their breathing is helped by setting the respiratory rate by electrical stimulation (pacing) of the phrenic nerve. underwent the procedure in 2003. medterms. It is being tested in patients with injuries that cut across (transect) the cervical spinal cord high in the neck and result in paralysis of all four limbs (tetraplegia) and respiratory failure which require constant mechanical ventilatory support.Diaphragmatic pacemaker 141 Diaphragmatic pacemaker A diaphragmatic pacemaker. diaphragm pacing is initiated. When the nerve is not stimulated. the function of the phrenic nerve must be normal. the diaphragm contracts. com/ script/ main/ art. is a surgically-implanted device used to help patients breathe following complications from spinal cord injuries. who was paralyzed and on a respirator after fracturing his neck in a horseback riding accident. Diaphragm pacing stimulates a normal breath response as follows: when an electrical current is passed through the electrodes. Patients undergo laparoscopic implantation of electrodes in the muscle of the diaphragm and initial electrical stimulation. The pacing is accomplished via electrodes surgically implanted into the diaphragm. Procedure This procedure was approved in Europe under CE mark and the US in 2008. causing air to be sucked into the lungs (inspiration). expanding the chest cavity. It is now done by laparoscopy through small openings in the chest. in medicine. which is controlled by the phrenic nerve. Diaphragm pacing originally required a surgical opening of the chest cavity (thoracotomy) to implant the electrodes. The actor Christopher Reeve.

EABR results are used in the development and refinement of the cochlear implant technology. [1] References [1] http:/ / www. In theory. which originally meant bark but is used in neuroscience for the outer bark-like layer of the brain that is the site of most sophisticated cognitive information processing. IO devices and software systems that would interact with. fcgi?cmd=Retrieve& db=PubMed& list_uids=2307303& dopt=Abstract Exocortex An exocortex is a theoretical artificial external information processing system that would augment a brain's biological high-level cognitive processes. An individual's exocortex would be composed of external memory modules. It was coined in allusion to the neocortex (literally 'new bark'). a person's biological brain. References • Electrically evoked auditory brain stem responses (EABR) and middle latency responses (EMLR) obtained from patients with the nucleus multichannel cochlear implant. making these extensions functionally part of the individual's mind. Thus the terminology suggests a progression from reptilian thought (the older parts of the brain) through human (neocortex) to high-level human or even supra-human cognitive processing capabilities (exocortex). nlm. and augment. spatial reasoning. Neuromancer is a book that has talked about such a scenario. Individuals with significant exocortices would be classified as transhumans. believed to be responsible for the highest human cognitive abilities including conscious thought. which is a brain-computer interface. ncbi. the exocortex would be a computer-like processing system that would co-exist with and enhance the power of the human brain. another interesting concept is the exocortex. . Living Digital provided one description of the concept: While [the traditional concept of] a cyborg has included artificial mechanical limbs embedded chips and devices. meaning external or outside.[1] Etymology The noun exocortex is composed of the Greek-derived prefix exo-. nih. and the Latin noun cortex. the newest part of the mammalian brain (in evolutionary history). Typically this interaction is described as being conducted through a direct brain-computer interface.EABR 142 EABR EABR refers to electrically Evoked Auditory Brain stem Responses in reference to cochlear implants. gov/ entrez/ query. processors. and sensory perception.

March 1960.C.C. One of the tools that shows the greatest immediate promise is the computer. and ideograms to alphabetic languages. At present. October 1962. his personal wearable computer could be considered an exocortex. the seeds were planted by the DARPA associated researcher J. these external symbolic systems have allowed for the . The purposes of this paper are to present the concept and. Licklider outlined his vision that humans and the new technology of computers. from its origins in prehistoric apes to the modern human being. mathematics and now computers. from a functionary perspective. The hope is that. there are no man-computer symbioses. A DARPA contemporary of Licklider. —Man-Computer Symbiosis. calling attention to applicable principles of man-machine engineering. can be viewed as a result of the ever increasing symbiotic coupling between human and computers.Exocortex 143 Specific applications In 1981 Steve Mann designed and built the first general purpose wearable computer. hieroglyphics. to foster the development of man-computer symbiosis by analyzing some problems of interaction between men and computing machines. integrated with new concepts and methods. hopefully. Although he does not refer to it as such. Psychology roots The exocortex concept also has roots in evolutionary psychology as a result of Merlin Donald of Queen's University. and methods that match his basic capabilities to his problems. From this basis. concepts. There are many man-machine systems. in not too many years. Licklider. In 1962. Donald. the concept of an exocortex. if tightly-coupled together.R. A detailed conceptual framework explores the nature of the system composed of the individual and the tools. Donald focuses significant attention on the use that modern humans make of external symbolic storage and manipulation systems—the range of technologies from cuneiforms. J. Later on he became one of the early pioneers in using wearable computers for augmented and computer-mediated reality. when it can be harnessed for direct on-line assistance. Douglas Engelbart. — Augmenting Human Intellect: A Conceptual Framework [3]. Intellectual background The concept of an exocortex has intellectual roots both in the fields of computer science and evolutionary psychology. was thinking along similar lines in the field of computer science.R. proposed an evolutionary model of the mind. and that the resulting partnership will think as no human brain has ever thought and process data in a way not approached by the information-handling machines we know today. human brains and computing machines will be coupled together very tightly. would prove to complement each others strengths to such a degree that many of the pure artificial intelligence systems envisioned at the time by optimistic researchers would prove unnecessary: Man-computer symbiosis is a subclass of man-machine systems. Licklider. Douglas Engelbart. however. Within his speculative 1960 paper Man-Computer Symbiosis. the direct coupling of the human mind with computers to leverage their respective complementary strengths. Running applications like the remembrance agent[2] on his wearable computer enhances his natural mental capabilities. Engelbart authored Augmenting Human Intellect [3] in which he details how to augment human intellectual effectiveness by exploiting the technology of the then emerging computer: This is an initial summary report of a project taking a new and systematic approach to improving the intellectual effectiveness of the individual human being. From Donald's perspective. Computer science roots Within computer science. and pointing out a few questions to which research answers are needed. in the 1990 book Origins of the Modern Mind as well as later papers.

. threads of personality spun right out of their heads to run on the clouds of utility fog – infinitely flexible computing resources as thin as aerogel – in which they live. (emphasis added) —Accelerando. which could result in significant functional reallocation. Charles Stross. isn't it? Right now. Latin -. Stross made use of the term in Elector [6]. Ben Houston. (emphasis in original) —early exocortex definition.an organ that resides outside of the brain that aids in high level thinking. again fits well within this long established trend.. Hamilton's Night's Dawn trilogy also describes in detail similar technological beings. —Precis of Origins of the modern mind. Beginning in 2004. Peter F. has led the adoption of the term exocortex within science fiction circles. . and the form of modern culture. The externalization of memory [via the use of external symbolic storage systems] has altered the actual memory architecture within which humans think.. This will not be a prominent term until prefrontal cortex neural implants become widespread. 2005.Exocortex functional reorganization of the human mind in how it deals with the world.both those composed of computational elements. The Wikibooks Accelerando Technical Companion provides this explanation: An EXOcortex can best be described as the portion of a trans. exocortex (eks'o kor'teks) n.. May 2000 [5].or posthuman entity's brain (or cortex) which exists outside of that entity's primary computing structure. (emphasis added) —Accelerando. a few passages indicate his meaning: About ten billion humans are alive in the solar system. More recently Vinge.. .. Merlin Donald. usually the brain inhabiting a person's 'meatbody. Houston coined the term to refer concisely to tightly-coupled cognition-level brain-computer interface technologies in the spirit of Licklider's and Engelbart's original visions.. 1996. While Stross himself does not provide an explicit definition of the term. Sometimes he isn't certain he's still human. Thus to Donald. the external threads of his consciousness are telling him that they like Annette. 144 Current applicability Cognitive science origin In November 1998 the specific term exocortex was coined by researcher Ben Houston [4]. Charles Stross. too many threads of his consciousness seem to live outside his head. The development of an exocortex. a short story published in the September issue of Asimov's Science Fiction.. each mind surrounded by an exocortex of distributed agents. the Hugo Award-nominated hard science fiction writer. reporting back whenever they find something interesting. the way in which the human brain deploys its resources.. in A Fire Upon the Deep and several short stories.' .. Charles Stross. Stross made more extensive uses the term exocortex and its derivatives in Accelerando [7]. his 2005 novel. and those enabled by high-bandwidth communication between groups of beings. 2005. which is changing the role of biological memory. described the functional effects of what are essentially several kinds of exocortices . Use in science fiction Speculative devices which fit the definition of exocortices were described in hard science fiction long before the term was coined. both published in 1984. examples appear in Neuromancer by William Gibson and in The Peace War by Vernor Vinge. the human mind has long been a hybrid structure built from the vestiges of earlier biological stages and combined with our new external symbolic systems. And it's too early for anyone out there to be trying to hack exocortices..

one can see that computational elements are already used as supporting elements of biological brains. The fulfillment of the initial vision of Licklider and Engelbart suggests that continued development along this path is likely. true exocortices remain speculative. a person's exocortex could very well be composed of all the external memory modules. References [1] [2] [3] [4] [5] [6] [7] [8] http:/ / livingdigitalindia. The term and concept of an exocortex has both been applied (i. ciol. Wikipedia itself is an example. processor.e. html [10] http:/ / swhack. bootstrap. accelerando. googleusercontent. decafbad. and devices that the person's biological brain interacts with on a realtime basis. and [11]. asp http:/ / www. ciol.e. org/ augdocs/ friedewald030402/ augmentinghumanintellect/ ahi62index. com/ blog/ 2005/ 07/ 05/ exocortex-stroke+ suffered+ a+ stroke+ in+ my+ exocortex& cd=1& hl=en& ct=clnk& gl=us& client=firefox-a [9] http:/ / www. thought processing and communication abilities directly into our brains. pl?node_id=457654 http:/ / www. asp [13] http:/ / ieet. asimovs. 2006 issue of the New Scientist: To remain the web’s weavers and not its ensnared victims. org http:/ / webcache. Here are some additional examples of proper contextual usage: [10]. com/ bs/ 2005/ 07/ found-words-exocortex. com/ _issue_0409/ elector. The main issue is that the required underlying technology is yet to be produced by the scientific research fields of (1) cognitive neuroscience. and growing dependence on parts of the Internet that serve cognitive functions has brought what could be considered a proto-exocortex into existence. com/ search?q=cache:z2HF5Cm59pIJ:decafbad. Wikibooks. com/ content/ Feature/ 2006/ 106032004. thereby in effect making those external devices a functional part of the individual's 'mind. wiring greater memory. Future prospects If one widens the definition of an exocortex. everything2. org/ http:/ / www. falsepositives. org/ ben http:/ / www. php/ IEET/ more/ hughes20061116/ .' (emphasis in original) —Accelerando Technical Companion. "Found Words: Exocortex" [9]) by various bloggers. as technological interfaces enable inter-brain co-operation on high-level cognitive tasks. shtml http:/ / www. html http:/ / www. exocortex. Currently. 145 Popular usage While initial recognition of the exocortex concept was nonexistent. com/ logs/ 2005-06-22 [11] http:/ / www. com/ blog/ 2005/ 06/ 23/ quick_mind_interface_thoughts [12] http:/ / livingdigitalindia. this has changed as a result of Charles Stross's recent publications and the growing awareness of brain-computer interfacing. (2) computational neuroscience and (3) neural engineering. James Hughen wrote in an essay entitled "What comes after humans? [13]" that appeared in the Nov 16. remem. The concept has been described in the March 2006 issue of Living Digital [12]. com/ content/ Feature/ 2006/ 106032004. org/ index.Exocortex For example. com/ index. "Suffered a Stroke in my Exocortex" [8]) and noted as a novel interesting word (i. we must merge with our electronic exocortex.

mit. Douglas Engelbart.pl?node_id=457654). The first commercially available FES devices treated foot drop by stimulating the peroneal nerve during gait.lcs. July 2005. Merlin Donald. May 2000. ISBN 0441012841. JCR Licklider. WikiBooks. although FES is also used for treatment of pain. • Elector (http://www. • Exocortex definition (http://www.[1] History FES was initially referred to as Functional Electrotherapy by Liberson.[2] and it wasn't until 1967 that the term Functional Electrical Stimulation was coined by Moe and Post. Charles Stross.bootstrap. pressure.com/_issue_0409/elector.com/index. Ian Irving. FES is primarily used to restore function in people with disabilities.org) novel. • Accelerando (http://www.asimovs. a switch. • Augmenting Human Intellect (http://www. restore hand grasp function in people with quadriplegia. located in the heel end of a user's shoe. In this case. Common Applications Spinal Cord Injury Injuries to the spinal cord interfere with electrical signals between the brain and the muscles.com/bs/2005/07/found-words-exocortex. • Accelerando Technical Companion. stand. 1990. October 1962. Functional electrical stimulation Functional electrical stimulation (FES) is a technique that uses electrical currents to activate nerves innervating extremities affected by paralysis resulting from spinal cord injury (SCI).falsepositives.accelerando. Ben Houston.Exocortex 146 External links • Man-Computer Symbiosis (http://medg. "Electrical stimulation of muscle deprived of nervous control with a view of providing muscular contraction and producing a functionally useful moment".[4] Offner's patent described a system used to treat foot drop.edu/people/psz/Licklider. 2004. sore prevention. would activate a stimulator worn by the user. • Found Words: Exocortex (http://www. 2005.shtml) short story. etc. . resulting in paralysis below the level of injury.[3] and used in a patent entitled. or restore bowel and bladder function. Charles Stross. March 1960. • Origins of the Modern Mind book.html) paper. It is sometimes referred to as Neuromuscular electrical stimulation (NMES). Some examples of FES applications involve the use of Neuroprostheses that allow people with paraplegia to walk.everything2. ISBN 0674644840.html) paper. stroke and other neurological disorders.org/augdocs/friedewald030402/ augmentinghumanintellect/ahi62index. 2005.html) False Positives blog posting. head injury. Restoration of limb function as well as regulation of organ function are the main application of FES.

1967 [4] Offner et al.W. Battery powered FDA approved electrical neuromuscular stimulators have been used in these research projects connected by wires to the pair of right wrist electrodes embedded in a custom made plastic orthosis to localize the stimulation target. Peckham and D.H. 306-12 • Peckham P. Kantor C. P..3 pp:185-188 [2] Liberson (1961) [3] Moe and Post. Claudia et al.344.. By subcortical connections.E. 2.if started within one to two weeks of the severe brain trauma. The advantage of the shorter than expected period of unconsciousness is a quicker start into a neurorehabilitation program to encourage ambulation and talking. the transmitted signals go to Broca's motor/speech planning area (whether the person is right or left-handed. The right median nerve was selected as the electrical portal as there is large cortical representation of that nerve in the dominant left cerebral hemisphere. (1992) “Motor prostheses for restoration of upper extremity function” Ch 8 in Neural Prostheses.792 Further reading • Crago P.. (Jun 1980) “Closed-loop control of force during electrical stimulation of muscle”. R. Vol. Vol. enough to produce contraction of the thumb. Lan N. E-stim can also be used for central nervous system stimulation to hasten awakening from coma or the vegetative state. Stein.. There is a long history of neurosurgeons who have implanted electrodes into the brain and spinal cord. Peckham P.. Functional electrical stimulation (FES) of paraplegics allows paraplegics with complete paralysis due to spinal cord injury at the thoracic level of their spinal cord to walk distances that average 450 meters per walk under some training procedures and 110 meters per walk when undergoing less demanding training.. the right median nerve has been used as a portal to help awaken injured human brains. Dev. (1996) “New control strategies for neuroprosthetic systems”. this RMNS project has spread from the USA East Coast to Central Japan. Mortimer J. No. China. 27. North Carolina (East Carolina University) and shortly after that in Charlottesville. • Crago P. Res..K. Trains of differentiated square electrical pulses at 40 Hz (a frequency for upregulation of the thalamus). and most recently in 2005 to Shanghai.Virginia (University of Virginia).B. 33. Awakening from deep coma from motor vehicle crashes with closed head injury in the Glasgow Coma Scale range of 4-6 can be expected to respond in half of the treated cases after two to four weeks of 8 hours/day electrical treatment. J. especially in Japan.H. No. Replacing Motor Function After Disease or Disability.E. FES for ambulation also shows improvements in blood flow to lower extremities and in other medical and psychological parameters including bone density.H. Certain such patients can walk one mile (1.. 6. the majority are left hemisphere dominant).T. parts of Europe. Keith M.H. Rehab. Other Electrical stimulation for the purpose of helping persons with paralysis of the arms or legs mainly focuses on the neuromuscular transmission peripherally. Abbas J. Veltink P.J. Patent 3.Functional electrical stimulation 147 Stroke FES is commonly used in foot drop neuroprosthetic devices. Popovic . Beginning in 1991 in Greenville.6 km) using that same system. have been applied to the palmar side of the right wrist for transdermal stimulation of the right median nerve at low amplitudes. for increasing cerebral blood flow and certain neurotransmitters in persons in long term coma states. 158-172. IEEE Transactions on Biomedical Engineering. References [1] M. 20 seconds on and 40 seconds off. (1965). Artificial Grasping System for the Paralyzed Hand.B. when using the noninvasive Parastep FES system that received the USA FDA approval in 1994.. International Society for Artificial Organs. Over the last decade.(2000). Vol 24 No.

Montalvo P.S. (1988) “Restoration of functional control by electrical stimulation in the upper extremity of the quadriplegic patient. Med.W. No. Marsolais E. Scherder E. Phys. Green B. Rehab. • Peckham P.G. Neurol. PA.S..B.A.org/ifess98/presentations/IFESS history . 24. Libin A.salisburyfes. Needham-Shropshire B..H. 7-10. 1998 (http://www. Cerrel-Bazo H. pp. 78.uk/information/publications/ factsheets/fes.B (2005) "Electrical treatment of reduced consciousness: experience with coma and Alzheimer's disease. Lewohl N.H. • Cooper E. • Graupe D.T. Vol.09/brainshock. Vol.org. Philadelphia.A.org/) • History of Functional Electrical Stimulation.edu/) • Back From the Dead.G.A (1997) "Evaluation of a training program for persons with SCI paraplegia using the Parastep-I ambulation system... Part 5: Lower extremity blood flow and hypermic responses to occlusion are augmented by ambulation training".. (1997) "Evaluation of a training program for persons with SCI paraplegia using the Parastep-I ambulation system.. 808-814..ifess. Carraro U. Medical Outcomes and Patient Training in FES of Innervated Muscles for Ambulation by Thoracic-Level Complete Paraplegics".. (2008).M. Part 1: Ambulation performance and anthropometric measures".Vol. Green B.J." Neuropsyh Rehab (UK). Arch. Needham-Shropshire B. Keith M. Wired Magazine (http://www.Vol.L.com/wired/archive/14. • Graupe D.ifess.. 78. 148 External links • International Functional Electrical Stimulation Society (http://www.B. Paper 205. Vol. Kern H. Ljunberg I. 70-A. 12th Annual Conf. (2007) " Preserving bone health after acute spinal cord injury: Differential responses to a neuromuscular electrical stimulation intervention". Vol. "Walking Performance. Bone Joint Surgery. Vol.B.& Cooper J..S. 31..mstrust. Nash M.B.389-405. Research. Arch.Functional electrical stimulation Editors.A. 5. Jacobs P. Guest J. Freehafer A. (1980) “Restoration of key grip and release in the C6 tetraplegic patient through functional electrical stimulation”. Session 2. • Cooper E. Klose K. 15.PPT95_files/frame. 5.jsp) . Med.. • Lichy A...htm) • Cleveland FES Center (http://fescenter. 144-148 • Peckham P.wired.. (2002) "An overview of the state of the art of noninvasive FES for independent ambulation by thoracic level paraplegics" Neurological Research. 462-9. Proc.. 87. Broton J.B. J Hand Surg [Am].... 789-793." Acta Neurochirurg Supp. R. Mortimer J... Groach L.J.. of the International FES Soc.. Phys.com/) • Functional electrical stimulation (FES) factsheet (http://www.. Jacobs P.L.” J. • Nash M.M. Rehab. Cooper J. Guest..case. 431-442. (2003) "Electrical treatment of coma via the median nerve.html) • UK National Clinical FES Centre (http://www.. Vol.J. 123–130. • Klose K.

then the rhythm is most likely not ventricular in origin. ATP is only effective if the underlying rhythm is ventricular tachycardia.Implantable cardioverter-defibrillator 149 Implantable cardioverter-defibrillator An implantable cardioverter-defibrillator (ICD) is a small battery-powered electrical impulse generator which is implanted in patients who are at risk of sudden cardiac death due to ventricular fibrillation and ventricular tachycardia. The most recent development is the subcutaneous ICD (S-ICD). ventricular tachycardia. In current variants. overdrive pacing. to try to break the tachycardia before it progresses to ventricular fibrillation. If this is the case. the ICD does not provide any therapy. If the rate in the atria is faster than or equal to the rate in the ventricles. and is never effective if the rhythm is ventricular fibrillation. and may try to pace the heart faster than its intrinsic rate in the case of VT. or ventricular fibrillation. The difference is that pacemakers are more often temporary and generally designed to consistently correct bradycardia. by way of an electrical shock. Similar to pacemakers. A study of 300 patients is in progress for US approvals. . usually being lodged in the apex of the right ventricle. these devices typically include electrode wire(s) which pass through a vein to the right chambers of the heart. Many modern ICDs use a combination of various methods to determine if a fast rhythm is normal. This prevents lead-related problems and the risk of dangerous infections in or near the heart. or anti-tachycardia pacing (ATP). This ICD is positioned just under the skin and outside the ribcage. Rate discrimination evaluates the rate of the lower chambers of the heart (the ventricles) and compares it to the rate in the upper chambers of the heart (the atria). The device is programmed to detect cardiac arrhythmia and correct it by delivering a jolt of electricity. without the need for a lead in or on the heart. It can be placed during a minor [1] procedure under conscious sedation. Working mechanism ICDs constantly monitor the rate and rhythm of the heart and can deliver therapies. the ability to revert ventricular fibrillation has been extended to include both atrial and ventricular arrhythmias as well as the ability to perform biventricular pacing in patients with congestive heart failure or bradycardia. Guidant ICD Implantation The process of implantation of an ICD is similar to implantation of a pacemaker. while ICDs are often permanent safeguards against sudden abnormalities. More modern devices can distinguish between ventricular fibrillation and ventricular tachycardia (VT). when the electrical manifestations of the heart activity exceeds the preset number. and is usually more benign. Current state-of-the-art electronics and batteries have enabled an implantable device to deliver enough energy to defibrillate the heart Automatic implantable cardioverter defibrillator. This is known as fast-pacing.

This normal ventricular impulse is often an average of a multiple of beats of the patient taken in the recent past. If the rhythm is irregular. On July 21. stated in the journal Circulation . There was doubt that their ideas would ever become a clinical reality. The problems to be overcome were the design of a system which would allow detection of ventricular fibrillation or ventricular tachycardia. In fact. Internal cardioverter defibrillators have also been used twice in dogs to prevent sudden death from arrhythmia. The patient was a Boxer dog with life threatening arrhythmias from arrhythmogenic right ventricular cardiomyopathy. a second ICD was implanted in a 6-month-old German Shepherd dog with inherited ventricular arrhythmias. In 1972 Bernard Lown. Despite the lack of financial backing and grants. 2008. Levi Watkins. These were then called implantable cardioverters. The first defibrillator was implanted at Washington State University by a team of cardiologists led by Dr Lynne Johnson in 2003. the inventor of the external defibrillator. Jr. such as atrial fibrillation. Modern ICDs do not require a thoracotomy and possess pacing. and defibrillation capabilities. Mirowski teamed up with Mower and Staewen and together they commenced their research in 1969 but it was 11 years before they treated their first patient. Similar developmental work was carried out almost coincidentally by Schuder and colleagues at the University of Missouri. So far.Implantable cardioverter-defibrillator Rhythm discrimination will see how regular a ventricular tachycardia is. and [2] cardioverter-defibrillator back to the patient's baseline cardiac rhythm. converting the rhythm to sinus rhythm. Morton Mower. an inherited disease. Generally. 150 History The development of the ICD was pioneered at Sinai Hospital in Baltimore by a team including Michel Lead II electrocardiogram showing Torsades being shocked by an implantable Mirowski. William Staewen. The 5-hour long surgery took place at Louisiana State University and was led by Dr Romain Pariaut. it is usually due to conduction of an irregular rhythm that originates in the atria. cardioversion. . ventricular tachycardia is regular. the implanted defibrillator system represents an imperfect solution in search of a plausible and practical application". Morphology discrimination checks the morphology of every ventricular beat and compares it to what the ICD believes is a normally conducted ventricular impulse for the patient. they persisted and the first device was implanted in February 1980 at Johns Hopkins Hospital by Dr."The very rare patient who has frequent bouts of ventricular fibrillation is best treated in a coronary care unit and is better served by an effective antiarrhythmic program or surgical correction of inadequate coronary blood flow or ventricular malfunction. Improved versions were programmed to be able to detect ventricular tachycardia. these pets are the only two client-owned dogs that have received such a high-tech treatment. often a forerunner of ventricular fibrillation. More than a decade of research went into the development of an implantable defibrillator that would automatically sense the onset of ventricular fibrillation and deliver an electric countershock within 15–20 seconds. The work was commenced against much skepticism even by leading experts in the field of arrhythmias and sudden death.

arm and torso area where the ICD is implanted. including the experience of anxiety. an ICD is a contraindication to the use of magnetic resonance imaging. Doing so may damage the ICD or the leads going from the unit to the patient's heart. Physical activities Almost all forms of physical activities can be performed by patients with an ICD. As with a pacemaker. Most electronic equipment such as cellphones. This phenomenon may be related. all electronic equipment is safe to use for patients with an ICD if kept at relative small distance from the unit. Anxiety is a common psychological side effect with approximately 13-38% [7] [8] The primary etiological factors contributing to anxiety of ICD patients reporting clinically significant anxiety. between ICD treated and medication-treated groups at 30 months in patient reported QoL. living with an ICD does impose some restrictions on the person's lifestyle. Both the magnetic fields and the EMI (Electromagnetic Interference) in an MRI scanner can interfere with the correct working of the ICD. largest study of examined 2.[3] Researchers including those from the field of cardiac psychology have concluded that the QoL of ICD patients is at least equal to.521 patients with stable heart failure in the showing the ICD generator in the upper left chest SCD-HeFT trial. among spouses or other romantic partners are also prevalent[9] . Devices that generate radio waves or radio interference should be kept at least 15 centimetres (6 in) from the ICD.Implantable cardioverter-defibrillator 151 Living with an ICD People that have an implanted cardioverter-defibrillator can live full and happy lives.[4] The A normal chest X-ray after placement of an ICD.[11] Electronic equipment used in a professional environment or equipment using large magnets or generating magnetic fields must be avoided by patients with an ICD. in ICD patients has not been determined. Quality of Life Implantable cardioverter defibrillators have demonstrated clear life-saving benefits but concerns about patient acceptance and psychological adjustment to the ICD have been the focus of much research. to shared shock anxiety and avoidance of physical and sexual contact [10] .[6] Psychological adjustment following ICD implantation has also been well-studied.[8] Problems in psychosocial adjustment to ICDs. Note the 2 opaque coils along the ICD lead. or better than those taking anti-arrhythmic medications. All forms of sports that do not pose a risk of damaging the ICD can be enjoyed by the patient.[12] .[5] Results indicated that there were no differences and the ICD lead in the right ventricle of the heart. at least in part. Depressive symptoms are also common but incidence of these problems have shown to be similar to those observed in other cardiac patient groups with approximately 24-41% of patients with ICDs experiencing depressive symptoms. Special care should be placed not to put excessive strain on the shoulder. Experiments are on the way for solving this kind of problem. Usually the ICD improves the living conditions of a patient significantly. As with other metallic objects. For example Medtronic showed interesting results with a pacemaker. however. Electronic equipment As a general rule.

Sears SF. et al. J Cardiovasc Electrophysiol 2009. J Cardiovasc Electrophysiol 2005. Measuring patient acceptance of implantable cardiac device therapy: initial psychometric investigation of the Florida Patient Acceptance Survey. Retrieved 13 May 2010. Retrieved 2007-07-29. Sears SF. nejm.20(11):1297-304 [5] Bardy. Examining the psychosocial impact of implantable cardioverter defibrillators: a literature review. com/ your-health/ heart-failure/ living-with-a-device/ questions-answers/ index. The device was attached via subcutaneous and transvenous leads to the device contained in a subcutaneous abdominal wall pocket. medtronic. Effective management of ICD patient psychosocial issues and patient critical events. .[15] Notes [1] Bardy. et al: Standby automatic defibrillator: An approach to prevention of sudden coronary death. Anstrom KJ. Kuhl EA. The SCD-HeFT trial (published in 2005) showed a significant all-cause mortality benefit for patients with ICD. doi:PMID: 20463331. In 2002 the MADITII trial showed benefit of ICD treatment in patients after myocardial infarction with reduced left ventricular function (EF<30).[14] An accompanying editorial by Dr. 2005 [6] Mark DB. Shea JB. Sexual health for patients with an Implantable Cardioverter Defibrillator. 2006 Jun. New England Journal of Medicine.060730. Sun JL. Canadian Medical Association Journal 177 (1): 49. Pacing Clin Electrophysiol. Lee. geographic.1503/cmaj. Douglas S.16:384-390. Hood. Circulation 2010.1503/cmaj. Conti JB. Arch Intern Med 126:158-161. Intravascular spring or coil electrodes are used to defibrillate. Sears SF. social and political reasons for this.9 mm thick. Ozben B. nih. cmaj. Sotile W. N Engl J Med 2008. Congestive heart failure patients that were implanted with an ICD had an all-cause death risk 23% lower than placebo and an absolute decrease in mortality of 7. Anxiety and marital adjustment in patients with Implantable Cardioverter Defibrillator and their spouses. Helen. Katherine. Tang. Lewis TS. Vasquez PM. Lemery. Green. Anthony SL (July 2007). Davidson-Ray L. "Use of implantable cardioverter defibrillators in Canadian and IS survivors of out-of-hospital cardiac arrest" (http:/ / www. PMC 1896028. Matchett M. Canadian Medical Association Journal 177 (1): 41. Walker RL.29(6):619-26 [8] Sears SF. Current ICDs weigh only 70 grams and are about 12. PMID 17606938. Lee KL. [15] Simpson. PMC 1896034. The device itself acts as an electrode. Mark et al.1 Reporting in 1999. Michael H. 1970 [3] Burns JL. A recent study by Birnie et al. Quality of life with defibrillator therapy or amiodarone in heart failure. Tsiatis AA. "An Entirely Subcutaneous Implantable Cardioverter–Defibrillator" (http:/ / content. Serber ER. Retrieved 2007-07-29. Martin S. . al. nlm. htm#question7) [12] http:/ / wwwp. org/ cgi/ content/ full/ NEJMoa0909545). Gust H. ca/ cgi/ reprint/ 177/ 1/ 41). gov/ entrez/ query. Depression and anxiety status of patients with implantable cardioverter defibrillator and precipitating factors. fcgi?cmd=Retrieve& db=pubmed& dopt=Abstract& list_uids=10551706& query_hl=5 [14] Birnie.. Bardy GH. (May 2010). ca/ cgi/ reprint/ 177/ 1/ 49). Initially ICDs were implanted via thoracotomy with defibrillator patches applied to the epicardium or pericardium. David H.Implantable cardioverter-defibrillator 152 Clinical trials A number of clinical trials have demonstrated the superiority of the ICD over AAD (antiarrhythmic drugs) in the prevention of death from malignant arrhythmias. Clapp-Channing NE. Jr. doi:10. Clin Cardiol 1999. do?itemId=1242305667391& format=print& lang=en_US [13] http:/ / www. [4] Sears S. and deaths in those treated with AAD were more frequent (n=122) compared with deaths in the ICD groups (n=80. 359(10):999-1008 [7] Bilge AK. Williams. PMID 17606939. ncbi. Sambell. The devices have become smaller and less invasive as the technology advances. p < 0. Gollob. Conti JB.so why aren't we using them?" (http:/ / www. "Implantable cardioverter defibrillators work . Demircan S. Conti J. . Lee. the Antiarrhythmics Versus Implantable Defibrillators (AVID) trial consisted of 1. Journal of Cardiopulmonary Rehabilitation and Prevention 2007. Staewen WS. . at the University of Ottawa Heart Institute has demonstrated that ICDs are underused in both the United States and Canada. Crozier et.2 percentage points after five years in the overall population.. cmaj..070470. Christopher S (July 2007). [2] Mirowski M. com/ Newsroom/ NewsReleaseDetails.27:46-49 [10] Vasquez LD.001)[13]. doi:10. Most ICDs nowadays are implanted transvenously with the devices placed in the left pectoral region similar to pacemakers. Christie.122:465-467 [11] Medtronic Patient Website FAQ: Can magnets affect my device? (http:/ / www. medtronic. Robert. Smith.22:481-489 [9] Vasquez-Sowell L. Todaro JF. Chris Simpson of Queen's University explores some of the economic.016 patients. Mower MM. Johansen. Keim S.

D.ecu. N Engl J Med 2008. et al. Lewis TS. Focus on ICD (http://www. Lee KL. Pacing Clin Electrophysiol. Conti J. Hayes D. Sears. Internal Medicine. aspx) . Conti JB. Demircan S. Davidson-Ray L.uk/html/icds. Full text (http://circ. Effective management of ICD patient psychosocial issues and patient critical events.20(11):1297-304. et al.org.29(6):619-26. Jr. East Carolina University. Epstein A. ecu. Sun JL. 359(10):999-1008. Mark DB. Clin Cardiol 1999. Anstrom KJ. Circulation 110 (25): 3866–9. External links • A Defibrillator in Action (http://www. 2009.org/cgi/content/full/110/25/3866) • Kumar and Clarke.Implantable cardioverter-defibrillator 153 References • Bardy GH. for the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. • Bilge AK.html) from the charity Arrhythmia Alliance • East Carolina Heart Institute at ECU.16:384-390. Ellenbogen K.. Serber ER.edu/cs-cas/psyc/searss) • Video.org/cvcenter/videos/SuccessfulLivingICD. N Engl J Med 2005.22:481-489. PMID 15611390. Cardiac Psychology. Quality of life with defibrillator therapy or amiodarone in heart failure.com/forum/topics/a-defibrillator-in-action) • Information on ICDs (http://www.org/cgi/content/abstract/352/3/225) • Stevenson W. Sotile W.ecu. Clapp-Channing NE. Lee KL. Cardiac Psychology Lab.. Todaro JF.. 352:225-237 (http://content. Strickberger S.03295. 2006 Jun.brighamandwomens. Jr. Coping with an ICD (http://www.nejm.CIR. Bardy GH. Ozben B. J Cardiovasc Electrophysiol 2009. Depression and anxiety status of patients with implantable cardioverter defibrillator and precipitating factors.0000149716.ahajournals.edu/cs-cas/ psyc/cardiacpsychology) • Samuel F.7C. • Sears S (http://www.1161/01. Examining the psychosocial impact of implantable cardioverter defibrillators: a literature review. Measuring patient acceptance of implantable cardiac device therapy: initial psychometric investigation of the Florida Patient Acceptance Survey. • Burns JL. Chaitman B. • Sears SF. Gross W.aral.doctorshangout. J Cardiovasc Electrophysiol 2005. • Mark DB. Tsiatis AA. doi:10. ICD QoL Specialist (http://www.edu/cs-cas/psyc/searss/). Matchett M. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. "Clinical assessment and management of patients with implanted cardioverter-defibrillators presenting to nonelectrophysiologists". Ph. Sweeney M (2004). Sears SF. Keim S.

[2] http:/ / medgadget. co. However early evidence suggests that it cannot produce the same reduction in excess weight loss as Bariatric surgery such as Roux-en-Y or Laproscopic Adjustable Gastric Banding (Lap Band) Although less risky than surgical procedrues such as a gastric band or gastric bypass. specifically vagus nerve a gastric pace maker mimics the feeling of satiety to the brain. By stimulating this nervous system. This device is implanted using laproscopic surgery. The second technique is based on the fact that enteric nervous system carries signals to the brain that indicate the state of satiety. womenrepublic. html http://www. The purpose of both techniques is to increase the duration of satiety and there by making the patient consume less intake. These devices are aimed at obesity management.Implantable Gastric Stimulation 154 Implantable Gastric Stimulation Implantable Gastric Stimulation (IGS) is a pacemaker like device.aetna. This device works on either or both of the following principles. 1) Disruption of motility cycle 2) Stimulation of Enteric nervous system. htm). and dislodgement of the device head. com/ archives/ 2005/ 07/ the_transcend_i. perforation of the stomach. although not found as effective works on keeping the food longer in the stomach by disrupting the natural motility cycle of stomach and there by continuing the satiety.[1] Medtronic which makes heart pacemakers.com/cpb/medical/data/600_699/0678. There are also some efforts to implant this device endoscopically avoiding surgery. These techniques can be referred to as gastric pacing.html . uk/ diet_fitness/ surgery/ stimulation. The Transcend Implantable Gastric Stimulator (IGS) (med gadget) [2] References [1] "Gastric stimulation risks" (http:/ / www. . the treatment can still have complications including pulmonary embolism. It is a technology that is still in the beginning phase and being tested in Europe and Canada and shows great promise. The first technique. where the pacemaker electrical leads are attached by a surgeon to the surface of the stomach. is developing this treatment.

artificial heart valves are in common use with artificial hearts and lungs seeing less common use but under active technology development. and nervous systems to assist or enhance motor control lost by trauma. but only a prosthetic part. disease.Intracortical visual prosthesis 155 Intracortical visual prosthesis To develop a visual prostheses system by electrical stimulation of the visual cortex has been a goal of researchers for the last four decades. Inside the body. Chicago.usually a "socket". The results from experiments performed in the past provide the motivation for advancing the field towards a more sophisticated and practical system. from a programming standpoint. . psychophysical behavior and any long-term changes observed in the individual subject’s response. It is part of the field of biomechatronics. a C-Leg knee alone is not a prosthesis. prosthetic. are using the experience gained from the past experiments and the recent advancements in video-camera and electronic technology for developing a practical system which will be light in weight with low power consumption and contain enough flexibility. Illinois Institute of Technology. process it and then deliver the corresponding signals to an implanted chip which in turn will stimulate the intracortically implanted electrodes. For instance. Prostheses are typically used to replace parts lost by injury (traumatic) or missing from birth (congenital) or to supplement defective body parts. artificial eyes. although given certain circumstances a prosthetic might end up performing some or all of the same functionary benefits as an orthotic. Other medical devices and aids that can be considered prosthetics include hearing aids. and dentures. a prosthesis. This system will capture the image in real time. gastric bands. Keep this in mind as often nomenclature is interchanged. or prosthetic limb (Greek: πρόσθεσις "addition") is an artificial device extension that replaces a missing body part. to adapt to different subjects’ visuotopic mappings. Prostheses (or "A" prosthesis) are technically the complete finished item. Researchers at Laboratory of Neural Prosthesis. palatal obturator. the science of using mechanical devices with human muscle. Prosthetics are specifically not orthotics. skeleton. or defect. The complete prosthesis would consist of the stump attachment system . The long-term objective of this research is to develop a continuously wearable intracortical visual prosthesis device. and all the attachment hardware parts all the way down to and including the foot. Prosthesis In medicine. A man with two prosthetic arms playing table football.

A new method of ankle amputation that did not involve amputating at the thigh. A famous and quite refined[4] historical prosthetic arm was that of Götz von Berlichingen. Gotz von Berlichingen. François de la Noue is also reported to have had an iron hand. and multi-articulated foot. During the Renaissance. a steel knee joint and an articulated foot that was controlled by catgut tendons from the knee to the ankle. They hold an international conference every three years and publish their own technical journal. and sign his name. in the 17th century. Around the same time. developed a pair of iron hands that could be moved by relaxing a series of releases and springs. American Academy of Orthotics and Prosthetics – These three groups work together to take responsibility for the academic side of orthotics and prosthetics and provide certification of individuals and facilities working with orthotics and prosthetics.First nonlocking below-knee (BK) prosthesis. the NAS (National Academy of Sciences) began to advocate better research and development of prosthetics. The functionality of his advancements showed what future prosthetics would function. Came to be known as “Anglesey Leg” or “Selpho Leg. prosthetics remained quite basic in form. prosthetics also underwent a rebirth. who tells the story of a Hegistratus. . • The International Society for Prosthetics and Orthotics – Founded in 1970 and headquartered in Copenhagen. Prosthetics development using iron. and knee lock control. Among his inventions was an above-knee device that was a kneeling peg leg and foot prosthesis that had a fixed position. Roman bronze crowns have also been found. Added an anterior spring and concealed tendons to simulate natural-looking movement. but their use could have been more aesthetic than medical. Improvement in amputation surgery and prosthetic design came at the hands of Ambroise Paré. The earliest recorded mention is the warrior queen Vishpala in the Rigveda. a research and development program was developed within the Army.Prosthesis made of a wooden shank and socket. a Persian soldier. Record written by an Italian surgeon also notes the existence of amputee who had an arm that allowed him to remove his hat.[3] Another early recorded mention of a prosthetic was done by the historian Herodotus. and wood started. • Marcel Desoutter & Charles Desoutter – First aluminum prosthesis [6] At the end of World War II. • Dubois Parmlee – Created prosthetic with a suction socket. Pliny the Elder also recorded that a Roman general Prosthetic toe from ancient Egypt who had his arm cut off had an iron one made to hold his shield up when he returned to battle. polycentric knee. a German mercenary. Only the wealthy were able to afford anything that would assist in daily function. Air Force. this association helps with the progression in research and clinical practice worldwide. copper. American Board for Certification in Prosthetics and Orthotics. • Benjamin Palmer . Through government funding.” • Sir James Syme . such as a wooden toe found on a body from the New Kingdom[2] . who cut off his own foot to escape his captors and replaced it with a wooden one.[5] During the Dark Ages. as is.Prosthesis 156 History Prosthetics have been mentioned throughout history.[1] . Functional prosthetics began to make an appearance in the 1500s. • James Potts .Improved upon the Selpho leg. steel. Debilitated knights would be fitted with prosthetics so they could be fitted with a shield. The following organizations have been created to help and inform the general publics about prosthetics: • American Orthotics and Prosthetic Association. Other major improvements before the modern era: • Pieter Verduyn . open his purse. René-Robert Cavalier de la Salle. Navy. adjustable harness. made in the beginning of the 16th century. Egyptians were early pioneers of the idea. and the Veterans Administration.

Sabolich's design held the patient's limb like a glove.trans-femoral (any amputation transecting the femur bone or a congenital anomaly resulting in a femural deficiency). Advocate the improvement of amputee lifestyle through education and also have their own publication. walking down stairs. the Adaptive Prosthesis. Knee disarticulations . This was the first instance of ischial containment and led to an extreme advancement in patient accomplishment.This is an ankle disarticulation while preserving the heel pad. locking it into place and distributing the weight evenly over the existing limb as well as the bone structure of the patient.. 157 Lower extremity prosthetics Lower extremity prosthetics describes artificially replaced limbs located at the hip level or lower. and a microprocessor to provide the amputee with a gait that was more responsive to changes in walking speed. Symes . sense of feel technology. modern plastic and bio elastic sockets.[9] . Prior. In the prosthetic industry a trans-tibial prosthetic leg is often referred to as a "BK" or below the knee prosthesis while the trans-femoral prosthetic leg is often referred to as an "AK" or above the knee prosthesis.This usually refers to when an amputee or congenitally challenged patient has either an amputation or anomaly at or in close proximity to the hip joint. 3. Other. The Adaptive Prosthesis utilized hydraulic controls.. in 1993 and made walking with the prosthesis feel and look more natural.Prosthesis • Association of Children’s Orthotic-Prosthetic Clinics – The organization was started in 1950s to advocate research and development of children’s prosthetics.This usually refers to an amputation through the knee disarticulating the femur from the tibia. John Sabolich C.trans-tibial (any amputation transecting the tibia bone or a congenital anomaly resulting in a tibial deficiency) and 2. The advancement was due to the difference in the socket to patient contact model. 2. less prevalent lower extremity cases include the following: 1. Because of Sabolich's dedication to research and development in lower extremity prosthetics. Blatchford & Sons.P. pneumatic controls. Ltd. of Great Britain. Sabolich Prosthetics saw the first above the knee prosthetic patients walk and run step over step with both one leg and two legs missing. invented the Contoured Adducted Trochanteric-Controlled Alignment Method (CATCAM) socket. The first microprocessor-controlled prosthetic knees became available in the early 1990s. suction sockets. Blatchford released another prosthesis. • Amputee Coalition of America – The organization was created in 1990 to improve the lives of amputees. The two main subcategories of lower extremity prosthetic devices are 1. and numerous other inventions in the prosthetic field. sockets were made in the shape of a square bucket with no specialized containment for either the patient's bony prominences' or muscular tissue.[8] An improved version was released in 1995 by the name Intelligent Prosthesis Plus. It was released by Chas. inMotion. in 1998. The Intelligent Prosthesis was first commercially available microprocessor controlled prosthetic knee. Lower extremity modern history Socket technology for lower extremity limbs saw a revolution of advancement during the 1980s when Sabolich [7] Prosthetics. They meet annually and have their own publication.O. A. Hip disarticulations . later to evolve into the Sabolich Socket.

which adjusts to these changes accordingly.[9] The microprocessor receives signals from its sensors to determine the type of motion being employed by the amputee.[10] Other microprocessor-controlled knee prostheses include Ossur's Rheo Knee. A charging port located on the front of the knee joint can be connected to a charging cable plugged directly into a standard outlet. the Plié Knee from Freedom Innovations[11] and DAW Industries’ Self Learning Knee (SLK). The C-Leg uses a knee-angle sensor to measure the angular position and angular velocity of the flexing joint. but has continued to be applied to all Otto Bock microprocessor-controlled knee prostheses.[16] However. a Canadian engineer. This information allows the user to make better use of the prosthetic. and amputees should seek help while becoming familiar with the [10] system to avoid injury. introduced in 2006. the Power Knee by Ossur. The C-Leg allows amputees to walk at near walking speed. Variations in speed are also possible and are taken into account by sensors and communicated to the microprocessor. The charger cord has lights that allow the user to observe the level of charge when connected to the knee. at the University of Alberta.Prosthesis C-Leg knee prosthesis The Otto Bock Orthopedic Industry introduced the C-Leg during the World Congress on Orthopedics in Nuremberg in 1997. depending on the intensity of use. rather than the one step at a time approach used with mechanical knees. from the foot. The C-Leg functions through various technological devices incorporated into the components of the prosthesis. Small valves control the amount of hydraulic fluid that can pass into and out of the cylinder. The C-Leg is susceptible to water damage and thus great care must be taken to ensure that the prosthesis remains dry. C-Leg is an abbreviation of 3C100. Otto Bock recommends that each amputee use the C-Leg for up to two months before the system can fully become accustomed to the individual’s unique gait.[10] The C-Leg’s ability to respond to sensor readings can 158 help amputees recover from stumbles without the knee buckling.[15] A "pigtail" charging port adapter permits the relocation of the charging port to a location more accessible when the prosthesis has a cosmetic cover applied. the C-leg can operate for up to 45 hours. thus regulating the extension and compression of a piston connected to the upper section of the knee.[13] The C-Leg uses hydraulic cylinders to control the flexing of the knee. The C-Leg provides certain advantages over conventional mechanical knee prostheses. the C-Leg has some significant drawbacks that impair its use. The company began marketing the C-Leg in the United States in 1999.[12] The idea was originally developed by Kelly James. and the magnitude of that force.[14] The C-Leg is powered by a lithium-ion battery housed inside the prosthesis below the knee joint. Sensors send signals to the Two different models of the C-Leg prosthesis microprocessor that analyzes these signals. The knee-angle sensor is [14] located directly at the axis of rotation of the knee. Moment sensors are located in the tube adapter at the base of the C-Leg. (cell is actually located within the axis of the joint) On a full charge. The microprocessor then signals the hydraulic cylinder to act accordingly. It also enables the amputees to walk down stairs with a step-over-step approach. . A 12 volt car charger adapter can also be purchased. Measurements are taken up to fifty times a second. It provides an approximation to an amputee’s natural gait. Becoming accustomed to the C-Leg is especially difficult when walking downhill. and communicates what resistance the hydraulic cylinders should supply. These moment sensors use multiple strain gauges to determine where the force is being applied to the knee. The microprocessor also records information concerning the motion of the amputee that can be downloaded onto a computer and analyzed. the model number of the original prosthesis. released in 2005.[14] The C-Leg controls the resistance to rotation and extension of the knee using a hydraulic cylinder.

Cosmesis Cosmetic prosthesis has long been used to disguise injuries and disfigurements. which can be made to match a person's skin tone but not details such as freckles or wrinkles. depending on the level of detail). cosmesis... It sends intention commands from the user to the actuators of the device. One type of these biosensors are employed in myoelectric prosthesis. such as bikers and rollerbladers may find the C-Leg suited to their needs.[17] 159 Robotic prostheses In order for a robotic prosthetic limb to work. and Alzheimer's disease. needle electrodes implanted in muscle. it must have several components to integrate it into the body's function: Biosensors detect signals from the user's nervous or muscular systems. some people are more suited to this prosthesis than others. The amputee must have satisfactory cardiovascular and pulmonary health. Examples include wires that detect electrical activity on the skin. and processes feedback from the limb and actuator (e. limb position. Custom-made cosmeses are generally more expensive (costing thousands of US dollars.[17] The prosthesis is recommended for amputees that vary their walking speeds and can reach over 3 miles per hour. position. applied force. or amputation above the knee. hair. such as artificial hands. it cannot be used for running. veins. The controller is also responsible for the monitoring and control of the movements of the device. using an adhesive. slopes. An actuator mimics the actions of a muscle in producing force and movement. language. however. In the case of bilateral amputations. and interprets feedback from the mechanical and biosensors to the user. With advances in modern technology. and memory. Scheduling devices such as Neuropage [20] remind users . stretchable skin. The C-Leg is practical for upwards of 3 miles daily. while standard cosmeses come ready-made in various sizes. and can be used on uneven ground. Cognition Unlike neuromotor prostheses. the creation of lifelike limbs made from silicone or PVC has been made possible. It then relays this information to a controller located inside the device. autism.[18] The recent field of Assistive Technology for Cognition [19] concerns the development of technologies to augment human cognition. Examples include a motor that aids or replaces original muscle tissue. attention. can now be made to mimic the appearance of real hands. suction. those who have undergone hip disarticulation amputations can be candidates for a C-Leg. Such prosthetics. Cosmeses are attached to the body in any number of ways. The balance and strength of the amputee must be sufficient to take strides while using prosthesis. The C-Leg is designed to support amputees weighing up to 275 pounds. Examples include force meters and accelerometers. or solid-state electrode arrays with nerves growing through them. Certain physical requirements must be met for C-Leg use. fingerprints and even tattoos. however. The controller is connected to the user's nerve and muscular systems and the device itself.g.g. the application of C-Legs must be closely monitored. traumatic brain injury. No neurocognitive prostheses are currently available but the development of implantable neurocognitive brain-computer interfaces has been proposed to help treat conditions such as stroke. or a skin sleeve. The C-Leg can be used by amputees with either single or bilateral limb amputations. load) and relay this information to the biosensor or controller. form-fitting. cerebral palsy. Mechanical sensors process aspects affecting the device (e. or stairs. neurocognitive prostheses would sense or modulate neural function in order to physically reconstitute or augment cognitive processes such as executive function.Prosthesis A wide range of amputees can make use of the C-Leg. force) and sends it to the controller. Another option is the custom-made silicone cover. complete with freckles. although they are often not as realistic as their custom-made counterparts. In some cases. Active amputees. The C-Leg is designed for use on people who have undergone transfemoral amputation.

The first experiment with a healthy individual appears to have been that by the British scientist Kevin Warwick.[24] In 2008. Oscar Pistorius. In 2002. an implant was interfaced directly into Warwick's nervous system. The electrode array.[23] In early 2008. and others can be replaced. Oscar Pistorius was briefly ruled ineligible for the 2008 Summer Olympics due to an alleged mechanical advantage over runners who have ankles. and has been ruled eligible to qualify for any future Olympics. feet. The morality and desirability of such technologies are being debated. which contained around a hundred electrodes. such as visiting the doctor. Pistorius did not qualify for the South African team for the Olympics. within the scientific community. arms. but went on to sweep the 2008 Summer Paralympics. the "Blade Runner" of South Africa. there has been consideration given to using advanced prostheses to replace healthy body parts with artificial mechanisms and systems to improve function. Micro-prompting devices such as PEAT. was briefly ruled ineligible to compete in the 2008 Summer Olympics because his prosthetic limbs were said to give him an unfair advantage over runners who had ankles. and. many amputees or congenital patients have special limbs and devices to aid in the participation of sports and recreational activities. with the appellate court stating that the overall set of advantages and disadvantages of Pistorius' limbs had not been considered. One researcher found that his limbs used twenty-five percent less energy than those of an able-bodied runner moving at the same speed. This ruling was overturned on appeal. Body parts such as legs. more recently. . The "Luke arm" is an advanced prosthesis currently under trials as of 2008. hands. was placed in the median nerve. AbleLink [21] and Guide [22] have been used to aid users with memory and executive function problems perform activities of daily living. 160 Prosthetic enhancement In addition to the standard artificial limb for everyday use.Prosthesis with memory impairments when to perform certain activities. Within science fiction. The signals produced were detailed enough that a robot arm was able to mimic the actions of Warwick's own arm and provide a form of touch feedback again via the implant.

a transfemoral A United States Marine with bilateral prosthetic amputee must use approximately 80% more energy to walk than a [25] legs leads a formation run. due in large part to retaining the knee. Transtibial prosthesis A transtibial prosthesis is an artificial limb that replaces a leg missing below the knee. via electrodes. . and transhumeral prostheses. These work by sensing. In the prosthetic industry a trans-femoral prosthetic leg is often referred to as an "AK" or above the knee prosthesis. transradial. motors. after employing hydraulics. when the muscles in the upper arm moves. The other form of prosthetics available are myoelectric arms. Transtibial amputees are usually able to regain normal movement more readily than someone with a transfemoral amputation. In newer and more improved designs. This is due to the complexities in person with two whole legs. movement associated with the knee. The type of prosthesis depends on what part of the limb is missing. Cable operated limbs work by attaching a harness and cable around the opposite shoulder of the damaged arm. Transfemoral prosthesis A transfemoral prosthesis is an artificial limb that replaces a leg missing above the knee. carbon fibre.Prosthesis 161 Types There are four main types of artificial limbs. In the prosthetic industry a trans-tibial prosthetic leg is often referred to as a "BK" or below the knee prosthesis. mechanical linkages. and innovative combinations of these technologies to give more control to the user. In general. In the prosthetic industry a trans-radial prosthetic arm is often referred to as a "BE" or below elbow prosthesis. Two main types of prosthetics are available. which allows for easier movement.[26] Transradial prosthesis A transradial prosthesis is an artificial limb that replaces an arm missing below the elbow. computer microprocessors. transfemoral. These include the transtibial. causing an artificial hand to open or close. Transfemoral amputees can have a very difficult time regaining normal movement.

Silicone liners can be obtained in standard sizes. Computers are also used extensively in the manufacturing of limbs. This makes mimicking the correct motion with an artificial limb very difficult. they can create a far better suction fit than hard sockets. the signal gets integrated and once it exceeds a certain threshold.a liner is used that then is fixed to the socket either by vacuum (suction sockets) or a pin lock. which can be painful. more commonly today. which control the limbs by converting muscle movements to electrical signals. the use of electronics has Knee prosthesis manufactured using WorkNC Computer Aided Manufacturing software. Measurement of the stump Measurement of the body to determine the size required for the artificial limb Fitting of a silicone liner Creation of a model of the liner worn over the stump Formation of thermoplastic sheet around the model – This is then used to test the fit of the prosthetic . 3.[27] In addition to new materials. have become much more common than cable operated limbs. This is especially important for transfemoral amputees. The custom socket is created by taking a plaster cast of the stump or. Further down the road. limiting the amount of extra energy necessary to operate the limb. Newer methods include laser guided measuring which can be input directly to a computer allowing for a more sophisticated design. mostly with a circular (round) cross section. Liners are soft and by that.[27] Most modern artificial limbs are attached to the stump of the amputee by belts and cuffs or by suction. 4. New plastics and other materials. and through that offers a certain degree of direct force feedback that myoelectric control does not. Ultimately. 5. Myoelectric signals are picked up by electrodes. Myoelectric limbs. have allowed artificial limbs to be stronger and lighter. One problems with the stump and socket attachment is that a bad fit will reduce the area of contact between the stump and socket or liner. or . due to the similar complexities associated with the movement of the elbow. custom liners can be made. The socket is custom made to fit the residual limb and to distribute the forces of the artificial limb across the area of the stump (rather than just one small spot). In the prosthetic industry a trans-humeral prosthesis is often referred to as a "AE" or above the elbow prothesis. and then making a mold from the plaster cast. Air pockets can allow sweat to accumulate that can soften the skin. Computer Aided Design and Computer Aided Manufacturing are often used to assist in the design and manufacture of artificial limbs. The stump either directly fits into a socket on the prosthetic. of the liner worn over the stump. Transhumeral amputees experience some of the same problems as transfemoral amputees. all myoelectric controls lag. which helps reduce wear on the stump. Conversely. Pressure then is higher.Prosthesis 162 Transhumeral prosthesis A transhumeral prosthesis is an artificial limb that replaces an arm missing above the elbow. this is a frequent cause for itchy skin rashes. such as carbon fiber. the prosthetic limb control signal is triggered which is why inherently. and increase pockets between stump skin and socket or liner. Additional materials have allowed artificial limbs to look much more realistic. which is important to transradial and transhumeral amputees because they are more likely to have the artificial limb exposed. cable control is immediate and physical.more commonly today . become very common in artificial limbs. but for any other stump shape. 2. Current technology/manufacturing In recent years there have been significant advancements in artificial limbs.[25] Artificial limbs are typically manufactured using the following steps:[27] 1. it can cause breakdown of the skin.

But regular work gloves may be worn as well. hands or other devices.[35] Another robotic hand is the RSLSteeper bebionic [36] . Mechanical hands are sold by Hosmer and Otto Bock as well. Texas Assist Devices (with a whole assortment of tools) and TRS that offers a range of terminal devices for sports. Limbless Association Acting CEO. Actor Owen Wilson gripping the myoelectric prosthetic arm of a United States Marine The first commercial myoelectric arm was developed in 1964 by the Central Prosthetic Research Institute of the USSR. Other terminal devices include the V2P Prehensor.[32] The hand. which is often uncomfortable. ball hinges and self lubricating cable sheaths. Current high tech allows body powered arms to weigh around half to only a third of the weight that a myoelectric arm has. was the first amputee to be fitted with customized feel. went on sale on 18 July 2007 in Britain. Hands require a large activation force.[29] [30] Robotic limbs Advancements in the processors used in myoelectric arms has allowed for artificial limbs to make gains in fine tuned control of the prosthetic. a versatile robust gripper that allows customers to modify aspects of it. Creation of metal parts of the artificial limb using die casting 9. wrist or elbow. and distributed by the Hangar Limb Factory of the UK. which requires straps and/or cables actuated by body movements to actuate or operate switches that control the movements of a prosthesis or one that is totally mechanical. A prosthesis of this type utilizes the residual neuro-muscular system of the human body to control the functions of an electric powered prosthetic hand. This is as opposed to an electric switch prosthesis.[28] Hosmer and Otto Bock are major commercial hook providers. The arm allows movement in five axes and allows the arm to be programmed for a more [31] Raymond Edwards. Formation of permanent socket 7. Wrist units are either screw-on connectors featuring the UNF 1/2-20 thread (USA) or quick release connector. The Boston Digital Arm is a recent artificial limb that has taken advantage of these more advanced processors. Myoelectric A myoelectric prosthesis uses electromyography signals or potentials from voluntarily contracted muscles within a person's residual limb on the surface of the skin to control the movements of the prosthesis. Prosthetic hands may be fitted with standard stock or custom made cosmetic looking silicone gloves. Assembly of entire limb 163 Body-powered arms Current body powered arms contain sockets that are built from hard epoxy or carbon fiber. manufactured by "Touch Bionics"[33] of Scotland (a Livingston company). of which there are different models. wrist supination/pronation (rotation) or hand opening/closing of the fingers. such as elbow flexion/extension.[34] It was named alongside the Super Hadron Collider in Time magazine's top fifty innovations. Hooks require a much lower force. the i-LIMB by the National Health Service in the UK. including vacuum forming and injection molding 8. Formation of plastic parts of the artificial limb – Different methods are used. It has a self suspending socket with pick up electrodes placed over flexors and extensors for the movement of flexion and extension respectively. It is not clear whether those few prostheses that provide feedback signals to those muscles are also myoelectric in nature. Terminal devices contain a range of hooks.Prosthesis 6. the Becker Hand is still manufactured by the Becker family. Cable harnesses can be built using aircraft steel cables.

if the socket has fit issues.[41] 164 Direct bone attachment / osseointegration Osseointegration is a new method of attaching the artificial limb to the body. The stump and socket method can cause significant pain in the amputee.000 to $15. It is marketed as a "robotic pants". The patient then feels any sensory stimulus on that area of the chest. In the future. targeted to replace the wheelchair. This function is often achieved with crude. A limited number of organizations.[25] Cost Transradial and transtibial prostheses typically cost between US $6. robotic limbs have improved in their ability to take signals from the human brain and translate those signals into motion in the artificial limb.[39] Recently.000. In addition. The abutment extends out of the stump and the artificial limb is then attached to the abutment.[37] Robotic legs exist too: the Argo Medical Technologies ReWalk is an example or a recent robotic leg. rather than motor nerves rerouted to muscle. As a result. the socket must be replaced within several months. these contractions can be made to control movement of an appropriate part of the robotic prosthesis. artificial limbs could be built with sensors on fingertips or other important areas. such as those experienced during jogging. is working to make even more advancements in this area. because of the potential for the bone to break. such as the pectoralis major. non-articulating.000 and $8. After several months the bone attaches itself to the titanium bolt and an abutment is attached to the titanium bolt. which is why the direct bone attachment has been explored extensively. a small area of muscle on his chest will contract instead. The cost of an artificial limb does recur because artificial limbs are usually replaced every 3–4 years due to wear and tear. such as pressure or temperature. • The ability to wear the prosthetic for an extended period of time. when a patient thinks about moving the thumb of his missing hand.000.Prosthesis Another neural prosthetic is Johns Hopkins University Applied Physics Laboratory Proto 1. The method works by inserting a titanium bolt into the bone at the end of the stump. . Transfemoral and transhumeral prosthetics cost approximately twice as much with a range of $10. which would produce a similar stimulus on the "rewired" area of chest skin. The user would then feel that stimulus as if it were occurring on an appropriate part of the artificial limb. This method is also sometimes referred to as exoprosthesis (attaching an artificial limb to the bone). such as the pylons. the university also finished the Proto 2 in 2010.[42] [43] Low cost above knee prostheses often provide only basic structural support with limited function. When a stimulus. as if it were occurring on the area of the amputated limb which the nerve originally innervated.[39] [40] An emerging variant of this technique is called targeted sensory reinnervation (TSR). • The ability for transfemoral amputees to drive a car. This procedure is similar to TMR.[38] Targeted muscle reinnervation (TMR) is a technique in which motor nerves which previously controlled muscles on an amputated limb are surgically rerouted such that they reinnervate a small region of a large. the Pentagon’s research division. By placing sensors over the reinervated muscle. or manually locking knee joints. Some of the benefits of this method include the following: • Better muscle control of the prosthetic. or endo-exoprosthesis. with the stump and socket method this is not possible. The main disadvantage of this method is that amputees with the direct bone attachment cannot have large impacts on the limb. DARPA. Besides the Proto 1.000 and can sometimes reach costs of $35. such as the International Committee of the Red Cross (ICRC). activated these sensors. such as pressure or temperature. Their desire is to create an artificial limb that ties directly into the nervous system. create devices for developing countries. unstable. an electrical signal would be sent to an actuator. If height is an issue components can be changed. intact muscle. except that sensory nerves are surgically rerouted to skin on the chest.

Low Cost Above Knee Prosthetic Limbs: ICRC Knee (left) and LC Knee (right) . It would be able to create an energy-return prosthetic leg for US $8. storing energy which is then returned during the latter phase of ground contact to help propel the body forward. Visit their site at http:/ / OpenProsthetics. Other companies soon followed suit. [45] Name of technology (country of origin) ICRC knee (Switzerland) ATLAS knee (UK) POF/OTRC knee (US) DAV/Seattle knee (US) LEGS M1 knee (US) JaipurKnee (US) LCKnee (Canada) None provided (Nepal) None provided (New Zealand) None provided (India) Friction knee (US) Wedgelock knee (Australia) SATHI friction knee (India) Brief description Single-axis with manual lock Weigh-activated friction Single-axis with ext.org. bringing the concept of an Energy Storing Prosthetic Foot (ESPF) to the fore. The group employs collaborators and volunteers to advance Prosthetics technology while attempting to lower the costs of these necessary devices. The heel is compressed during initial ground contact. Denmark. composed primarily of fiberglass. India. where it won the Index: Award.[44] Table. foot prostheses merely restored basic walking capabilities.00. and before long. A plan for a low-cost artificial leg. designed by Sébastien Dubois. Since then. and marketability. the foot prosthetics industry has been dominated by steady. assist Compliant polycentric Four-bar Four-bar Highest level of evidence Independent field Independent field Field Field Field Field 165 Single-axis with automatic lock Field Single-axis Roto-molded single-axis Six-bar with squatting Weigh-activated friction Weigh-activated friction Weigh-activated friction Field Field Technical development Technical development Technical development Limited data available There is currently an open Prosthetics design forum known as the "Open Prosthetics Project". Jaipur Foot. Each model utilized some variation of a compressible heel.[46] Prior to the 1980s. List of knee joint technologies based on the literature review. was featured at the 2007 International Design Exhibition and award show in Copenhagen.Prosthesis Their device which is manufactured by CR Equipments is a single-axis. there were multiple models of energy storing prostheses on the market. small improvements in performance. an artificial limb from Jaipur. The introduction of the Seattle Foot (Seattle Limb Systems) in 1981 revolutionized the field. manually operated locking polymer prosthetic knee joint. comfort. costs about US$ 40. These early devices can be characterized by a simple artificial attachment connecting one's residual limb to the ground.

This heel is equipped not just with a standard compressible foam piece. but seeks to maximize performance (in both energy and compliance) with a complex metal heel component. Two particular models exemplify the innovation in these areas: the Elite foot (Endolite) and the Venture foot (College Park Industries). No one foot is perfect for all transtibial amputees. which allegedly allows the foot to closely mold to the contours of any surface. . Hopefully.Prosthesis 166 Design considerations There are multiple factors to consider when designing a transtibial prosthesis. The Elite foot relies on a polymeric material with a very specific set of elasticity and resistance requirements in order to optimize energy storage and return. Manufacturers must make choices about their priorities regarding these factors. It also uses an unprecedented three-pronged foot. but also hinges which allow rotation on three different axes.how the socket will join and fit to the limb Other The buyer is also concerned with numerous other factors: • • • • Cosmetics Cost Ease of use Size availability Emerging technology Most companies choose to focus on two areas of performance: energy capabilities and ground compliance. allegedly yielding superior comfort (ground compliance) and a more precise mimicry of native foot biomechanics (energy capabilities). the Venture foot retains the common one-point contact with the ground. there are certain elements of foot mechanics that are invaluable for the athlete. each amputee can find a foot that is best for his or her particular pattern of physical activity. Performance Nonetheless. In contrast. however. balance and speed • Suspension . Many other foot prostheses employ other useful innovative technology and designs. and these are the focus of today’s high-tech prosthetics companies: • Energy storage and return – storage of energy acquired through ground contact and utilization of that stored energy for propulsion • Energy absorption – minimizing the effect of high impact on the musculoskeletal system • Ground compliance – stability independent of terrain type and angle • Rotation – ease of changing direction • Weight – maximizing comfort.

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Quality control" (http:/ / www. htm [3] "Bronze single crown-like prosthetic restorations of teeth from the Late Roman period = Des restaurations par prothèses identiques à des couronnes en simple bronze de dents pendant la fin de la période romaine" (http:/ / cat.2008. ablelinktech. . 2003 [24] "IEEE Spectrum: Dean Kamen's "Luke Arm" Prosthesis Readies for Clinical Trials" (http:/ / spectrum. 60(10). Num 5" (http:/ / www. “The New High Tech Prostheses”. [4] "The Iron Hand of the Goetz von Berlichingen" (http:/ / www. academia. Retrieved 16 March 2008. .

icrc. . Marasco PD. Retrieved 11 February 2007. J.. [42] "Cost of Prosthetics Stirs Debate" (http:/ / www. E. [45] ANDRYSEK. Bennett Wilson.org. E.html) — Information about artificial limbs • Encyclopedia about Dental Implants in Russian (http://www. Retrieved 2010-10-03.ottobockus.com.howstuffworks. of which prosthetics is a part • Otto Bock (http://www. Early Online. html). J. . .. "Lower-limb prosthetic technologies in the developing world: A review of literature from 1994–2010" Prosthetics and Orthotics International.. Retrieved 2010-10-03.Prosthesis [33] "Touch Bionics" (http:/ / www.ca/nac/limbs. Dumanian GA (February 3. Ferguson . October 2002. 2007-05-01. J.com/) — Children's Electronic Hand Assistance Project (CEHAP) . Physical Therapy 68(12) Dec 1988: 1874-1881.oandp. "Gripping stuff" (http:/ / www. A Primer on Amputations and Artificial Limbs.waramps. Sanders. J. • National Amputee Centre (http://www. 5 July 2005. PMID 17276777. (http://www..howstuffworks. J.ca/nac/limbs. • ‘Biomechanics of running: from faulty movement patterns come injury. [43] [8] [44] "ICRC: Trans-Femoral Prosthesis – Manufacturing Guidelines" (http:/ / www. The Biomechanics of Amputee Running. Miller LA.uk/Pioneers_in_Artifical_Limbs/) Display of James Gillingham's work on post WW1 artificial limbs.asp) • Hafner. com/ professionals. (1997). 1–21. [34] Highfield.org/) • Chard Museum (http://www. Technology Review. United States of America: Charles C Thomas Publisher.htm) .waramps.mil.com/) — Information about Myoelectric Prosthetics • Myoelectric Prosthetesis (http://www. 2010.co. asp?id=706& show=nomination& nominationid=163& playmovie=wmv) 168 • Murdoch. ric. No. of which prosthetics is a part • Myoelectric Prosthetics (http://www.com/biomechatronics.com/edge/issues/ articles/2002-10_02.An overview of the field of biomechatronics.com/) • American Academy of Orthotists and Prosthetists (http://www. The Boston Globe. B. Ltd. 1 Jan/Feb 2002: 1-11..An overview of the field of biomechatronics. htm). boston. nsf/ htmlall/ p0868/ $File/ Eng-Transfemoral. dk/ 2007/ default. Stubblefield K.htm) . com/ items/ 89499345/ bionic_hand_makes_top_inventions_list.ru/) • How Stuff Works : Biomechatronics (http://health. pdf) (PDF). [35] "Bionic hand makes top inventions list // Current" (http:/ / current. Darpa.myoelectricprosthetics. darpa. org/ aboutus/ mediacenter/ press/ 2007/ o501. Lipschutz RD.' Sports Injury Bulletin. (http://www. [38] ReWalk robotic pants (http:/ / trendsupdates. Ric. 2007). Prosthetic feet. Roger (31 May 2008). com/ business/ globe/ articles/ 2005/ 07/ 05/ cost_of_prosthetics_stirs_debate/ ). com/ rewalk-robotic-pants-can-help-paralysed-patients-stand-up-and-walk-again/ ) [39] Kuiken TA. State of the Art. Zhou P. telegraph. Retrieved 2010-10-03.1016/S0140-6736(07)60193-7. . Retrieved 2010-10-03. co. [36] [www. M. Journal of Rehabilitation Research and Development Vol. Transtibial energy-storage-and-return prosthetic devices: A review of energy concepts and a proposed nomenclature. 3–31. Jr. [41] "Defense Sciences Office" (http:/ / www.com/biomechatronics. .html) • Edelstein. Retrieved 2010-10-03.html) — Information about artificial limbs • How Stuff Works : Biomechatronics (http://health.myoelectricprosthesis. [46] INDEX:2007 INDEX: AWARD (http:/ / www. doi:10. uk/ motoring/ 2754644/ Gripping-stuff. technologyreview. • National Amputee Centre (http://www. Lancet 369 (9559): 371–80. Current.com/ RSLSteeper bebionic] [37] "Proto 1 and Proto 2" (http:/ / www. com/ blog/ editors/ 22730/ ). . php?section=5). Retrieved 25 April 2010. indexaward. sportsinjurybulletin. The Daily Telegraph (London).com/archive/biomechanics-running. "Targeted reinnervation for enhanced prosthetic arm function in a woman with a proximal amputation: a case study". • Gailey. Czerniecki. org/ Web/ eng/ siteeng0. J. [40] "Blogs: TR Editors' blog: Patients Test an Advanced Prosthetic Arm" (http:/ / www. . Robert. A. 39. aspx). ISBN 0-398-06801-1.rslsteeper. 2008-11-06. touchbionics. htm).chardmuseum. mil/ dso/ solicitations/ sn07-43. Lock BA.oandp. Touch Bionics. pp. George. Retrieved 2010-10-03. 2009-02-10.dental-materials.

bostonretinalimplant. directly stimulating ganglia using signals sent from the external camera and power sent from an external transmitter. while still rudimentary. The implant is meant to partially restore useful vision to people who have lost theirs due to degenerative eye conditions such as retinitis pigmentosa or macular degeneration. io. retina-implant. due to a lack of an external power source. mei. com/ http:/ / www. jp/ research/ retina/ . where Subretinal Implants sit under the retina. 2-sight. Subretinal Implants generate signals directly from the incoming light. would allow the user to see a scoreboard type image made up of bright points of light viewed from about arm's length. titech. However. com/ http:/ / www. while others use only incident light as a power source and effectively replace damaged photoreceptors leaving all other structures within the eye untouched. Some Subretinal Implants use power from external circuitry. Epiretinal Implants sit on top of the retina. The technology.Retinal implant 169 Retinal implant A retinal implant is a biomedical implant technology currently being developed by a number of private companies and research institutions worldwide. External links • • • • Second Sight Medical Products [1] Retina Implant Germany [2] Boston Retinal Implant Project [3] Japan Retinal Implant Project [4] References [1] [2] [3] [4] http:/ / www. ac. There are two types of retinal implants currently showing promise in clinical trials: Epiretinal Implants (on the retina) and Subretinal Implants (behind the retina). de/ en/ http:/ / www. the image signal in this second type of subretinal implant may not be as strong as that given by an externally powered epiretinal or subretinal implant. stimulating bipolar or ganglion cells from underneath.

Two to four leads are placed in the brain where the seizures start.to five-hour procedure that occurs while the patient is asleep. Patients use a wand to transfer information from the neurostimulator to the DTR. The system is implanted by a study physician during a two. The data transmitter (or DTR) is used by the patient to provide information to the study physician. Then the neurostimulator is placed in the skull. The study physician can also look at records of actual brain electrical activity. seizurestudy. When the device identifies seizure activity. The study physician uses the programmer to look at information stored in the device about the patient’s detections and stimulations.RNS System 170 RNS System RNS System is a deep brain stimulation treatment for epilepsy patients. The device is powered by a battery and contains a computer chip that detects and stores a record of the brain’s electrical activity. The treatment is being studied for people with epilepsy in 28 clinical trial sites across the country. After the procedure. The physician-operated programmer communicates with the RNS neurostimulator via a hand-held wand. References • The RNS System [1] References [1] http:/ / www. com/ InvestigationalTreatment. This information helps the study physician select the best detection and stimulation settings for a particular patient. The programmer is then used to program the detection and stimulation settings in the neurostimulator. This type of treatment is called responsive stimulation. It is approved for use only in clinical research studies. Patients then connect the DTR to a phone line and information is provided to his or her study physician via a protected website. The neurostimulator is a device that is implanted within the skull by a study physician. The RNS system is currently being evaluated to determine how well it can reduce the frequency of uncontrolled seizures. html . it attempts to suppress the seizure by sending electrical stimulation through the leads to a small part of the brain. The study physician is then able to view the response to the stimulation and decide on the best seizure detection and stimulation settings for the patient. the patient will typically stay in the hospital one to three days. The RNS system uses the method of vagus nerve stimulation via a brain pacemaker and a neurostimulator. The study physician has a programmer device while the patient has a data transmitter to provide information from his or her neurostimulator to the study physician.

Polkey CE. it delivers intermittent stimulation which improves bladder emptying. [2] Schmidt RA. Sacral nerve study group. For others. Rushton DN (1982): Sacral anterior root stimulator for bladder control in paraplegia. Jonas A. Sacral nerve stimulation for treatment of refractory urinary urge incontinence. and many groups believe that the best results are only seen when this procedure is performed alongside the implantation. the benefits outwiegh the downside. It may also assists in defecation and may enable male patients to have a sustained full erection. the slower contraction kinetics of the bladder wall (smooth muscle) compared to the spinchter (striated muscle) means that voiding occurs between the stimulation pulses. Siegel SW. Hassouna MM. van Kerrebroeck PE. The rhizotomy will remove sensory reflexes. J Urol 1999 Aug.16(2):352-357. The related procedure of sacral nerve stimulation patients. Paraplegia 20: 365-381. Although both spinchter and detrussor muscles are stimulator at the same time. with successful human trials from the early 1980's onwards. It is often performed in conjunction with a dorsal rhizotomy. intra-thecally or extra-durally. Description This device is implanted over the sacral anterior root ganglia of the spinal cord. Janknegt RA. .Sacral anterior root stimulator 171 Sacral anterior root stimulator An implantable medical device enabling patients with a spinal cord lesion to empty their bladders. rather than during them. Oleson KA. [2] is for the control of incontinence in otherwise able-bodied References [1] Brindley GS. History From 1969 onwards Brindley [1] developed the sacral anterior root stimulator. which in men may include sexual reflexes. For some patients this is a major handicap to the device. The device is implanted in one of two regions. controlled by an external transmitter.

in one experiment by Bach-y-Rita.[8] Technological support In order to have sensory substitution and stimulate the brain without intact sensory organs to relay the information. a person who has lost the ability to retrieve data from the retina can still see subjective images by using data gathered from other sensory modalities such as touch or audition. a coupling system. This brain–machine interface is where external signals are collected and transduced into electrical signals for the brain to interpret. The visual or auditory data collected from the sensors is transduced into tactile stimuli that are then relayed to the brain for visual and auditory perception. the data collected by the retina is converted into an electrical stimulus in the optic nerve and relayed to the brain. In case the sensor obtains signals of a kind not originally available to the bearer it is a case of sensory augmentation. we can see that while they are only receiving tactile information. Generally a camera or a microphone is used to collect visual or auditory stimuli that are used to replace lost sensory information. History Sensory Substitution was introduced in the '60s by Paul Bach-y-Rita as a means of using one sensory modality. For example.[8] . mainly tactition.[6] In a regular visual system. The sensor records stimuli and gives them to a coupling system which interprets these signals and transmits them to a stimulator. During sensory substitution an intact sensory modality relays information to the visual perception areas of the brain so that the person can perceive to see. Sensory substitution concerns human perception and the plasticity of the human brain.[5] Since the vision processing pathways are still intact. In blind persons. A sensory substitution system consists of three parts: a sensor. mainly vision. they simply lose their ability to transmit the sensory signals from the periphery (retina for visions and cochlea for hearing) to brain. human cognition and rehabilitation. sensory substitution has contributed to the study of brain function. Touch-to-visual sensory substitution transfers information from touch receptors to the visual cortex for interpretation and perception. he was able to restore the touch perception in a patient who lost peripheral sensation from leprosy. sensory substitution has been the basis of many studies investigating perceptive and cognitive neuroscience. we can determine which parts of the brain are activated during sensory perception. to gain environmental information to be used by another sensory modality. it is also possible to develop machines that do the signal transduction.Sensory substitution 172 Sensory substitution Sensory substitution means to transform the characteristics of one sensory modality into stimuli of another sensory modality. and therefore. sensory substitution is possible. information gained from one sensory modality can reach brain structures physiologically related to other sensory modalities.[1] [2] The first sensory substitution system was developed by Bach-y-Rita et al. which re-creates the image and perceives it. This type of sensory substitution is only possible due to the plasticity of the brain.[7] We can also have touch to touch sensory substitution where information from touch receptors of one region can be used to perceive touch in another region. Because it is the brain that is responsible for the final perception. as a means of brain plasticity in congenitally blind individuals. For example. and a stimulator. through fMRI.[3] After this historic invention. Since then. It is hoped that sensory substitution systems can help handicapped people by restoring their ability to perceive a certain defective sensory modality by using sensory information from a functioning sensory modality. their visual cortex is also activated as they perceive to see objects.[4] Physiology of sensory substitution When a person becomes blind or deaf they generally do not lose the ability to hear or see. With sensory substitution. allows us to study these aspects of neuroscience more through neuroimaging.

– perception due to sensory substitution is not one modality but a result of cross-modal interactions. people learn to use the information gained from this stimulation to experience a perception of the sensation they lack instead of the actually stimulated sensation. free nerve endings. and of audio stimuli to tactile. There are six basic types of tactile receptors: Pacinian corpuscle. which would explain their oft-displayed propensity towards increased strength of the other senses. Different applications of sensory substitution Applications are not restricted to handicapped persons. This is an evolutionary mechanism that allows people with the deprivation of a sense to adapt and compensate by using other senses.[11] There have been two different types of stimulators: electrotactile or vibrotactile. Sensory substitution is therefore most likely explained through the study of brain plasticity.[9] In short. These receptors are mainly characterized by their ability to adapt to stimuli and their thresholds. pressure etc. whose perception of peripheral touch was restored. but also include artistic presentations. depends on the stimulating voltage. Some examples are substitution of visual stimuli to audio or tactile. games. it is essential to distinguish between sensing and perceiving.[8] Tactile sensory substitution systems To understand tactile sensory substitution it is essential to understand some basic physiology of the tactile receptors of the skin. and tactile disks. we can say that while sensory substitution for vision induces visual-like perception in sighted individual. Some of the most popular are probably Paul Bach-y-Rita's Tactile Vision Sensory Substitution (TVSS). Therefore. In sensory substitution systems. Cortical re-mapping or reorganization takes place when the brain experiences some sort of deterioration. developed with Carter Collins at Smith-Kettlewell Institute and Peter Meijer's Seeing with Sound approach (The vOICe). a leprosy patient.[9] After training. the patient was able to experience data from the glove as if it was originating in the fingertips while ignoring the sensations in the forehead. The general question posed by this differentiation is: Are blind people seeing or perceiving to see by putting together different sensory data? While sensation comes in one modality – visual. Vibrotactile stimulators use pressure and the properties . Meissner's corpuscle. and sound discrimination. auditory.[10] Because of the relative high thresholds of most these receptors and their rapid adaptation to stimulus. Technical developments. such as miniaturization and electrical stimulation help the advance of sensory substitution devices. the sensation triggered. Functional imaging of congenitally blind patients showed a cross-modal recruitment of the occipital cortex during the realization perceptual tasks such as Braille reading. tactile etc. tactile perception. and augmented reality. we generally have sensors that collect the data from the external environment. itch. to perceive objects though the use of other sensory modalities. was equipped with a glove containing artificial contact sensors coupled to skin sensory receptors on the forehead (which was stimulated). generally used for vision.[4] This shows that blind people can use their occipital lobe. Ruffini endings.Sensory substitution 173 Brain plasticity Brain plasticity is the brain’s ability to adapt to the complete absence or the deterioration of a sense. Electrotactile stimulators use direct electrical stimulation of the nerve ending in the skin to initiate the action potentials. pain. Merkel nerve endings. After training and acclimation. Perception versus sensing While talking about the physiological aspects of sensory substitution. sound localization. tactual object recognition. This data is then relayed to a coupling system that interprets and transduces the information and then replays it to a stimulator. blind people perceive to see through touch and audition with sensory substitution. This stimulator ultimately stimulates a functioning sensory modality. burn. the human body requires rapidly changing tactile stimulation systems. For example. it induces auditory or tactile perception in blind individuals.

To identify objects in different orientations requires several hours of learning.[5] [19] In this way. After training.[13] Alternatively.[11] Below you can find some descriptions of current tactile substitution systems. skin location. waveform. Tactile–visual substitution One of the earliest and most well known form of sensory substitution devices was Paul Bach-y-Rita’s TVSS that converted the image from a video camera into a tactile image and coupled it to the tactile receptors on the back of his blind subject. This electrode array is connected to a Tongue Display Unit [TDU] via a ribbon cable passing out of the mouth. transfers it to the TDU for conversion into a tactile image.[14] Electrostatic arrays are explored as human-computer interaction devices for touch screens. With the electrotactile stimulating systems a lot of factors effect the sensation triggered: stimulating voltage. thickness and hydration. Furthermore. tactile sensation can be used for visual perception. This tongue TVSS system works by delivering electrotactile stimuli to the dorsum of the tongue via a flexible electrode array placed in the mouth.[18] Also. peltier diodes. At the Center for Cognitive Ubiquitous Computing @ Arizona State University researchers have developed technologies that enable people who are blind to perceive social situational information 174 . solenoids. it took around 50 trials to achieve 100 percent correct recognition. which allows microamperre-level currents to be felt as roughness on a surface. show that electrotactile stimulation of the tongue required 3% of the voltage required to stimulate the finger. or through the skin (transcutaneous). which requires only about 3% as much voltage. etc.[11] Electrotactile stimulation may involve the direct stimulation of the nerves (percutaneous). abdomen. legs and arms. The tactile image is then projected onto the tongue via the ribbon cable where the tongue’s receptors pick up the signal. Sensory substitutions have also been successful with the emergence of wearable haptic actuators like vibrotactile motors. and is a major disadvantage of this approach. Another important aspect of tactile sensory substitution systems is the location of the tactile stimulation. Tactile receptors are abundant on the fingertips. the tongue-machine interface is more popular among TVSS systems. stimulation of the skin without insertion leads to the need for high voltage stimulation because of the high impedance of the dry skin. The activators are solenoids of one millimeter diameter.[16] [17] Vibrotactile systems use the properties of mechanoreceptors in the skin so they have fewer parameters that need to be monitored as compared to electrotactile stimulation.[1] Recently. blind (or blindfolded) subjects equipped with the TVSS can learn to detect shapes and to orient themselves. several new systems have been developed that interface the tactile image to tactile receptors on different areas of the body such as the on the chest. since it is more practical to wear an orthodontic retainer holding the stimulation system than an apparatus strapped to other parts of the body. current.[11] unless the tongue is used as a receptor. fingertip. the roof of the mouth has been proposed as another area where low currents can be felt. material. There are advantages and disadvantages for both these stimulation systems. The tongue-machine interface is both protected by the closed mouth and the saliva in the mouth provides a good electrolytic environment that ensures good electrode contact. In the case of simple geometric shapes. face.[18] Results from a study by Bach-y-Rita et al. It is essential to take into account the spatial resolution of the receptor as it has a major effect on the resolution of the sensory substitution.[12] This latter technique is undergoing clinical trials for various applications. electrode size. and forehead. brow. However.Sensory substitution of the mechanoreceptors of the skin to initiate action potentials. and tongue while sparse on the back. Percutaneous application causes additional distress to the patient. subjects are able to associate certain types of stimuli to certain types of visual images.[15] These are based on a phenomenon called electrovibration. In experiments. A system using the tongue as the human-machine interface is most practical. vibrotactile stimulation systems need to account for the rapid adaptation of the tactile sense. A video camera records a picture.[5] The tactile image is produced by hundreds of activators placed on the person. contact force.

in one experiment by Bach-y-Rita. Schurmann et al. to build prototypes for 'proof of concept' considerations. the information from these arms can be used by patients to perceive that they are holding and manipulating objects while their robotic arm actually accomplishes the task.[23] Tyler et al. com/ y20020173823 and select Download PDF 20020173823 for descriptions with diagrams. Both technologies use miniature cameras that are mounted on a pair of glasses worn by the user who is blind.[24] After more research and development.[22] To test for the auditory areas activated by touch. 175 .[25] While this is not purely a sensory substitution system.[23] Tactile–tactile substitution to restore peripheral sensation Touch to touch sensory substitution is where information from touch receptors of one region can be used to perceive touch in another. Using a head-mounted accelerometer and a brain-machine interface that employs electrotactile stimulation on the tongue.”[24] Tactile feedback system for prosthetic limbs The development of new technologies has now made it plausible to provide patients with prosthetic arms with tactile and kinesthetic sensibilities. Tactile–auditory substitution While there are no tactile-auditory substitution system currently available. One promising invention is the 'Sense organs synthesizer'. Some tactile feedback methods of restoring a perception of touch to amputees would be direct or micro stimulation of the tactile nerve afferents. unstable gait. Tactile–vestibular substitution Some people with balance disorders or adverse reactions to antibiotics suffer from bilateral vestibular damage (BVD). They experience difficulty maintaining posture. which may be viewed at http:/ / freepatentsonline. which he had been unable to experience for 20 years. recent experiments by Schurmann et al. they have a lot of difficulty standing. For example. After training and acclimation. next to the spine.[25] Other applications of sensory substitution systems can be seen in function robotic prostheses for patients with high level quadriplegia. it uses the same principles to restore perception of senses.[22] Therefore.[8] After two days of training one of the leprosy subjects reported “the wonderful sensation of touching his wife. Because BVD patients cannot integrate visual and tactile cues. which suggests that there is a relationship between audition and tactition. information about head-body orientation was relayed to the patient so that a new source of data is available to orient themselves and maintain good posture. vibration and texture detection that they relay to the patient through feedback.Sensory substitution using wearable vibrotactile belts [20] (Haptic Belt) and gloves [21] (VibroGlove). show that tactile senses can activate the human auditory cortex. These robotic arms have several mechanisms of slip detection. studied the restitution of postural control through a tactile for vestibular sensory substitution. The Haptic Belt provides vibrations that convey the direction and distance at which a person is standing in front of a user. future research can be done to investigate the likelihood of a tactile-auditory sensory substitution system. the touch perception was restored in a patient who lost peripheral sensation from leprosy. this leprosy patient was equipped with a glove containing artificial contact sensors coupled to skin sensory receptors on the forehead (which was stimulated). while the VibroGlove uses spatio-temporal mapping of vibration patterns to convey facial expressions of the interaction partner. the patient was able to experience data from the glove as if it was originating in the fingertips while ignoring the sensations in the forehead. Inventor is incorporating a nonprofit organization in August 2010.[8] For example. tested subjects while stimulating their fingers and palms with vibration bursts and their finger tips with tactile pressure. Full normal hearing range of nine octaves is delivered via 216 electrodes to sequential touch nerve zones. Currently vibrotactile stimuli can be used to facilitate hearing in normal and hearing-impaired people. and oscillopsia. They found that tactile stimulation of the fingers lead to activation of the auditory belt area.

Sensory substitution 176 Auditory sensory substitution systems Auditory sensory substitution systems like the tactile sensory substitution systems aim to use one sensory modality to compensate for the lack of another sensory modality in order to gain a perception of one that is lacking. O'Regan K. Neuroscience research has shown that the visual cortex of even adult blind people can become responsive to sound. Journal of Integrative Neuroscience 4 (2005) 505-21). While the patient moves around. Each receptive field is a set of localized pixels. The Vibe is an Open Source project hosted by Sourceforge. as well as functional improvement through training... .[5] Visual stimuli are transduced into auditory stimuli with the use of a system that uses pixel to frequency relationship and couples a rough model of the human retina with an inverse model of the cochlea. The extent to which cortical plasticity indeed allows for functionally relevant rewiring or remapping of the human brain is still largely unknown and is being investigated in an open collaboration with research partners around the world. corresponding each to a "receptive field" in the image. we use visual or tactile sensors to detect and store information about the external environment. The vOICe The vOICe vision technology is one of several approaches towards sensory substitution (vision substitution) for the blind that aims to provide synthetic vision to the user by means of a non-invasive visual prosthesis. With auditory sensory substitution. The frequency and the inter-aural disparity are determined by the center of gravity of the co-ordinates of the receptive field's pixels in the image (see "There is something out there: distal attribution in sensory substitution.[30] This system utilizes a head-mounted TV camera that allows real-time.[30] The Vibe The sound produced by this software is a mixture of sinusoidal sounds produced by virtual "sources". PSVA Another successful visual-to-auditory sensory substitution device is the Prosthesis Substituting Vision for Audition (PSVA). The vOICe converts live camera views from a video camera into soundscapes.[26] This system uses general video to audio mapping by associating height to pitch and brightness with loudness in a left-to-right scan of any video frame. The sound's amplitude is determined by the mean luminosity of the pixels of the corresponding receptive field. Lenay C. and “seeing with sound” might reinforce this in a visual sense with live video from a head-mounted camera encoded in sound. the device captures visual frames at a high frequency and generates the corresponding complex sounds that allow recognition.[5] Views are typically refreshed about once per second with a typical image resolution of up to 60 x 60 pixels as can be proven by spectrographic analysis. Auvray M. Hanneton S.. online translation of visual patterns into sound. twenty years later". This information is then transduced by brain-machine interfaces into auditory signals that are then relayed via the auditory receptors to the brain.[27] [28] [29] The ultimate goal is to provide synthetic vision with truly visual sensations by exploiting the neural plasticity of the human brain.[26] Neuroscience and psychology research indicate recruitment of relevant brain areas in seeing with sound. Auditory vision substitution Auditory vision substitution aims to use the sense of hearing to convey visual information to the blind.

investigations into the possibility of augmenting the body's sensory apparatus are now beginning.[33] Criticism It has been argued that the term "substitution" is misleading. [35] of the Open University The findings of research into sensory augmentation (as well as sensory substitution in general) that investigate the emergence of perceptual experience (qualia) from the activity of neurons have implications for the understanding of consciousness. tests of the influence of the belt information on the rotational nystagmus effect suggested that. for half of the participants. like one perceives a glass on a table as an entity distinct from the impact of reflected photons on the retina. it is possible to apply current pulses to be learned and reliably recognized by the recipient. much as natural human echolocation does. the processing of the belt information became subcognitive. as it is merely an "addition" or "supplementation" not a substitution of a sensory modality. the feelSpace group conducted a study[37] of sensory augmentation with a vibrotactile magnetic compass belt worn around the waist. and the feelSpace [36] project of the University of Osnabrück. Active work in this direction is being conducted by. Further. that signals can be employed from force/touch indicators on a robot hand as a means of communication. Zach Capalbo's Kromophone uses a basic color spectrum correlating to different sounds and timbres to give users perceptual information beyond the vOICe's capabilities.Sensory substitution Other systems Other approaches to the substitution of hearing for vision use binaural directional cues. An example of the latter approach is the "SeeHear" chip from Caltech.[6] Magnetic Perception In 2005.[31] Other visual-auditory substitution devices deviate from the vOICe's greyscale mapping of images. the participants were provided with the direction of magnetic north as a vibration on their waist.[34] Sensory Augmentation Building upon the research conducted on sensory substition. the perception of the belt's vibration underwent a profound change from simple tactile innervation to approach a genuine and direct sense of allocentric orientation: in other words. The intention is to extend the body's ability to sense aspects of the environment that are not normally perceivable by the body in its natural state. . In this study. It has been shown successfully in experimentation. Significant performance improvements in navigational tests were observed (over and above those experienced by control subjects during the same period with the same training) and. among others. by Kevin Warwick. could perceive north as an entity distinct from the vibrating transducer on the waist.[32] 177 Nervous system implants By means of stimulating electrodes implanted into the human nervous system. after training. the e-sense project and Edinburgh University.

IEEE Transactions Biomedical Engineering. Noe. and Kaczmarek KA . Academic Press New York:1972. Trullemans C. and David J. “Form perception with a 49-point electrotactile stimulus array on the tongue. “Cognitive and brain mechanisms in sensory substitution of vision: a contribution to the study of human perception.tb07235. Bach-y-Rita P. Webster JG. Jousmaki V. "SeeHear. Human Neurobiology. A. S. Hanneton and J. ncbi. Danilov Y. 3637-3642. edu/ sensory_substitution.x pdf (http:/ / www.”. [5] Bach-y-Rita P. cutaneous sensation of microampere current.1109/TBME. 207–227. Trends in Cognitive Neuroscience. Reading: Addison-Wesley. Audio and Visual Environments and Games. “A sensorimotor account of vision and visual consciousness. (2003). nlm. Neuroimage. Krishnakant Nammi. Perception. A.1111/j. [7] Bach-y-Rita P. S. Krishna.”. O'Regan. De Volder AG. Bach-y-Rita P (2003). IEEE International Workshop on Haptic. IEEE Transactions Biomedical Engineering. “Properties of cutaneous mechanoreceptors in the human hand related to touch sensation. [6] O’Regan. 3(3): e1840. [10] Vallbo AB. google. gordon. Meijer and A. Nature. Springer. Scadden L. [20] • T.881804. [8] Bach-y-Rita P. (2004).Sensory substitution 178 References [1] Bach-y Rita P.450. McDaniel. Stern. jsp?arnumber=1183739 [15] http:/ / www. 3: 3-14. Journal of Integrative Neuroscience.”. 31: 1064-1070. edu/ cogsci/ private/ bach-y-rita-tongue. [19] Bach-y-Rita P. gov/ pmc/ articles/ PMC2582732/ ).". ISBN 0387987193. [29] M. org/ xpl/ freeabs_all. [23] Tyler M. Kaczmarek KA. htm [14] http:/ / ieeexplore. 36(3): 416-430. D. Annals of New York Academic Sciences." in Analog VLSI and Neural Systems. 1013:83–91. Form perception with a 49-point electrotactile stimulus array on the tongue: a technical note. PLoS ONE. Mead. Collins CC. by C. Kaczmarek. J. March 2008. White B. Garcia-Lara J (1998). Demos-Vermande. gc. Tongue placed tactile output device. Journal of Rehabilitation Research Development. 2006 October. 37:465-474. pdf (http:/ / web. [32] http:/ / ppl. “Vision substitution by tactile image projection. [26] Meijer PBL (1992). Kaczmarek KA. [12] Bach-y-Rita P. no/ elg/ bioimp/ pdf/ vibration. T. 7 (12):541-546. Bermpohl. Behavioral and Brain Sciences. Electrovibration. [11] Kaczmarek KA. Abhishek K. doi: 10. Bala.2006. hizook. 10(6): 687-689. "Seeing 'Where' through the Ears: Effects of Learning-by-Doing and Long-Term Sensory Deprivation on Localization Based on Image-to-Sound Substitution". S. "Learning to perceive with a visuo-auditory substitution system: Localisation and object recognition with ‘The vOICe’". chapter 13. J. Hemond. [9] Poirier C.” Neuroscience and Behavioral Reviews. Balasubramanian. 39: 112-121. . Steven J. fys. Knoll. Mahowald M. “Electrotactile and vibrotactile displays for sensory substitution systems” IEEE Transactions Biomedical Engineering. Journal of Integrative Neuroscience. "A real-time experimental prototype for enhancement of vision rehabilitation using auditory substitution. A History of the Mind: Evolution and the Birth of Consciousness (http:/ / books. Beebec Polarity effect in electrovibration for tactile display (http:/ / www. Proulx. [30] Capelle C.”. and S. ieee. nih. “What neuroimaging tells us about sensory substitution.”. pp. 2:159-164. (2002). [31] Nielson L. P. Mitchell E. GRIMNES.1748-1716.". Proceedings of the 28th of the international conference extended abstracts on Human factors in computing systems. S. (2005). 13-18. “Sensory substitution and the human-machine interface. Arno P. 2008. [25] Rise RR (1999).35(4):427-30. E. K. Pascual-Leone. Garcia-Lara J. De Volder AG. Tyler ME. "An Experimental System for Auditory Image Representations. L. [4] Renier L. [18] Bach-y-Rita P. 2010. 4 (4):489–503. Panchanathan. 35:427-430. (1991). McDaniel. (2001). VibroGlove: an assistive technology aid for conveying facial expressions. [3] Bach-y-Rita P. (1984). Caetano G. [21] S. Haase. HAVE 2008.”. Tyler. 45: 1279-1293. New York :1995. Technology and Health Care. 2007. Atlanta. com/ books?id=W8G8Oji53XsC& pg=PA79& dq="Paul+ Bach-y-Rita"& lr=& as_brr=3& ei=RMn3R7zKFaistAPnxpiFCg& sig=KtTuO7ZgvcsSLGFk2Y_VLE07U-0). cuny. 24 (5):939-973. [22] Schurmann M. JK. [27] A. Nature Neuroscience. C. W. Mead C (1989). V. howstuffworks.1983. Georgia. pdf) [17] Kurt A. Spinal Cord. [24] Bach-y-Rita P (1999).”. P. Veraart C (1998). 221:963–964. DOI: 10. (2007). Agarwal. F. Nonsynaptic Diffusion Neurotransmission and Late Brain Reorganization. US Patent 6. uio. Hari R (2006).(1969). Krishna. “Theoretical aspects of sensory substitution and of neurotransmission-related reorganization in spinal cord injury. [28] M. S. “Strategies for providing upper extremity amputees with tactile and hand position feedback – moving closer to the bionic arm. 1998 Oct. June 2007. IEEE Trans Biomed Eng. Ludowig and I. [2] Nicholas Humphrey (1999). "Shape conveyed by visual-to-auditory sensory substitution activates the lateral occipital complex". Amedi. Tyler ME. pdf) [13] http:/ / science. Scheiber C.. Brain Mechanisms in Sensory Substitution. Johansson RS. “Tactile sensory substitution studies. S. com/ blog/ 2010/ 08/ 11/ electrotactile-arrays-texture-and-pressure-feedback-during-robotic-teleoperation [16] S. Camprodon. J Rehabil Res Dev. Merabet. 7:401-409. 30:1325–1331. Colbry.430.”.”. “Closing an open-loop control system: vestibular substitution through the tongue. McGuire. 38 (1): 1-16. Stoerig. . Panchanathan. USA: ACM. Auvray. Saunders F. Kercel SW. Tompkins WJ.”. 53(10): 2047–2054. Rotman. com/ brainport2. php . Hlushchuk Y. Using a haptic belt to convey non-verbal communication cues during social interactions to individuals who are blind. “Touch activates human auditory cortex”.

so it is typically only used when the tremors are incapacitating. [34] Lenay C. can be found in the novel The Terminal Man. Typically. [35] http:/ / www. esenseproject. which may also be implanted. stroke and dysarthria. Geouelle C (2003). org [36] http:/ / feelspace. For optimal installation. "Sensory Substitution: limits and perspectives". IEE Proceedings on Communications.edu/Courses/BI108/2006-108websites/group03retinalimplants/) Sensory Substitution:limits and perspectives C. Installation is invasive.html) Artificial Retinas (http://biomed. de/ en/ technology_01. out decades before the device itself. Carl C.Sensory substitution [33] Warwick K. A fictional treatment of the device.utc. “Thought communication and control: A first step using radiotelegraphy”. Kringe T.com) The vOICe auditory display for sensory substitution (http://www.php?wiki=TheVibeInEnglish) • feelSpace . Marque C.The Magnetic Perception Group of the University of Osnabrück (http://feelspace.de/en/technology_01. and talks to the surgeon to find the best placement.lycos. Cognitive psychology of haptic manual perception.learning the sixth sense".seeingwithsound. Lenay et al. König P. such as those caused by Parkinson's Disease or essential tremor.hanneton.wicab. Once in place. the patient is awake during the procedure.edu/SSD. iop. Wu.gordon. Risks arising from the operation are infection. and medication is ineffective. It is sometimes regarded as a better alternative to pallidotomy or thalamotomy because it is non-permanent. with subcutaneous leads to a neurostimulator. (http://www. Goodhew I. Gapenne O. one or more electrodes are implanted in the brain.pdf) • The Vibe (http://sylvain. X (2004). (2005).brown. Webpage of Laurent Renier (http://membres. and prevents the use of MRI. "Beyond sensory substitution . Hutt B. Hanneton S. for improved effectiveness during the day. 185-189. 275-292.com). uni-osnabrueck.fr/gsp/publi/ Lenay03-SensorySubstitution.free. Kyberd P.fr/ren1er/experiences.html) Thalamic stimulator A thalamic stimulator is a relatively new medical device that can suppress tremors. html [37] Nagel SK. Märtin R. It was approved for use by the Food and Drug Administration (FDA) on August 4. The electrodes stimulate the area of the thalamus. cogsci. 1997. the device can be activated and deactivated.html) • Kromophone at Gordon College's Philosophical Psychology Lab (http://ppl. It is notable that the presence of thalamic stimulators significantly changes ECG patterns. org/ EJ/ abstract/ 1741-2552/ 2/ 4/ R02/ 179 External links • • • • • Tongue display for sensory substitution (http://www. Journal of neural engineering 2(4):R13-26. Gasson M.fr/wikini/wakka. . SchulzrinneH. Available at: http:/ / www. Touching for Knowing.cogsci. 151 (3). specifically the part of the brain that controls movement and muscle function. uni-osnabrueck.

wustl. the FDA approved the use of VNS for treatment-resistant depression. In 2005.[3] [4] Many other studies concur that VNS is indeed efficacious in treating depression. the United States Food and Drug Administration (FDA) approved the use of VNS as an adjunctive therapy for partial-onset epilepsy. Little is understood about exactly how vagal nerve stimulation modulates mood and seizure control but proposed mechanisms include alteration of norepinephrine release by projections of solitary tract to the locus coeruleus. cnn. A. According to Dr. The afferent vagal fibers connect to the nucleus of the solitary tract which in turn projects connections to other locations in the central nervous system. according to the Hamilton Depression Rating Scale. org/ 10. the FDA's approval of VNS for refractory depression remains controversial.Thalamic stimulator 180 Sources • • • • Differential electrocardiographic artifact from implanted thalamic stimulator [1] FDA Okays Powerful Brain Implant [2] Washington University implanting brain device to control tremor [3] New device offers relief for patients with tremors [4] References [1] [2] [3] [4] http:/ / dx. Mechanism of action Vagus. vice chairman for research in the Department of Psychiatry at the University of Texas Southwestern Medical Center at Dallas. these finding do not take into account improvements over time in patients without the device. results of the VNS pilot study showed that 40 percent of the treated patients displayed at least a 50 percent or greater improvement in their condition. edu/ medadmin/ PAnews. nsf/ 0/ 2B773E4A990AE42486256B1F0074064B http:/ / www. In the only randomized controlled trial VNS failed to perform any better when turned on than in otherwise similar implanted patients whose device was not turned on. com/ parkin3. arises from the medulla and carries both afferent and efferent fibers. doi. 2003. 04. the tenth cranial nerve. neurohaven. 061 http:/ / www. elevated levels of inhibitory GABA related to vagal stimulation and inhibition of aberrant cortical activity by reticular system activation. htm http:/ / mednewsarchive. John Rush. com/ HEALTH/ 9604/ 07/ tremor_treatment/ Vagus nerve stimulation Vagus nerve stimulation (VNS) is an adjunctive treatment for certain types of intractable epilepsy and treatment-resistant depression. .[2] Although the use of VNS for refractory depression has been endorsed by the American Psychiatric Association. ijcard. However. 1016/ j.[5] To better understand the opinions of the medical professionals relating to this treatment option a compilation has been prepared from the responses to CMS (Medicare) during the write-in period from 08/07/2006 .[1] Approval and endorsement In 1997.09/06/2006 entitled "Letters from the Medical Professionals [6]".

[16] up to approximately one third develop mild obstructive sleep apnoea post treatment. Most patients undergoing VNS treatment experience an increase of apnoea hypopnoea index (AHI) post treatment.[16] Screening for obstructive sleep apnoea (OSA) in patients with a seizure disorder who are undergoing a VNS implant is also important because adequate treatment of previously undiagnosed and untreated OSA is likely to result in better seizure control in these patients. Transcranial magnetic stimulation (TMS) is under study as a therapy for both depression and epilepsy.[16] and a minority of patients develop severe obstructive sleep aponea related to VNS therapy. including various anxiety disorders. .[14] Clinically significant sleep disordered breathing associated with VNS has been described in pediatric[15] and adult[16] patient populations. but these symptoms are generally insensitive and a sleep study (diagnostic polysomnography) is generally required to diagnose the presence of obstructive sleep apnoea. Alzheimer's disease.[2] fibromyalgia. awareness of this causation is important for appropriate diagnosis and treatment of OSA related to vagal nerve stimulators.[10] Trigeminal Nerve Stimulation (TNS) is being researched at UCLA as a treatment for epilepsy. Continuous Positive Airway Pressure (CPAP) is a viable therapeutic option for patients who develop OSA related to the VNS. a study subject in the investigational trial of vagus nerve stimulation therapy for treatment-resistant depression. fatigue and sleepiness may alert the patient or parent to the presence of obstructive sleep apnoea. research is being done to determine its usefulness in treating other illnesses.[7] Other uses Because the vagus nerve is associated with many different functions and brain regions. a measure of the control the vagus nerve has over the heartbeat.[12] by having the patient sleep in non-supine position or by applying positive airway pressure.[12] This seems to be due to an increase in vagal tone[13] . Donovan. wrote Out of the Black Hole: The Patient's Guide to Vagus Nerve Stimulation and Depression.[11] Adverse effects Sleep apnea Intermittent decrease in respiratory flow during sleep has consistently been demonstrated in patients with VNS implants.[8] and tinnitus. Other options include increasing the cycle length or stimulation frequency of the device.[9] Other brain stimulation techniques used to treat depression include Electroconvulsive therapy (ECT) and Cranial electrotherapy stimulation (CES).[17] Patients undergoing vagal nerve stimulator placement are at risk for developing OSA related to the VNS and should therefore be screened clinically for the presence of OSA after the procedure.Vagus nerve stimulation 181 Patients Charles E.[15] These obstructive events can be alleviated by decreasing the frequency or intensity of VNS stimulation. migraines. Deep brain stimulation is currently under study as a treatment for depression. The fact that many of these patients are children and may have associated cognitive deficits makes diagnosing the problem even more difficult without a sleep study. With increasing number of indications and the number of patients undergoing the procedure. Symptoms such as loud snoring or intermittent cessation of breathing during the night or daytime symptoms as behavioral changes.

coughing(45%)."[25] The device is currently only made by Cyberonics.[10] Anti-inflammatory Activities of Vagus Nerve Stimulation The discovery by Kevin J. One such device is the cerbomed NEMOS[24] VNS stimulator implantation This is currently the only widely used method of therapeutic VNS. The Cyberonics VNS devices consist of a titanium-encased generator about the size of a pocket watch with a lithium battery to fuel the generator. dyspepsia. nausea. at points where branches of the vagus nerve have cutaneous representation. myocardial infaction. #20070067004. but the meatus and concha have also been targets. though these are not suitable for therapeutic use. pharyngitis(35%) and throat pain(28%)[15] and hoarseness (very common) to frank laryngeal muscle spasm and upper airway obstruction (rare). Inc. vomiting. SetPoint Medical. #20090287035.g. Inc.[18] The left vagus has proportionally lesser number of cardiac efferent fibers and placing the stimulator on this side potentially limits the arrhythmogenic effects of vagal stimulation but reversible bradyarrhythmias associated with vagal nerve stimulators have been well described. These devices are similar to TENS (Transcutaneous Electrical Nerve Stimulation) devices that are often used for pain management. depending on the settings [ie how strong the signal being sent is. US Patent Application Publication Nos. there have been no studies conducted on the effectiveness of such devices.. though several patents have already been filed.[23] Methods of Stimulation Vagal Maneuvers VNS can be achieved by one of the Vagal maneuvers. The battery life for the pulse generator is "between 1 [and] 16 years. The electrical impulses are targeted at the left aurical (ear).[19] Other nonspecific symptoms such as headache. a lead wire system with electrodes. and congestive heart failure. other "wearable" devices are being tested and developed by other companies that involve transcutaneous stimulation and do not require surgery. Remicade or Enbrel) to treat inflammation. and an anchor tether to secure leads to the vagus nerve. is an early stage medical device company developing the experimental implantable neurostimulation devices for the treatment of inflammation. #20100057154. and how frequently the device stimulates the nerve]. Transcutaneous Vagus Nerve Stimulators These allow for the stimluation of the vagus nerve without surgical procedure. Tracey that vagus nerve stimulation inhibits inflammation by suppressing cytokine production has led to significant interest in the potential to use this approach for treating inflammatory diseases ranging from arthritis to colitis. the neural circuit that converges on the spleen to inhibit the production of TNF and other cytokines by macrophages there. It requires the surgical implantation of a stimulator device. However. . To date. #20080249594. ischemia.[19] dyspnea and paresthesia.[20] Action potentials transmitted in the vagus nerve activate the efferent arm of the Inflammatory Reflex. it may be possible to use vagus nerve stimulation instead of anti-TNF antibodies (e. the length of time the device stimulates the nerve each time.[21] This efferent arc is also known as the Cholinergic anti-inflammatory pathway[22] Because this strategy targets the release of TNF.Vagus nerve stimulation 182 Other VNS causes stimulation of the superior and recurrent laryngeal nerves and is associated with problems ranging from alteration of voice(66%). These are just coming onto the market in 2010 and 2011. specifically the inner left tragus.

G (2000).014. Emerging Technologies: Vagus Nerve Stimulation for the Treatment of Depression. PMC 2504833. O. KJ (2007). [12] Malow. BA. Fromes. 2006-07-25. com/ commenteditem/ c0b04d20-a869-4e81-ba98-fa0e6ecbc163/ default. PMID 8777557.". T. HA.x. D'cruz.[10] 183 References [1] Ghanem. Harris. com/ vagus/ ) [5] FDA Summary of VNS Data (http:/ / www. R. [26] Panescu. McLarney.1213/01. JT. so that the surgeon can access the vagus nerve.2003. Beach. KJ (2008). PMID 10686263. YT. Messenheimer. Once successfully implanted.004. Sagher. asp?RelNum=7163). "Vagus Nerve Stimulation: A New Tool for Brain Research and Therapy".c6. com/ dg/ 15131a. BG (2006). Fromes.. doi:10.71743. JA (1996). K. ucla. html [25] Cyberonics. PMID 12823576. PMID 16815181. and connects the electrodes to the generator. gov/ ct/ show/ NCT00294281?order=3 [9] http:/ / www. (2000). html [10] George. C.1172/JCI30555. edu/ page. utdallas. "Effects of vagus nerve stimulation on sleep-related breathing in epilepsy patients. Biological Psychiatry 47 (4): 287–295. SV (2006). BV. M. Ochani. doi:10. Retrieved 2006-07-26. doi:10.1016/S0006-3223(99)00308-X. vagusnervestimulation. WR. Marzec. (2005. [17] Vaughn. "Brain Pacemaker" Designed as External or Implant Device" (http:/ / newsroom.56202. Husain. PMC 1783813.Vagus nerve stimulation Implantation of the Cyberonics VNS device is usually done as an out-patient procedure. com/ p7-00_lettersfromthemedicalprofessional.1016/j. Tracey. Chen.". doi:10. J. Nature reviews. Lisanby. J.1528-1157. The procedure goes as follows: an incision is made in the upper left chest and the generator is implanted into a little "pouch" on the left chest under the clavicle. (2005). Y (2008). Neurology 55 (10): 1450–4. Seizure : the journal of the British Epilepsy Association 5 (1): 73–8.09. Duncan A. Inc. "Effects of vagus nerve stimulation on respiration during sleep: a pilot study. OF. neurologychannel. [16] Marzec. G. KJ (2009). BA (2003). AJ. Brown. T.[26] The left vagus nerve is stimulated rather than the right because the right plays a role in cardiac function such that stimulating it could have negative cardiac effects. Proceedings of the National Academy of Sciences of the United States of America 105 (31): 11008–13.1016/j. Also: http:/ / www. Anesthesia and analgesia 103 (5): 1241–9.0000244532. T. S. Immunology 9 (6): 418–28. Chavan. McAfee. com/ [24] http:/ / www. M.01. doi:10. Verity J. [11] "UCLA Develops Unique Nerve-stimulation Epilepsy Treatment. the generator sends electric impulses to the vagus nerve at regular intervals.". pslgroup. "Reflex control of immunity". A second incision is made in the neck. [23] http:/ / www. "Physiology and immunology of the cholinergic antiinflammatory pathway". [20] Tracey. MM. "Splenic nerve is required for cholinergic antiinflammatory pathway control of TNF in endotoxemia". Parrish. Kifle. PMID 15087642. Anesthesiology 100 (4): 1017–8. [13] http:/ / www. Epilepsia 44 (7): 930–5. fda. Sackeim.". The Journal of clinical investigation 117 (2): 289–96.. (2007. PMID 17273548.1073/pnas. PMID 19461672. Sagher. A.ane. IEEE Engineering in Medicine and Biology Magazine.1038/nri2566. Fahy. Marangell. PMID 15820552. htm) [4] Neurology Channel: Vagus Nerve Stimulation (http:/ / www. "Vagal nerve stimulation: overview and implications for anesthesiologists.02.pediatrneurol. Malow.1097/00000542-200404000-00037. Edwards. LLC.2006. PMID 18669662. LB. JM. vnsdepression. aspx [14] http:/ / www.1046/j. cerbomed.2005. PMID 18206790. . M. [21] Rosas-Ballina. "Improvement of epileptic seizure control with treatment of obstructive sleep apnoea. iworx. Nahas.otohns.". S. Pediatric neurology 38 (2): 99–103. [2] Groves.neubiorev. htm [7] Donovan. O. com/ support/ manuals/ pieces/ 214_bp1L. setpointmedical. doi:10. Pittman. Burt. [18] Bernards.2007. doi:10. Ochani. pdf) [6] http:/ / www. PMID 11094096. doi:10. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 135 (1): 46–51. [19] Hatton. Dorin (2005). M. KW. Mark S. gov/ ohrms/ dockets/ ac/ 04/ briefing/ 4047b1_02_Summary of Safety and Effectiveness. com/ [8] http:/ / clinicaltrials.0803237105.".". CM (2004). Press release. "An unusual cause of airway obstruction during general anesthesia with a laryngeal mask airway. T et al. The surgeon then wraps the leads around the left branch of the vagus nerve. doi:10. Rush. Early. "Sleep-related breathing disorder in children with vagal nerve stimulators. M. PMID 17056962.) VNS Therapy Patient Essentials: Depression. com/ product. doi:10. "Vagal nerve stimulator implantation: an otolaryngologist's perspective. [3] Doctor's Guide: Vagus Nerve Stimulation Successful For Depression (http:/ / www. . edu/ news/ 2010/ 8/ 9-4791_NIH-Grant-Supports-Profs-Search-for-Tinnitus-Cure_article. Neuroscience and Biobehavioral Reviews 29 (3): 493–500. [22] Tracey. Z.1016/j.) Out of the Black Hole: The Patient's Guide to Vagus Nerve Stimulation and Depression Wellness Publishers. Edwards. pdf [15] Hsieh. Huston.037. "Vagus Nerve Stimulation: A Review of its Applications and Potential Mechanisms That Mediate its Clinical Effects". cnsforum.

• VNS Message Board (http://www.com) North American Neuromodulation Society (http://www.Comments on vagus nerve stimulation for depression Public Citizen petition to the FDA not to approve VNS (http://www.vagusnervestimulation.brainstimulation.org/publications/release.accessdata.com (http://www.nytimes.vnsdepression.info) .com (http://www. pl?ACCT=109&STORY=/www/story/12-18-2006/0004493422&EDATE=) International Neuromodulation Society (http://www. Out of the Black Hole: The Patient's Guide to Vagus Nerve Stimulation and Depression.pdf) Vagus Nerve Stimulation (http://www.pdf).net/0103-vagus-nerve-stimulation.com/vns. • FDA-MAUDE Database (http://www.citizen.fda.com/).aurorabioscience.vnsmessageboard.Independent forum where VNS patients share their experiences • FDA OKs Brain Stimulator for Depression (http://counsellingresource.whatisguide. (http://www. L. • VNSTherapy. • VagusNerveStimulation. cfm?ID=7385) The VNS From A Patient's Point Of View (http://www. (III) (2004). html?ex=1315540800&en=7877734ab451d64f&ei=5090&partner=rssuserland&emc=rss) (http://www.org) Therapeutic Neuromodulation Weblog (http://www. ISBN 0-9748484-1-7.com/features/archives/2005/ • • • • • • • • • • in-practice/depression-brain-stimulator/) . Inc.au) Australian VNS Information FDA Warning Letter to Cyberonics.com.gov/foi/warning_letters/archive/g5129d.com/) Publisher's website for Out of the Black Hole.C.com/2006/09/10/business/yourmoney/10cyber.edu/psych/mdoc/research/ vnsintro.html) Cyberonics Receives Third Determination Letter (http://www. Louis: Wellness Publishers.org/) .Vagus nerve stimulation 184 Further reading • Donovan.L.html) Battle Lines in Treating Depression (http://www. • VNSdepression. St.neuromodulation.com/) Proactive website and message forum sharing an accumlation of information and patient experiences relating to the VNS Therapy.com (http://www. Charles E.com/cgi-bin/stories.howdydave. cfm?start_search=1&SearchString=cyberonics&SearchYear=A&ProductCode=&ProductProblem=& DeviceName=&KNumber=&PMANumber=&Manufacturer=&BrandName=&EventType=& ReportDateFrom=&ReportDateTo=&PAGENUM=10&Key_Count=1500) External links • VNS: A New Tool for Brain Research and Therapy (PDF file) (http://www.gov/scripts/cdrh/cfdocs/cfMAUDE/Results.prnewswire.fda.vnstherapy.neuromodulation.bcm.

and National Science Foundation) have supported the work at Second Sight and USC. yet it costs roughly around $100.[2] [3] Additionally they have planned clinical trials worldwide. Many devices have been developed. Mark Humayun and Eugene DeJuan at the Doheny Eye Institute (USC) were the original inventors of the active epi-retinal prosthesis [1] and demonstrated proof of principle in acute patient investigations at Johns Hopkins University in the early 1990s along with Dr. in the US. Biological considerations The ability to give sight to a blind person via a bionic eye depends on the circumstances surrounding the loss of sight. choroideremia.S. who were all completely blind prior to implantation. Mann.Visual prosthesis 185 Visual prosthesis For the non-functional prosthesis or glass eye see Ocular prosthesis and Craniofacial prosthesis. currently have this model. More recently. For retinal prostheses. can now perform a surprising array of tasks using the device. Second generation Argus II trials are currently ongoing in the U. which are the most prevalent visual prosthetic under development (due to ease of access to the retina among other considerations). Persons born with blindness may lack a fully developed optical nerve. Their first generation implant had 16 electrodes and was implanted in 6 subjects between 2002 and 2004. the company announced that it has received FDA approval to begin a trial of its second generation. and are still waiting on FDA approval for public sale. 60 electrode implant.S. A visual prosthesis. Alfred E. Ongoing projects Argus Retinal Prosthesis Drs. often referred to as a bionic eye is an experimental visual device intended to restore functional vision. The Argus III model is currently in process of improved sight with 240 electrodes. It was recently approved in Europe. Technological considerations Visual prosthetics are being developed as a potentially valuable aid for individuals with visual degradation. a type of neural prosthesis in use since the mid 1980s. These subjects. Robert Greenberg. geographic atrophy macular degeneration) is the best candidate for treatment. Five of these subjects still use the device in their homes today.[4] Three major US government funding agencies (National Eye Institute. which all got underway in 2007. Only around ten people in the U. . usually modeled on the cochlear implant or bionic ear devices.000. vision loss due to degeneration of photoreceptors (retinitis pigmentosa. to develop a chronically implantable retinal prosthesis. Department of Energy. Greenberg along with medical device entrepreneur. In the late 1990s the company Second Sight was formed by Dr. Candidates for visual prosthetic implants find the procedure most successful if the optic nerve was developed prior to the onset of blindness. which typically develops prior to birth. The visual prosthetic in humans remains investigational.

the implant and retina surrounding it were examined and there were no noticeable changes to anatomical integrity. Harvard/MIT Retinal Implant Joseph Rizzo and John Wyatt at the Massachusetts Eye and Ear Infirmary and MIT began researching the feasibility of a retinal prosthesis in 1989.[5] Implantable Miniature Telescope Although not truly an active prosthesis. this is a spiral cuff electrode around the optic nerve at the back of the eye.[6] [7] [8] This type of device is implanted in the eye's posterior chamber and works by increasing (by about three times) the size of the image projected onto the retina in order to overcome a centrally-located scotoma or blind spot. The thresholds identified in this study were similar to those required in epiretinal stimulation. It is connected to a stimulator implanted in a small depression in the skull. and performed a number of proof-of-concept epiretinal stimulation trials on blind volunteers between 1998 and 2000. The implant doesn’t affect your natural eye movement. The stimulator receives signals from an externally-worn camera. As natural photoreceptors are far more efficient than photodiodes.2x or 2. The latest reports from this group concern the results of a clinical pilot study on eight participants suffering from RP. visible light is not powerful enough to stimulate the MPDA.[9] Tübingen MPDA Project A Southern German team led by the University Eye Hospital in Tübingen. The stimulator chip decodes the picture information beamed from the camera and stimulates retinal ganglion cells accordingly.Visual prosthesis 186 Microsystem-based Visual Prosthesis (MIVIP) Designed by Claude Veraart at the University of Louvain. At 14 months post implantation. an array of electrodes. the telescope is about the size of a pea and is implanted behind the iris of one eye. They have since developed a subretinal stimulator. The results were to be presented in detail on the ARVO 2007 congress in Fort Lauderdale. Their second generation prosthesis collects data and sends it to the implant through RF fields from transmitter coils that are mounted on the glasses. The chip is located behind the retina and utilizes microphotodiode arrays (MPDA) which collect incident light and transform it into electrical current stimulating the retinal ganglion cells. an external power supply is used to enhance the stimulation current. was formed in 1995 by Eberhart Zrenner to develop a subretinal prosthesis. 2. when evoked cortical potentials were measured from Yucatán micropigs and rabbits. you’ll need to wear glasses and may need to sometimes use a hand-held magnifying glass to read or see fine details.[7] [8] Created by VisionCare Ophthalmic Technologies in conjunction with the CentraSight Treatment Program.7x magnification strengths make it possible to see or discern the central vision object of interest while the other eye is used for peripheral vision because the eye that has the implant will have limited peripheral vision as a side effect. A secondary receiver coil is sutured around the iris. Therefore. The implants were successful in producing evoked cortical potentials in half of the animals tested. The German team commenced in vivo experiments in 2000. and is enlarged to reduce the effect the blind spot has on central vision. outside the degenerated macula. an Implantable Miniature Telescope is one type of visual implant that has met with some success in the treatment of end-stage age-related macular degeneration. that is placed beneath the retina in the subretinal space and receives image signals beamed from a camera mounted on a pair of glasses. which are translated into electrical signals that stimulate the optic nerve directly. Images are projected onto healthy areas of the central retina.[10] .

process them and generate instructions which will then be transmitted to implanted circuitry via a telemetry link. stopped operations.000 microscopic solar cells called “microphotodiodes” that each have their own stimulating electrode.[14] [5] Intracortical Visual Prosthesis The Laboratory of Neural Prosthesis at Illinois Institute Of Technology (IIT). in turn stimulating the visual cortex. Many subjects have been implanted with a high success rate and limited negative effects. which detect light and convert it into electrical impulses. The group is developing a wearable external image capture and processing system. The ASR microchip is a 2mm in diameter silicon chip (same concept as computer chips) containing ~5. These arrays will be implanted on the occipital lobe. upon the death of Dr.Visual prosthesis 187 Artificial Silicon Retina (ASR) The brothers Alan Chow and Vincent Chow have developed a microchip containing 3500 photo diodes. Dobelle. selling the eye for profit was ruled against in favor of donating it to a publicly funded research team. Studies on animals and psyphophysical studies on humans are being conducted to test the feasibility of a human volunteer implant. Chow acquired the Optobionics name. but Dr. Dobelle Eye Similar in function to the Harvard/MIT device.[11] Optoelectronic Retinal Prosthesis Daniel Palanker and his group at Stanford University have developed an optoelectronic system for visual prosthesis [12] that includes a subretinal photodiode array and an infrared image projection system mounted on video goggles. Chicago. 850-900 nm) video goggles. The ASR requires no externally-worn devices. rather than on the retina. except the stimulator chip sits in the primary visual cortex. External hardware will capture images. and activates photodiodes in the subretinal implant that convert light into pulsed bi-phasic electric current in each pixel. is developing a visual prosthetic using Intracortical Iridium Oxide (AIROF) electrodes arrays. the ASR implants and will be reorganizing a new company under the same name. The circuitry will decode the instructions and stimulate the electrodes. . Information from the video camera is processed in a pocket PC and displayed on pulsed near-infrared (IR.[5] The original Optobionics Corp. which stimulate healthy retinal ganglion cells. Still in the developmental phase. Charge injection can be further increased using a common bias voltage provided by a radiofrequency-driven implantable power supply [13] Proximity between electrodes and neural cells necessary for high resolution stimulation can be achieved utilizing effect of retinal migration. IR image is projected onto the retina via natural eye optics.

Curr Opin Ophthalmol. Retrieved 20 March 2011.1097/01. Fine IH. Hoffman RS.Visual prosthesis 188 Virtual Retinal Display (VRD) Laser-based system for projecting an image directly onto the retina. the battery-operated outer control comprises a micro-camera which captures the image as well as a processor and a command generator which process the imaging data to select and translate the captured images and to generate and manage the electrical stimulation process and oversee the implant. and the Bionic Vision Australia multi-institute partnership. "The Retinal Implant Project" (http:/ / www. uk/ 1/ hi/ sci/ tech/ 6368089. or a damaged cornea. com/ centrasight_technology).".86627. Sawan’s technology consists in stimulating the visual cortex by implanting a silicium microchip on a network of electrodes made of biocompatible materials and in which each electrode injects a stimulating electrical current in order to provoke a series of luminous points to appear (an array of pixels) in the field of vision of the sightless person. "Ending the Journey through Darkness: Innovative Technology Offers New Hope for Treating Blindness due to Retinitis Pigmentosa" (http:/ / www. [8] Lane SS. Tohru Yagi in Japan Visual Prosthesis Project [4]. The implant lodged in the visual cortex wirelessly receives dedicated data and energy from the external controller.030. Chuck RS. Koch DD. Heier JS.col1). com/ video/ watch/ ?id=7358218n& tag=content. The basic principle of Dr.01.2. This could be useful for enhancing normal vision or bypassing an occlusion such as a cataract. pdf). shtml). doi:10. "How the Artificial Retina Works" (http:/ / artificialretina. 2 (6): 657–65. gov/ howartificialretinaworks. BBC. Jr. [2] Second Sight (January 9. On the other hand. Research Laboratory of Electronics (RLE) at the Massachusetts Institute of Technology (MIT). [6] Chun DW. has been working on a visual prosthesis to be implanted into the human cortex.1586/17434440. 2007). This implantable part contains all the circuits necessary to generate the electrical stimuli and to oversee the changing microelectrode/biological tissue interface. Packer M. [9] Lipshitz. stm). . Raizman MB. . [5] James Geary (2002). "Trials for bionic eye implants" (http:/ / news.ajo. This system is The Visual Cortical Implant composed of two distinct parts: the implant and an external controller. Expert Rev Med Devices. bbc. Inc. Phoenix. . Ed Tehovnik at MIT. . doi:10. PMID 16293092. Kuppermann BD. mit..S. "The Implantable Miniature Telescope for macular degeneration. Mohamad Sawan [15]. The Body Electric. 17 (1): 94–8. htm).. . Dr. . [7] Lane SS. es).[5] Visual Cortical Implant Dr. The implant is powered the same way..a1. Department of Energy Office of Science. Gordon JF. Eduardo Fernandez and the European Consortium CORTIVIS (http:/ / cortivis. edu/ media/ pr151/ 19. Isaac.6. CBS Interactive Inc. (2006).657. rle.2004. Retrieved 20 March 2011. The external controller and the implant exchange data in both directions by a powerful transcutaneous radio frequency (RF) link.icu. com/ Argus_II_IDE_pr. 2-sight.". Professor and Researcher at Polystim neurotechnologies Laboratory [16] at the Ecole Polytechnique de Montreal.". [3] Jonathan Fildes (16 February 2007). . centrasight.0000193067. PMID 15183782. (2005).. doi:10.L. 137 (6): 993–1001. Retrieved 20 March 2011. (2004).1016/j. J. "Implantable Telescope Technology" (http:/ / www. VisionCare Ophthalmic Technologies. "A prospective multicenter clinical trial to evaluate the safety and effectiveness of the implantable miniature telescope. References [1] U. PMID 16436930. "Visual prosthetic device for bilateral end-stage macular degeneration. energy. [10] Wyatt.[17] Other projects Other note-worthy researchers include Richard Normann (University of Utah [18]) and David Bradley at University of Chicago. co. [4] "Bionic eye gives partial sight to blind" (http:/ / www. Hamill MB. Kuppermann BD. umh. Am J Ophthalmol. cbsnews.

[14] Simon Ings (2007).ASR® Device .uk/1/hi/sci/tech/6368089. Japan Visual Prosthesis Group • Palanker Group Publication List (http://www.shtml) • .pdf) .stm). edu/ faculty/ RAN/ 189 ==External links== • ARMD. Loudin. 24 April 2007. bioen. "Chapter 10(3): Making eyes to see".emedicine. ca/ recherche/ rc/ en/ professeurs/ details. Retrieved 20 March 2011.cbsnews. pdf) (PDF). The Eye: a natural history.rle.mit.shtml) • The Boston Retinal Implant Project (http://www. D.bbc.K. Optobionics.co.com (http://www.uk/1/hi/health/6585367. polystim.optobionics. BBC.Visual prosthesis [11] "ASR® Device" (http:/ / optobionics.co.newscientist. Bloomsbury.edu/~palanker/List_of_publications. utah.org/index. doi:10.com (http://optobionics.stm) • NewScientist.com/video/watch/ ?id=7358218n&tag=content.control.ac.F.com/centrasight_technology) • .com.com (http://www. shtml).M.com/article. Simanovskii. Retinal Electronic Prosthesis and RPE Transplantation . Palanker (2007). edu/ ~palanker/ lab/ retinalpros.com/ oph/topic763. • Visual Prosthesis Links (http://www. com/bionic-eye. [15] http:/ / www.1088/1741-2560/4/1/S09.Y.control. php?NoProf=108/ [16] http:/ / www. ca/ [17] Sawan. stanford.mei.uk/1/hi/health/4411591.html) • Published Papers Related to the DOE Artificial Retina Project CRADA (http://artificialretina. com/ asrdevice.au/ issues2009/86nano. "Artificial Sight: Optoelectronic Retinal Prosthesis" (http:/ / www.health.issues.php?fontsize=bigger& hicontrast=) • 'Bionic eye gives partial sight to the blind' . "Optoelectronic retinal prosthesis: system design and performance" (http:/ / www. pp. and D. . K.bostonretinalimplant.io.The Retinal Implant Project .CBS News Video (http://www.V. ns?id=dn7216) • BBC: 'Artificial eye' (http://news. PMID 17325419. McLean.'Tiny Technologies Raise Big Ethical Issues' .gov/ papers.col1) • Implantable Telescope Technology .stm) • How does a "bionic eye" allow blind people to see? . ca/ polystim/ en/ navigation/ Prothesevisuelleintra-corticale.titech. G.com. html). A.jp/research/retina/#link). .BBC (http://news. edu/ ~palanker/ publications/ OptoelectronicRetinalProsthesis.mit.co.D.edu (http://www. Montréal Polytechnical.com: 'Bionic eye' may help reverse blindness (http://www. C.energy.bbc.CentraSight (http://www. . stanford. [18] http:/ / www.au (http://issues.howstuffworks. P. . Retrieved April 10 2011.pdf) • .eMedicine. Vijayraghavan.centrasight. "INTRA-CORTICAL VISUAL PROSTHESIS" (http:/ / www. J Neural Engineering 4 (1): S72–S84. Huie.com/asrdevice.rle.edu/media/pr151/19. php).stanford. [12] Palanker Group. Butterwick. polymtl.bbc. 276–283.HowStuffWorks.htm) • Research opens way for bionic eye (http://news.htm) • 'Bionic' eye implants look ahead . [13] J. INTRA-CORTICAL VISUAL PROSTHESIS. Sramek. polymtl.

materials science. edu/ ~ne2009/ • Neuroengineering (2007) ISBN 978-0849381744 • Neural Engineering (Bioelectric Engineering) (2005) ISBN 978-0306486098 • Operative Neuromodulation: Volume 1: Functional Neuroprosthetic Surgery. Other research concentrates more on investigation by experimentation. org/ EJ/ journal/ JNE [2] http:/ / www. Neural engineers are uniquely qualified to solve design problems at the interface of living neural tissue and non-living constructs. The Journal of Neural Engineering [1] and The Journal of NeuroEngineering and Rehabilitation [2] both emerged in 2004. References [1] http:/ / www. or otherwise exploit the properties of neural systems. jneuroengrehab. cybernetics. iop. neural tissue engineering. electrical engineering and signal processing of living neural tissue. information and research relating to it is comparatively limited. International conferences on neural engineering have been held by the IEEE since 2003. quantifying how this processing is altered in the pathological state. experimental neuroscience. Much current research is focused on understanding the coding and processing of information in the sensory and motor systems. including the use of neural implants connected with external technology. repair. most recently from 29 April until 2 May 2009 in Antalya. although this is changing rapidly. Overview This field of engineering draws on the fields of computational neuroscience.Neural engineering 190 Neural engineering Neural engineering (also known as Neuroengineering) is a discipline within biomedical engineering that uses engineering techniques to understand. computer engineering. The first journals specifically devoted to neural engineering. enhance. asu. replace. and nanotechnology. Turkey 4th Conference on Neural Engineering [3]. and encompasses elements from robotics. clinical neurology. History As neural engineering is a relatively new field. fulton. Prominent goals in the field include restoration and augmentation of human function via direct interactions between the nervous system and artificial devices. An Introduction (2007) ISBN 978-3211330784 • Deep Brain Stimulation for Parkinson's Disease (2007) ISBN 978-0849370199 • Handbook of Stereotactic and Functional Neurosurgery (2003) ISBN 978-0824707200 • Neural Prostheses: Fundamental Studies (1990) ISBN 978-0136154440 • IEEE Handbook of Neural Engineering (2007) ISBN 978-0470056691 • Foundations on Cellular Neurophysiology (1995) ISBN 978-0262100533 . and how it can be manipulated through interactions with artificial devices including brain-computer interfaces and neuroprosthetics. com/ [3] http:/ / www.

memory. and the network development can be visually observed using microscopy techniques[4] .org/) IEEE Transactions on Neural Systems and Rehabilitation Engineering (http://tnsre. Another disadvantage lies in the fact that the cultured neurons lack a body and are thus severed from sensory input as well as the ability to express behavior – a crucial characteristic in learning and memory experiments. It allows researchers to investigate neuronal activity in a much more controlled environment than would be possible in a live organism. chemical analysis of the neurons and their environment is more easily accomplished than in an in vivo setting[4] [5] .com/) Journal of Neurophysiology (http://jn. One example of this can be seen in the Multielectrode Array Art (MEART) system developed by the Potter Research Group at the Georgia Institute of Technology in collaboration with the Symbi-oticA Research Group at the University of Western Australia.physiology.bme. respectively. Electrophysiological recording and stimulation can take place either across the network or locally via an MEA. Ultimately.embs. Disadvantages Cultured neuronal networks are by definition disembodied cultures of neurons. especially the brain. Through this mechanism researchers have gleaned important information about the mechanisms behind learning and memory. Moreover.jneuroengrehab.edu/) The Journal of Neural Engineering (http://iopscience.[3] Use as a Model Advantages The use of cultured neuronal networks as a model for their in vivo counterparts has been an indispensable resource for decades[4] . Foremost among these abnormalities is the fact that the neurons are usually harvested as neural stem cells from a fetus and are therefore disrupted at a critical stage in network development[6] . and information processing. thus allowing two-way communication between the researcher and the network.jhu.[2] Another example can be seen in the neurally controlled animat. When the neurons are suspended in solution and subsequently dispensed.Neural engineering 191 External links Journals • • • • • IEEE Transactions on Biomedical Engineering (http://tbme.[1] Cultured neurons are often connected via computer to a real or simulated robotic component. Often. where the neuronal networks are able to interact with their environment and receive at least some artificial sensory feedback. the neurons are influenced in ways that are not biologically normal.org/) Cultured neuronal network A cultured neuronal network is a cell culture of neurons that is used as a model to study the central nervous system. the connections previously made are destroyed and new ones formed. A cultured neuronal network allows researchers to observe neuronal activity from several vantage points. cultured neuronal networks are connected to an input/output device such as a multi-electrode array (MEA). plasticity. the connectivity (and consequently the functionality) of the tissue is changed from what the original template suggested. Thus by being outside their natural environment. Researchers can then thoroughly study learning and plasticity in a realistic context. connectivity. This model has proved to be an invaluable tool to scientists studying the underlying principles behind neuronal learning. It is believed that such sensory deprivation has adverse effects on the development of these cultures and may result in abnormal .org/jne) JNER Journal of NeuroEngineering and Rehabilitation (http://www. creating a hybrot or animat.

when coupled with a sealed incubation chamber this device greatly reduces the risk of culture contamination by nearly eliminating the need to expose it to air[4] [5] [8] .Cultured neuronal network patterns of behavior throughout the network[6] . gases necessary for metabolism) but impermeable to water and microbes[4] . One solution to this problem involves growing cells on an MEA inside a sealed chamber. Studies commonly employ rat cortical. although lab mouse neurons have also been used. Indeed. neuron cultures are highly susceptible to infection. such MEAs are only capable of region-specific data acquisition and stimulation. Ideally it would be possible to record and stimulate from a single or a few neurons at a time. They are also susceptible to hyperosmolality from medium evaporation[4] . These cells were acquired from a fetus that spontaneously aborted after ten weeks in gestation[7] Long-Term Culture One of the most formidable problems associated with cultured neuronal networks is their lack of longevity. and this fact probably plays a large role in skewing some of the conclusions derived from experiments based on this model. This chamber serves as a non-humidified incubator that is enclosed by a fluorinated ethylene propylene (FEP) membrane that is permeable to select gases (i. This remains one of the most striking differences between the model and the reality.000 cells or more (or a density of 5. Other solutions entail an incubator with an impermeable membrane that has a specific mix of gases (air with 5% CO2 is typical) sealed inside[4] .000 cells/mm2)[9] .e. The communication can be. a process considered too costly to perform on many mammals that are valuable in other studies. relatively little research has been conducted on growing primate or other animal neuronal networks. and spinal neurons. commonly used MEAs have relatively poor spatial resolution. Additionally. neuronal networks are typically cultured from dissociated rat neurons. Harvesting neural stem cells requires sacrificing the developing fetus. Another study investigates establishing a stable one-to-one connection between . This device has been an essential biosensor for more than thirty years. are large three-dimensional structures with much greater interconnectivity. bidirectional. and usually is. researchers can both record electrophysiological data from a live network and stimulate it with a number of patterns. also commonly called a microelectrode array. Most in vivo neuronal systems. is a patterned array of electrodes laid out in a transparent substrate used for communication with neurons in contact with it. One study. Currently. however. It follows that each electrode in the array services a large cluster of neurons and cannot provide resolute information regarding signal origin and destination. to the contrary. companies such as Axion Biosystems are working to provide MEAs with much higher spatial resolution to this end (a maximum of 768 input/output electrodes)[10] . The long timelines associated with studying neuronal plasticity (usually on the scale of months) makes extending the lifespan of neurons in vitro paramount. Multi-electrode Arrays (MEAs) A multi-electrode array (MEA). It has been used not only in the study of neuronal plasticity and information processing but also in drug and toxin effects on neurons. Cultured networks on traditional MEAs are flat. 192 Growing a Neuronal Network Neurons Used Because of their wide availability. Currently. did make use of human neural stem cells grown into a network to control a robotic actuator. They employ approximately sixty electrodes for recording and stimulation in varying patterns in a dish with a typical culture of 50. hippocampal. Like most cell cultures. single-layer sheets of cells with connectivity only two dimensions.

Cultured neuronal network neurons and electrodes. The goal was to meet the ideal interface situation by establishing a correspondence with every neuron in the network. They do so by caging individual neurons while still allowing the axons and dendrites to extend and make connections. Neurons are contained within ‘’neurocages’’, and the device itself is referred to as the caged neuron MEA or neurochip[8] . Other research suggests alternative techniques to stimulating neurons in vitro. One study investigates the use of a laser beam to free caged compounds such as neurotransmitters and neuromodulators[5] . A laser beam with wavelength in the UV spectrum would have extremely high spatial accuracy and, by releasing the caged compounds, could be used to influence a very select set of neurons.

193

Network Behavior
Spontaneous Network Activity
Spontaneous network bursts are a commonplace feature of neuronal networks both in vitro and in vivo[11] . In vitro, this activity is particularly important in studies on learning and plasticity. Such experiments look intensely at the network-wide activity both before and after experiments in order to discern any changes that might implicate plasticity or even learning[9] . However, confounding this experimental technique is the fact that normal neuronal development induces change in array-wide bursts that could easily skew data. In vivo, however, it has been suggested that these network bursts may form the basis for memories[9] [11] . Depending on experimental perspective, network-wide bursts can be viewed either positively or negatively. In a pathological sense, spontaneous network activity can be attributed to the disembodiment of the neurons; one study saw a marked difference between array-wide firing frequency in cultures that received continuous input versus those that did not[12] . To eliminate abhorrent activity, researchers commonly use magnesium or synaptic blockers to quiet the network. However, this approach has great costs; quieted networks have little capacity for plasticity[11] due to a diminished ability to create action potentials. A different and perhaps more effective approach is the use of low frequency stimulation that emulates sensory background activity[13] . In a different light, network bursts can be thought of as benign and even good. Any given network demonstrates non-random, structured bursts[11] . Some studies have suggested that these bursts represent information carriers, expression of memory, a means for the network to form appropriate connections, and learning when their pattern changes[9] [12] [13] [14] . Array-Wide Burst Stability Stegenga et al. set out to establish the stability of spontaneous network bursts as a function of time. They saw bursts throughout the lifetime of the cell cultures, beginning at 4–7 days in vitro (DIV) and continuing until culture death. They gathered network burst profiles (BPs) through a mathematical observation of array-wide spiking rate (AWSR), which is the summation of action potentials over all electrodes in an MEA. This analysis yielded the conclusion that, in their culture of Wistar rat neocortical cells, the AWSR has long rise and fall times during early development and sharper, more intense profiles after approximately 25 DIV. However, the use of BPs has an inherent shortcoming; BPs are an average of all network activity over time, and therefore only contain temporal information. In order to attain data about the spatial pattern of network activity they developed what they call phase profiles (PPs), which contain electrode specific data[9] . Data was gathered using these PPs on timescales of milliseconds up through days. . Their goal was to establish the stability of network burst profiles on the timescale of minutes to hours and to establish stability or developmental changes over the course of days. In summary, they were successful in demonstrating stability over minutes to hours, but the PPs gathered over the course of days displayed significant variability. These finding imply that studies of plasticity of neurons can only be conducted over the course of minutes or hours without bias in network activity introduced by normal development [9] .

Cultured neuronal network

194

Learning vs. Plasticity
There is much controversy in the field of neuroscience surrounding whether or not a cultured neuronal network can learn. A crucial step in finding the answer to this problem lies in establishing the difference between learning and plasticity. One definition suggests that learning is “the acquisition of novel behavior through experience”[15] . Corollary to this argument is the necessity for interaction with the environment around it, something that cultured neurons are virtually incapable of without sensory systems. Plasticity, on the other hand, is simply the reshaping of an existing network by changing connections between neurons: formation and elimination of synapses or extension and retraction of neurites and dendritic spines[1] . But these two definitions are not mutually exclusive; in order for learning to take place, plasticity must also take place. In order to establish learning in a cultured network, researchers have attempted to re-embody the dissociated neuronal networks in either simulated or real environments (see MEART and animat). Through this method the networks are able to interact with their environment and, therefore, have the opportunity to learn in a more realistic setting. Other studies have attempted to imprint signal patterns onto the networks via artificial stimulation[14] . This can be done by inducing network bursts[11] or by inputing specific patterns to the neurons, from which the network is expected to derive some meaning (as in experiments with animats, where an arbitrary signal to the network indicates that the simulated animal has run into a wall or is moving in a direction, etc.)[3] [7] . The latter technique attempts to take advantage of the inherent ability of neuronal networks to make sense of patterns. However, experiments have had limited success in demonstrating a definition of learning that is widely agreed upon. Nevertheless, plasticity in neuronal networks is a phenomenon that is well-established in the neuroscience community, and one that is thought to play a very large role in learning[1] .

External links
• http://www.neuro.gatech.edu/groups/potter/

References
[1] Wagenaar DA, Pine J, Potter SM (2006). "Searching for Plasticity in Dissociated Cortical Cultures on Multi-Electrode Arrays". Journal of Negative Results in BioMedicine: 516–35. [2] Bakkum DJ, Gamblen PM, Ben-Ary B, Chao ZC, Potter SM (2007). "MEART: The semi-living artist". Frontiers in Neurorobotics 5: 1–10. [3] DeMarse TB, Wagenaar DA, Blau AW, Potter SM (2001). "The Neurally Controlled Animat: Biological Brains Acting with Simulated Bodies" (http:/ / www. neuro. gatech. edu/ groups/ potter/ papers/ AutonRobots. pdf). Autonomous Robots 11 (3): 305–310. doi:10.1023/A:1012407611130. . [4] Potter SM, DeMarse TB (2001). "A New Approach to Neural Cell Culture for Long-Term Studies". Journal of Neuroscience Methods 110 (1-2): 17–24. doi:10.1016/S0165-0270(01)00412-5. PMID 11564520. [5] Ghezzi D, Menegon A, Pedrocchi A, Valtorta F, Ferrigno G (2008). "A Micro-Electrode Array Device Coupled to a Laser-Based System for the Local Stimulation of Neurons by Optical Release of Glutamate". Journal of Neuroscience Methods 175 (1): 70–78. doi:10.1016/j.jneumeth.2008.08.003. PMID 18761373. [6] Potter SM, Wagenaar DA, Madhavan, Demarse TB (2003). "Long-Term Bidirectional Neuron Interfaces for Robotic Control, and In Vitro Learning Studies". Proceedings of the IEEE-EMBS. [7] Pizzi RMR, Rossetti D, Cino G, Marino D, Vescovi AL, Baer W (2008). "A Cultured Human Neural Network Operates a Robotic Actuator". BioSystems. [8] Erickson J, Tooker A, Tai YC, Pine J (2008). "Caged Neuron MEA: A System for Long-Term Investigation of Cultured Neural Network Connectivity". Journal of Neuroscience Methods 175 (1): 1–16. doi:10.1016/j.jneumeth.2008.07.023. PMC 2585802. PMID 18775453. [9] Stegenga J, Feber JL, Marani E, Rutten WLC (2008). "Analysis of Cultured Neuronal Networks Using Intraburst Firing Characteristics". IEEE Transactions on Biomedical Engineering 55 (4): 1382–1390. doi:10.1109/TBME.2007.913987. PMID 18390329. [10] "Axion MEA Systems" (http:/ / axionbiosystems. com/ index. php?option=com_content& view=article& id=44& Itemid=50#maestro). . [11] Potter, S (2008). "How Should We Think About Bursts?". 6th Int. Meeting on Substrate-Integrated Microelectrodes. pp. 22–25. [12] Wagenaar DA, Pine J, Potter SM (2006). "An Extremely Rich Repertoire of Bursting Patterns During the Development of Cortical Cultures". BMC Neuroscience 7 (1): 11. doi:10.1186/1471-2202-7-11. PMC 1420316. PMID 16464257. [13] Chao ZC, Wagenaar DA, Potter SM (2005). "Effects of Random External Background Stimulation on Network Synaptic Stability after Tetanization: A Modeling Study". Neuroinformatics 3 (3): 263–280. doi:10.1385/NI:3:3:263. PMC 2584804. PMID 16077162.

Cultured neuronal network
[14] Baruchi I, Ben-Jacob E (2007). "Towards Neuro-Memory Chip: Imprinting Multiple Memories in Cultured Neural Networks". Physical Review E 75. [15] Bakkum DJ, Shkolnik AC, Ben-Ary G, Gamblen P, DeMarse TB, Potter SM (2004). "Removing Some ‘A’ from AI: Embodied Cultured Networks". Embodied Artificial Intelligence: International Seminar, Dagstuhl Castle, Germany, July 7–11, 2003, Revised Selected Papers.

195

Neurally controlled animat
A Neurally Controlled Animat is the conjunction of 1. a cultured neuronal network 2. a virtual body, the Animat, "living" in a virtual computer generated environment, connected to this array Patterns of neural activity are used to control the virtual body, and the computer is used as a sensory device to provide electrical feedback to the neural network about the Animat's movement in the virtual environment. The current aim of the Animat research is to study the neuronal activity and plasticity when learning and processing information in order to find a mathematical model for the neural network. It leads towards interesting questions about consciousness theories as well.

References
• T. B., Demarse, D. A. Wagenaar, A. W. Blau and S. M. Potter, ‘Neurally controlled computer-simulated animals: a new tool for studying learning and memory in vitro’ in Society for Neuroscience Annual Meeting, (2000) SFN ID: 2961. • T. B., Demarse, D. A. Wagenaar, A. W. Blau and S. M. Potter, (2001). ‘The neurally controlled Animat: biological brains acting with simulated bodies’ [1]. Autonomous Robots no.11, pp.305–310

External links
• Neurally-Controlled Animat [2]

References
[1] http:/ / www. neuro. gatech. edu/ groups/ potter/ papers/ AutonRobots. pdf [2] http:/ / www. neuro. gatech. edu/ groups/ potter/ animat. html

and advocacy groups from around the globe. Inc. cell-based therapeutics. Membership is also open to university neuroscience research centers. Brain Resource Company Ceregene Cogmed CNS Response Cyberkinetics Neurotechnology Systems CyberLearning Technology EEG Spectrum International NeuroNova NeuroPace Sound Pharmaceuticals Targacept • Neuroscience Research Centers • Allen Institute for Brain Science • Blanchette Rockefeller Neurosciences Institute • McGovern Institute for Brain Research • Patient Advocacy Groups and Research Foundations • Accelerate Brain Cancer Cure Leadership Zack Lynch is the executive director of NIO. Membership NIO membership is open to organizations engaged in the manufacture. as well as to promote and advocate for treatment and diagnostic options. and co-author of NeuroInsights’ annual report on The Neurotechnology Industry Report. BrainCells. the goal of NIO is to enhance awareness of brain and nervous system illnesses. . brain research centers. non-profit brain-state charities. an industry weblog providing commentary on the intersection of neuroscience and society. and diagnostic and surgical equipment used for treating neurological diseases. Inc. a market research firm covering the neurotechnology industry. nervous systems ailments and mental illnesses. research and development. Neurotech Insights. which he founded as a vehicle to give the neurotechnology industry a collective voice. He is the publisher of the investment newsletter. Member organizations include: • • • • • • • • • • • • • • • Acumen Pharmaceuticals Amarin Boston Life Sciences. Operating as a coalition of organizations in the field of neurotechnology. or marketing of pharmaceuticals. biologics. medical devices.Neurotechnology Industry Organization 196 Neurotechnology Industry Organization The Neurotechnology Industry Organization (NIO) is a San Francisco. He is the managing director of NeuroInsights. and non-profit brain research centers. editor of Brain Waves. California based non-profit trade association that represents a broad spectrum of companies involved in neuroscience.

and motor cortex stimulation. serotonin. is used mostly in the treatment of failed back surgery syndrome. implanted the first spinal cord stimulator device directly on the dorsal column for the treatment of chronic pain[2] and in 1971. at the present. It was hypothesized that input to the latter could be manipulated to “close the gate” to the former. Mechanism of action The neurophysiologic mechanisms of action of spinal cord stimulation are not completely understood yet. in the simplest form. Shealy et al. Specifically. In the case of ischemic pain.[7] . analgesia seems to derive from restoration of the oxygen demand supply. History Electrotherapy of pain by neurostimulation began shortly after Melzack and Wall proposed the gate control theory in 1965. It is also probable that a combination of the two abovementioned mechanisms is involved. Linderoth and others[5] [6] have noted that the mechanism of analgesia when SCS is applied in neuropathic pain states may be very different from that involved in analgesia due to limb ischemia.Neurotechnology Industry Organization 197 External links • NeurotechIndustry. an electrical pulse generator.Official website References [1] http:/ / www.[] This effect could be mediated by inhibition of the sympathetic system. complex regional pain syndrome and refractory pain due to ischemia. although vasodilation is another possibility. implanted in the epidural space. implanted in the lower abdominal area or gluteal region. consists of stimulating electrodes. neurotechindustry. there is some evidence for increased levels of GABA release. Shimogi and colleagues first reported the analgesic properties of epidural spinal cord stimulation[3] . In neuropathic pain states. suppressing the hyperexcitability of the neurons.[1] This theory proposed that nerves carrying painful peripheral stimuli and nerves carrying touch and vibratory sensation both terminate in the dorsal horn (the gate) of spinal cord. spinal cord stimulation. Since then this technique has undergone numerous technical and clinical developments. SCS has notable analgesic properties and.[4] At this time neurostimulation for the treatment of pain is used with peripheral nerve stimulation. As an application of the gate control theory. Spinal cord stimulation (SCS). and the generator remote control. deep brain stimulation. and perhaps suppression of levels of some excitatory amino acids. experimental evidence show that SCS alters the local neurochemistry in dorsal horn. org/ Spinal cord stimulator A spinal cord stimulator is a device used to exert pulsed electrical signals to the spinal cord to control chronic pain.org [1] . including glutamate and aspartate. conducting wires connecting the electrodes to the generator.

implanted stimulating electrodes and conducting wires connecting the electrodes to the generator. tunneling and connection of the connecting wires. which can be placed parallel to each other or at two different vertical sites. RF receivers have traditionally been used for patients that require high power settings that would quickly deplete a primary-cell IPG. variable current. a trial period (which takes between 5–7 days).[] . anchoring the electrodes to the interspinal ligaments. Percutaneous electrodes are easier to insert in comparison with paddle type.Spinal cord stimulator 198 Technical consideration Equipment SCS. variable voltage or constant voltage. For instance. Four quatrodes (four lead electrodes) could be inserted to cover two different sites bilaterally or up to four sites vertically. the area of paresthesia must overlap the area of pain. The former case. A patient could have two octrodes (eight lead electrodes). Selection of leads depends on which arrangement will give the best paresthesia coverage to the painful area. SC stimulators come in constant current. which are inserted via incision over spinal cord and laminectomy. which consist of an array of leads. and depending on the device and the surgeon’s preference. could be percutaneous type or paddle type. a maximum of 16-source devices are manufactured.[] Various current. could be a complete pulse generator module with its own battery or only a radio frequency (RF) receiver. The RF receiver on the other hand is externally driven by a transmitter from which it gets its power and pulses.[4] Insertion procedures and techniques SCS procedure involves careful placement of electrodes in the epidural space. usually called implantable pulse generator or IPG.[] Generator The generator.[] Selecting the level of stimulation The representation of the dermatomal level in the dorsal columns of the spinal cord is much higher than the corresponding vertebral level. Up to now. At present up to 16 electrodes can be stimulated by one system. consists of a pulse generator with its remote controls. the sweet spot for sciatic pain (dermatomal level L5/S1) is around T10 nerve. This external transmitter has a battery which can be easily replaced. has a battery of its own and could come with rechargeable battery which can be charged externally via a wireless power charger so that it does not need to be replaced surgically when it loses charge. in simplest form. implanted subcutaneously.[] The patient is also provided with a remote control to turn on and off the stimulator. voltage and waveforms configurations are possible. programming the system for the special pattern of stimulation and performing required postoperative cares.[] See dermatome and Spinal cord segments.[] A distinction is also made with respect to the number of independent power sources incorporated within the device. There are single source devices and multiple-source devices.[] Electrodes The electrodes. if the results of pain relieving was satisfactory in the trial period. The surgeon has a programming device that could be used to modify a wide range of stimulation settings of the RF generator. can change the programming of the stimulation patterns. and. positioning and implantation of the pulse generator. Electrodes selection For the SCS to be effective.

[15] . If the patient’s pain pattern requires the use of many electrodes with high power settings. mainly involving the lower back and/or legs after successful spinal surgery. Several studies showed overall efficacy of the SCS for FBSS.Spinal cord stimulator Generator implant The IPG or the RF unit is usually implanted in the lower abdominal area or in the posterior superior gluteal region. Widening the pulse width will also broaden the area of paraesthesia. Cycling of stimulation is also employed to save battery life. Changing of stimulator program may have to be undertaken during the course of therapy and follow-up. Lower voltage is chosen for peripheral nerves and paddle type electrodes. width and frequency of electrical pulses.[] Indications The most common use of SCS is failed back surgery syndrome (FBSS) in the United States and peripheral ischemic pain in Europe. the patient has failed conservative therapy. A trial period of stimulation over a period of 5–7 days should follow the psychiatric evaluation to demonstrate its effectiveness. Amplitude indicates the intensity of stimulation. It is an individual preference: some patients choose low frequency beating sensation whereas others prefer high frequency buzzing. FBSS. The trial is considered successful if the patient achieves more than a 50% reduction in pain.[13] Furthermore. It should be in a location that patients can access with their dominant hand for adjustment of their settings with the patient-held remote control.[] Patient selection Appropriate patients for neurostimulation implants must meet the following criteria: the patient has a diagnosis amenable to this therapy. See [] and [] for a more complete list and references of further applications. this technique is studied in various applications. decreasing the probability of angina attack. it has been shown to modulate the function of sympathetic nervous system and increase norepinephrine release in refractory angina pectoris[14] . but the newer IPG units will generally last several years at average power settings. It affects about 40% of patients who undergo spinal surgeries. The IPG battery life will largely depend on the power settings utilized. This is set within a range of 0–10 V according the type of electrode used and the type of nerves stimulated. classified as mixed pain syndrome (neuropathic and nociceptive). Ideally paraesthesia should be felt between 2 and 4 V. adjusting the amplitude. significant psychological issues have been ruled out. The decision to use a fully implantable IPG or an RF unit depends on several considerations. Frequency of pulse wave is usually between 20 and 120 hertz.[] Selection of lowest possible setting on all parameters is important in conserving battery life in non-rechargeable models of SCS. an RF unit should be used. and a trial has demonstrated pain relief. The electrodes are implanted in the bilateral suboccipital region.[8] [9] [10] [11] [12] SCS is also indicated in the treatment of inoperable ischemic limb pain. Pulse width usually varies from 100 to 400 us. SCS units have been used to treat patients with frequent migraines. This part of the protocol is important because of the cost of the equipment and the invasive nature of the procedure. For instance.[] 199 Programming Programming involves selecting the electrode stimulating configuration. . is the persistent or recurrent pain.

Anesth. Journal of Clinical Monitoring and Computing. emergency center visits. 2574–2583. MRI and therapeutic ultrasound can result in unexpected changes in stimulation. and Resnick. [4] Dilorenzo. 333-339.Spinal cord stimulator 200 Complications Complications with SCS range from simple easily correctable problems to devastating paralysis. Neuroengineering. See [] for list of such studies on cost effectiveness in various applications of SCS. so it can have associated complications such as infection. . D.D. Electrical inhibition of pain by stimulation of the dorsal columns: Preliminary reports. N. x-rays. and ongoing physician visits. Strong evidence is still lacking for SCS which may emerge in near future following robust research studies complimenting the rapid technological advances that is taking place in the field of SCS. [6] Oakley.[] Future SCS is finding its way to be applied to Parkinson’s disease. Advantages and disadvantages SCS is analgesia on demand.N.. Mortimer. 15% returned to work in the stimulation group versus 0% in the other group. 150–164. 63(4). Asai S. [3] Shimoji K. 3. [7] Kunnumpurath S. bleeding. The higher costs in the nonstimulator group were in the categories of medications. it might be possible to combine SCS with implanted drug delivery systems to produce synergistic effects minimizing side effects and complications. (2009). Chapter 7. J. and Wall. Soc. and Prager. J. Neurosurgery. fractured electrodes. and infection. R. The stimulation group annual cost was $29. Neuromodulation. (1999) "Physiology of spinal cord stimulation: review and update".. The most complications include lead migration. It is a useful option when other forms of therapy fail. [2] Shealy. Vadivelu. 20: 444–447. C.. J. 762–770. post dural puncture headache.. 23. It can also lead to failure of the device. [8] Kumar. Spine. Closed loop bio-feedback systems which communicate and record neural responses following spinal cord stimulation could be applied and utilized[20] In the future. (2008). K. R. present and future practice: A review. serious patient injury or death. Spinal cord stimulation: Principles of past. Higashi H. Kano T.. 1967. (2002). R. J. Int. They examined 104 patients with failed back surgery syndrome.. et al. Srinivasagopalan. Science. "Spinal cord stimulation: mechanism of action". L. 60 were implanted with a spinal cord stimulator. It reduces pain medication and side effects. seroma and transient paraplegia.000 in the other group. and dural puncture. Morioka T. pacemakers.S. (2008). Jacques. D. Taylor. Hardware-related complications such as electrode migration. 27.[] Cost effectiveness The cost effectiveness of spinal cord stimulation in the treatment of chronic back pain was evaluated by Kumar and colleagues in 2002[16] .000 versus $38. B. However. Both groups were monitored over a period of five years. in a 7-year follow-up. and rotation of pulse generator are also reported.[] References [1] Melzack. nerve injury and death. Electrical management of intractable pain.. It has the risk of disconnection or equipment failure. cerebrospinal fluid (CSF) leak. J. It is an invasive procedure. Of the 104 patients. Res. ISBN 978-0-8493-8174-4 [5] Linderoth.. discomfort at pulse generator site. J.[18] [19] More complex and power efficient microprocessor based equipments increasing the battery life could be developed. J.. Pain mechanisms: a new theory. 150:971–979.[] SCS interaction with diathermy. See also[17] for another study of cost effectiveness. R. (1965). (1971) Masui (The Japanese journal of anesthesiology). It is effective in about 50–70% cases. Other complications include haematomas (subcutaneous or epidural).T. and Foreman. 46:489–491. P. the overall complication rate was 5-18%. lead breakage. CRC Press. and Bronzino. "The effects of spinal cord stimulation in neuropathic pain are sustained: a 24-month follow-up of the prospective randomized controlled multicenter trial of the effectiveness of spinal cord stimulation".

"Neural interface devices: spinal cord stimulation technology". 323(5921). Neurosurgery. (2008). Sandoval JA.A. (2009). Operative Neuromodulation: Volume 2: Neural Networks Surgery. "Spinal cord stimulation for chronic low back pain: a systematic literature synthesis". doi:10. 178(1). J. 37(6). Berg. Ross.. 2. B. Furlan AD. 13 (5). [17] Bell.S... E.. 96. W. Loeser. (2009). Gersbach. R. T. "Treatment of chronic pain with spinal cord stimulation versus alternative therapies: cost-effectiveness analysis". J. D. D. et al.G. 22.. Bartsch T.H.. Brian. Sakas. and Piantadosi. North RB. "Spinal cord stimulation in the treatment of nonreconstructable stable critical leg ischaemia: results of the European Peripheral Vascular Disease Outcome Study (SCSEPOS) ". and Demeria.. controlled trial". [11] Turner. discussion 106–7. 99–102.. "Cost-effectiveness analysis of spinal cord stimulation in treatment of failed back surgery syndrome". Implantable Neural Prostheses 1: Devices and Applications.H.. De Vries. J. Pain Symptom Manage.T. (2001). Y. Spinal Cord Stimulation Restores Locomotion in Animal Models of Parkinson's Disease. S. (2003). J. J..1002/14651858. 201 Further reading Zhou.. Piantadosi SA (2005). Proceedings of the IEEE. PMID 15266501. 280–286. Eur J Vasc Endovasc Surg.Spinal cord stimulator [9] North. PMID 15617591. et al. Neurosurgery. Law. . A. Brain 127 (Pt 1): 220–30. Cochrane Database Syst Rev (3): CD003783. G. 1578-1582. R. "Spinal cord stimulation for chronic pain of spinal origin". Caron. Damianos. [18] Fuentes. "Spinal cord stimulation for chronic pain". David and Greenbaum. [15] Matharu MS. Brown. "Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study". Suppl.. Taylor R (2004). Petersson. "Epidural spinal cord stimulation with a multiple electrode paddle lead is effective in treating low back pain".. Kidd.. (2007). 333–428. (1995). S.64. G. randomized study design". J.B. Malik. Siesser.1093/brain/awh022.. "Spinal cord stimulation in the treatment of refractory angina: systematic review and meta-analysis of randomised controlled trials". BMC Cardiovasc Disord.B.A. 26. J. 1108-19. (2009) "A retrofitted neural recording system with a novel stimulation IC to monitor early neural responses from a stimulating electrode". E. pp.. & Nicolelis. M... PMID 14607792. Goadsby PJ (2004). R. Gamain. Oakley.CD003783. P. [19] Spinal Cord Stimulator Sparks Hope for Parkinson's Disease – Duke University (http:/ / www.. R. [14] Taylor.D. Springer. Weiner R. Buchser. Science. 9(13). et al. [12] North. 285–296. Neurosurgery 56 (1): 98–106. Acta Neurochir. K. 2584–2591. J. (2002). L. [13] Amann.pub2. Mailis-Gagnon A. D. Frackowiak RS. P. Kidd DH. M. 59–66. P. (2002). Ward N. Raphael. K. youtube. G. 106–108. ISBN 978-0-387-77260-8. Simpson. W. and Bell..D.. Springer. J. (2009). doi:10. Neuromodulation. R. [16] Kumar.. Spine.. Ubbink. Elias. ISBN 978-3-211-33080-7 North. 51(1). 1088–1095. 106–115. pp. (1995). "Spinal cord stimulation versus reoperation for failed back surgery syndrome: a prospective. J Neurosci Methods. Farrokhi F. [10] Barolat. and North. and Wetzel. com/ watch?v=0b6OElzJlMg) [20] Nam. R... (1997).. "Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: a randomized.

In the Shaper/Mechanist stories of Bruce Sterling. "When we turn the current on. the patients report the emptiness suddenly disappears" (http:/ / www. sometimes causing them to speak other nam-shubs to other non-wired but programmable. 1992. The Guardian reported that trials of deep brain stimulation with electric current. uk/ science/ 2006/ mar/ 31/ medicalresearch. page 427. selecting against that portion of Known Space humanity without self-control. spoken programs which they immediately carry out."[3] The name "wirehead" refers to the foot long black rubber[4] antenna that protrudes from their heads. Alok (2006-03-31). moving these guys around like an air traffic controller. . In 2006. In Neal Stephenson's novel Snow Crash. 1992. In Larry Niven's Known Space stories. [3] Stephenson. page 370. Asherah-infected people around them. [2] Stephenson. . 1992.[1] This is the method used by wireheads in the earlier Niven stories (such as the 'Gil the Arm' story Death By Ectasy). "wirehead" is the Mechanist term for a human who has given up corporeal existence and become an infomorph. References [1] Jha. Bantam Books. Bantam Books. page 836. co. a wirehead is someone who has been fitted with an electronic brain implant (called a "droud" in the stories) to stimulate the pleasure centers of their brain. Bantam Books. The Guardian. neuroscience). Wireheading is so powerful and easy that it becomes an evolutionary pressure. wireheading is the most addictive habit known (the only given example of withdrawal is Louis Wu). and wireheads usually die from neglecting themselves in favor of the ceaseless pleasure. guardian. sitting in the Enterprise's control tower. Bantam Books. an en.Wirehead (science fiction) 202 Wirehead (science fiction) Wirehead is a term used in science fiction works to denote different kinds of interaction between people and technology. [5] Stephenson. 1992. Neal: Snow Crash. a "wirehead" (also called "antenna head") is someone fitted with low level brain stem[2] implant used (perhaps among other things) for control by and communication with a "hacker-in-charge. the pleasure center can be remotely activated by a small device called a "tasp" (important in the Ringworld novels). via wires inserted into the brain. Neal: Snow Crash. They are said by Eliot to be "Raft gargoyle types" [5] suggesting a capability for information gathering and surveillance. The antenna is permanently grafted to their skulls and enables them to receive nam-shubs. In the Known Space universe. Wireheading need not use an actual brain implant. had successfully lifted the mood of depression sufferers. Neal: Snow Crash. page 385. Neal: Snow Crash. [4] Stephenson.

Scrane72. Omegatron. Tiak. Taylorchas. Xetrov. Skomorokh. Gil987. Accuruss. Rjanag. Bobo192. Rettetast. DabMachine. Dessydes. Dontaskme. Marleneklingeman. Hu. Deodar. Michael Tangermann. LittleHow. Yelyos.php?oldid=401080604  Contributors: Alin0Steglinski. Clngre. Rich Farmbrough. Merlion444. Enric Naval. Grstain. Meightysix. Spiritia. Yug. Grundle2600. Shwmtpf. Bonadea. Gaius Cornelius. Fnijboer. Emperorbma. DutchiePwn. Tritium6. Kondaz. DanielCD. LittleHow. Dudeyowuzup. Shadowmage13. The Thing That Should Not Be. Mike118. Odissea. Gaius Cornelius. AngryParsley. Joeyo. Benreaves.v2. Wingman4l7. EBlack. Jaguara. Facts707. Avraham. Yamamoto Ichiro. Theladybug007. Rjwilmsi. RebeccaMurff. Whelanrobwiki. Ylwarrior. Ling. VSEPR. Stuart Morrow. Sarathlals. Rjanag. GDallimore. Ashishbhatnagar72. Royalguard11. Cburnett. 31 anonymous edits Electroencephalography  Source: http://en. Oleg Alexandrov. Julesd.php?oldid=418764396  Contributors: Aneuroscientist. Yashgaroth. Sir anon1. Crash Comet. 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Gronky. Sepiraph. Jreferee. Njyoder. Sarah. David Latapie. ThoHug. MichaelMcGuffin. AI. Rror. Xnike315x. Pnm. Verdatum. Philip Trueman. Plasticup. Joe3600. Halda. Lüder Deecke. PaulWicks. 1 anonymous edits Comparison of consumer brain–computer interfaces  Source: http://en. Giftlite. Sberger11604. II MusLiM HyBRiD II. Anthonyhcole. Glacier Wolf. Nectarflowed. Chowbok. Sjschen.kuzovkin. Epastore. Urod. Beland. Pjacobi. Chendy. SimonP.php?oldid=421864451  Contributors: A314268. FiachraByrne. Giraffedata. Poorman1. Neuroscientist1. AbsolutDan. Piet Delport. SFairchild. D. Yamara. Mswonderly1948. Trevyn. Speedwiki. Lordvolton. GoOdCoNtEnT. Mrs. Naddy. Cry Rebel Spaceman. Mbauman. Omegatron. Edgar181. Wknight94. Primate1. Papa November. Jncraton. Leszek Jańczuk. Human. Neuro11. Nightscream. Animalresearcher. Tatterfly. Alynna Kasmira. Monito. Rustyfence. Mikage31582. Xieliwei. Dependent Variable. Selket. Wikifarzin. Thexeve. Caesura. Beyondsquirrelly. Jake Nelson. Can't sleep. Jugander. Bigmantonyd. Rich Farmbrough.. Reinyday. Chris Capoccia. Jjoensuu. Ilphin. Jagged37. Rich Farmbrough. Mac Davis. McSly.php?oldid=427635880  Contributors: 43?9enter. Glogger. Epbr123.killer. Thuglas. Greenrd. TakuyaMurata. AdjustShift. Emptymountains. SanGatiche. Jcsutton. River2010. Saganaki-. 22 anonymous edits Cyberware  Source: http://en. Back ache. Saganaki-.org/w/index. Sole Soul. Saganaki-. STGM. Animalresearcher. Bilalkhalid. TjeerdB. Omegatron. Cpiral. 29 anonymous edits Brain implant  Source: http://en. Lradrama. Lordvolton. Artuskg. LookingGlass. Delphii. Rjwilmsi. Crippled Sloth. SFairchild. Lemmey.org/w/index. KUutela. Mac.wikipedia. Furrykef. Schelkopf. Creature8. Foglemark. Jeff G.org/w/index. Hu. BenRayfield. 373 anonymous edits Bereitschaftspotential  Source: http://en. Deodar. Minna Sora no Shita. Ahruman. Martarius. Clicketyclack.org/w/index. LittleHow. Wjousts. Psydoc. Tikiwont. Touch. Iridescent. Fitibones. 488 anonymous edits Emotiv Systems  Source: http://en. 2over0. Dancter. PhilipisTrue. Geenah. PiccoloNamek. Carolus. GoingBatty.ילארשי יסוי‬anonymous edits BrainGate  Source: http://en. Stratocracy. Marcus Brute. Eequor. Spoonyhands.Warner. 35 anonymous edits Electrocorticography  Source: http://en. Sineenuchn.and. Wikinatious. DFRussia. Schuetzm. clown will eat me. Ariangiovanni. Tesseract2. InternetMeme. Ed Poor. Fyyer. Cliché Online. Lent1999. Aorwing. Katharine908. CliffC. Kbwinn1. MakeBelieveMonster. Δ. Jfolt. Jack Merridew. Tonyfaull. River2010. Janbrogger. Barrylb. Panserbjørn. Sirmikey. Centrx. Larsie. Rama. Neo-Vortex. Old Guard. Three887. Repku. Mextor. Eykanal.delanoy. Flamurai. 22 anonymous edits Cyberkinetics  Source: http://en. Longhair. Luccas.wikipedia. Schulze-bonhage. Kollision.lifeguard. Cambyzez nl. Samuel Blanning. Beltz. Pingveno. BlackAndy. Pearle. Waldir. Deodar. Antandrus. Cyphercube. Filip em. DXBari. LindsayH. Llxwarbirdxll. GeoffreyMay. Themfromspace. Koveras. Yamishadow. Zsinj. Kndiaye. Looie496. Jdlambert. Veinor.wikipedia. Sannse.org/w/index. FeloniousMonk. Wmattis. Kozuch. Mlewis000. Jumping cheese.wikipedia. Theo177. Ozzykhan. Larsie. AbsolutDan. Veinor. LabFox. EvilCouch. KrakatoaKatie. A314268. Jfdwolff. A314268. Tom Morris. Gregbard. Polyparadigm. Recurring dreams. Ebeeto. Poshzombie. CarlKenner. Riedl. Daggnydavis. Wjousts. Wingman4l7. Fences and windows. Paiamshadi. Twinsday. Spantik2011. Mike. Kizor. Berserkerus. George Church. 172 anonymous edits Force Trainer  Source: http://en. Rjwilmsi.org/w/index. AllenFerguson.wikipedia. Trusilver. OrangUtanUK. Cygnette. Usertoday1234. Arcadian. Schmloof. Miroku Sanna. SunCreator. Zefryl. Bob A.org/w/index. Mschick22. Edward. Flash. Esprit15d. Giftlite. BenRayfield. DopefishJustin. David Latapie. Jim. HaeB. Redheylin. Aviatorpilotman. Suryadas. YOKOTA Kuniteru. DXBari. Fences and windows. Rolando. Superm401. Epolk. Jones2. Kilo-Lima. PaulWicks. Arcadian. Kostmo. David Latapie.php?oldid=420745131  Contributors: Aminto. Rvanschaik. Endoran. Bewildebeast. Jrockley. Hoary. Speedwiki.php?oldid=428227269  Contributors: 5Q5. Insanity Incarnate. Posix memalign. Javert. PSYBIRD1. Zondor. Bakashi10. Legija. Marra. Nabinkm. A314268. Baksiidaa. Jjoensuu. Millencolin.wikipedia. Namita123. Veronica Roberts. Atstdriver. Dbroadwell.0. Jweis. LizzardKitty. Validmoved. DXBari. Serapion. Matt B. ACSE. Tom Morris. 55 anonymous edits Comparison of neurofeedback software  Source: http://en. Bcjordan. Chinasaur. CardinalDan. J.org/w/index. Quadalpha. Mac.. Hobartimus. JWSchmidt. Michael Bednarek. Hajor. L Trezise. PaulWicks. Ahruman. Zokvok. Male1979. Eleassar. Dsackett. Hbent. CliffC. BenKovitz. Calvin 1998.php?oldid=427954044  Contributors: AVRS. G. Pro crast in a tor. Crazymonkey1123. Waldir. Pmcmenamin3. RJFJR. Addshore. Alex Spade. Imasleepviking. C. Mindcode. Jumbolino. Fragglet. Dfrankow. Kbdank71. Heah. YOKOTA Kuniteru. CBM. DocWatson42. Roberrific. Raphman. Lansey. TheBilly. Noclevername. Radagast83.wikipedia. Saganaki-. Simbven. SiobhanHansa. The Ark Angell. BirgitteSB. Neozoon.Nut. This deserves inclusion. Meightysix. Bhamadicharef. Trippsusername. DoctorDog. Iplant. Surv1v4l1st. Alphalobe. Codeczero. Corinne68. Steve Quinn. Martynas Patasius. Hewn. Waldir. Datahaki. SpeedyGonsales. Mbmaciver. Tonyfaull. Splitpeasoup. Russell. VladV. Heron. Wojder. Oleg Alexandrov. Joe3600. Sonjaaa. DerHexer. Eekerz. Celebere. GregRM. NawlinWiki. McGeddon. Neuro11. Fnielsen. Supten. ShelfSkewed. Mossig. Mmoneypenny. Simbamford.wikipedia. Former user. Zeuszeus1122. Kesla. Sceptre. Shadowmage13. Wingman358. LegitimateAndEvenCompelling. Macdorman. DividedByNegativeZero. Maximus Rex. Cshirky. PFHLai. Sietse Snel. Callumny. Jorend. Serapion. Chowbok. ReeseAllen. MarcoTolo. Ade mc.php?oldid=422171680  Contributors: ***Ria777. Atomicthumbs. ShanqingCai. MIRROR. Nono64. Betacommand. Materialscientist. Eldang. MrRadioGuy. Mendaliv. AGToth. Keilana. Andycjp. Myrvin. Woohookitty. Mikael Häggström. Trevyn. CanadianCaesar. Grrow. Pjacobi. Avraham. RJHall. InternetMeme. JonathonReinhart. Kwiki. JeanneMish. Bugnot. Eekerz. Kpmiyapuram.wikipedia. AbsolutDan. Toussaint. Kanags. Redhorseby.wikipedia. Bk0. Axfangli. Gleng. Mirasoledrecovery. Lockg. CAnc. Robert K S. Jake Nelson. Zachlipton. Tekhnofiend. Antaya.org/w/index.org/w/index. John of Reading. Gyro2222. Ashdurbat. Colin. Wavelength. Delldot.wikipedia. Looie496. Martarius. Trevyn.Right. Neuro11. Balizarde. TexasAndroid.henderson. Chstdu. Deodar. Forteanajones.wikipedia. A. BrandonSargent. Ceyockey. The Evil IP address. Brighterorange. Rsabbatini. Capricorn42. MasterDoom. RMHED. Rhombus. Dark Shikari. MissAlyx. Shantavira. Rjwilmsi. IceKarma. Speedwiki. Banus. McGeddon. Tim!. Mjnhbg3. Middleman 77. Bradka. The Anome. XXLOLDAXx. MrSandman. LLcopp. Phoenix1177. MrOllie. Torchwoodwho. Dreftymac. Radomil. Tyhsu. Shooravi. Emotivated. Can't sleep. MacGyverMagic.org/w/index. Mmortal03. Calabraxthis.luxemburg. AVJP619. Donhoraldo. Giftlite.org/w/index. JuneD. Lancewf. Karada. clown will eat me. Davecrosby uk. Furrykef. Mellery. Edgar181. MrPinky. EastTN. Ismailmohammed.php?oldid=423917755  Contributors: ASK. Btait101. Sonicandfffan. Tani unit. Fredrik. Dranorter. Eykanal. Michaelbusch. 6 anonymous edits Intracranial EEG  Source: http://en. Canislupusarctos. Rjwilmsi. Nonlinearity. Sayeth. Info005. Irishguy. Destynova. NZUlysses. Kieranfox. Lossenelin. Blueboy96. Ilja. Sribulusu. Rjwilmsi. Jeremystalked. Hedgehog33. Tarotcards. A. Muntfish. LilHelpa. Geenah71. Datahaki. Altermike. Methegreat. Sigmo32. Mikael Häggström. XApple. WhatamIdoing. Nono64. Ryan. Crusio. Salsb. Mackseem. Tritium6. Grundle2600. Lateg. The Ark Angell. Dragice. Sondast. PiccoloNamek. Rsabbatini. RJFJR.Article Sources and Contributors 203 Article Sources and Contributors Brain–computer interface  Source: http://en. Richwil. DabMachine. SchfiftyThree. Jtoomim. Chephyr. Frei Hans. Lova Falk. Cronides2. Gaius Cornelius. Popefauvexxiii. Temporaluser. AndrewTJ31. Beefnut. Axfangli. Smihael. Simbamford. Gromster127. Saifullakc87. Simoneau. Alouisos. Jaberwocky6669.meganmmc. Ohconfucius. Gurch. Th1alb. Altermike. Jayseye. RoyBoy. GreyCat. Yuriybrisk. Epugachev.tec. Carax. Mamling. Moonraker12.php?oldid=424164487  Contributors: 4RM0. Kfederme.php?oldid=400674794  Contributors: Asdf98761. Recury. Goethean. Army1987. Vssun.php?oldid=420745163  Contributors: Mitch Ames. Snowolf. Looie496. Epbr123. Tis the season to be jolly. Oleg Alexandrov. Mjnhbg3. Fallenangei. MasterGreenLantern. Iridescent. JustinWick. Clicketyclack. PaulWicks. Robertmabell. Valdeanebrown. Geschichte.

GoOdCoNtEnT. E123. Untrue Believer. Petrelli. A314268. Alai. TBAmes. Bobo192. Stevvvv4444. Lbeben. Impp. VSerrata. Beetstra. Nono64. Ediacara. Keilana. JeanneMish. Fratrep. MWadwell. Cygnette.wikipedia. Frasor.eyes. SamEV. clown will eat me. Vladimir Grichina. Kbh3rd. Didgeweb. Janm67. Shanel. Gbleem.p. Ph. Floegger. Dancter. Amalas. Markhoney. ABF. Fabrictramp. Alchemystical. Betterbelieveitnoway. Millencolin.php?oldid=409522636  Contributors: Arbitrarily0. IO Device. ArmadilloFromHell. K1zza1. Zodon. Tonlist. Christaj. Lockg. ‫ 73 . Delta494.. Unregistered12. MightyMongo. Johnpseudo. Rickterp. Johnny Controletti. Ser Amantio di Nicolao. Allen3.php?oldid=410459201  Contributors: ASA-IRULE. Back ache. Scampuza. SunCreator. Matagascar. Rich Farmbrough. John of Reading. Fanra. Woohookitty. DanShearer. Moink. Isotope23. LaszloWalrus. Dffgd. Rjwilmsi. LtPowers. Halda. Sjara. Ericjlee. Hankwang. Mindspillage. Wloveral.wikipedia. AllenFerguson. RedWolf. Woohookitty. Fconaway.org/w/index. Tehreem Chaudhary. Stoljaroff1987. Eduardo. Typhoon. DanMS. Henry. WikipedianMarlith. Cedders. Katalaveno. Axl. Dlyons493. Courtarro. The Evil Spartan. RHaworth. Matt Deres. Giraffedata. Great Dazz. Stevenfruitsmaak. Oanabay04. Bidoman. Rjwilmsi. BlueAmethyst. DXBari. Jfarr11. Rich Farmbrough. Darklilac. ArglebargleIV. Light current.wikipedia. Cirecipient. Pol098.wikipedia. Lujanjl. Victorma92. Chinasaur. Autocracy. Cathryn. Ds13. Fayenatic london. Jtrainor. GerardM. Flip619. Bsadowski1. Disavian. RetroS1mone. RNazar RN. Leirbag. Bricology. The136th. Rpaliga. Lordvolton. Stronghold Six. AnotherSolipsist. Gary King. Crickets2011. MER-C. Hadal. Jaysscholar. MER-C. Txomin. Marj Tiefert. Eric Kvaalen. Deodar.wikipedia. Arrenlex. Spartanus. Gmchambless1. Bostonvaulter. Andyjsmith. Akhilleus.. Nsevs. Gaggafuto. Dina. Uppland. MrOllie. Linnell. Courcelles. J04n. Brooknet. Froxyroxy. Gene Nygaard. Otolemur crassicaudatus. Pbrolli. Conscious. Arcadian. CochlearUK. Jfdwolff. 32 anonymous edits Miguel Nicolelis  Source: http://en. JeanneMish. Dantadd. Yaxu. Osmodiar. Intangir. Maximus Rex. VsevolodKrolikov. RDBrown. Looie496.pintens. Cyrius. Dogbertbh. DAJF. Mehmet Karatay. Pavel Vozenilek. Ekko. Jacklee. A2107706. ONUnicorn.wikipedia. Shadowjams. El3146a. Crushfo. DBailey635. Jared Preston. ElBenevolente. Hannroy 13. Funnyfiggy.php?oldid=395153251  Contributors: Agamemnon2. Salgueiro. Jessi1989. QuiescentWonder. Ruhrfisch. OneElitePenguin.org/w/index. Goulo. Can't sleep. Iknowyourider. Diberri. Hugo999.Article Sources and Contributors Mindball  Source: http://en. Seppe. Trevyn. Owain.org/w/index. Hivequeen.php?oldid=410459272  Contributors: Ace Frahm. Christaj. Wikiborg. Kozuch. Ssspera. Omicronpersei8. MrOllie. Bradka. Geodyde. Tabletop. Charly36065. KnightRider. DanielDeibler. Amx. 2 anonymous edits Brain pacemaker  Source: http://en. Olli. Kf4bdy. Dreadstar. 1 anonymous edits Jorge Cham  Source: http://en. Ian Pitchford. John Broughton. Rich Farmbrough. MRK2001. MarcoTolo. SalineBrain. Centrx. Lujanjl. Cahk. Janm67.tan. Zvar. Joeyo.wikipedia. LittleHow. 97198. SFairchild. Bartendersam. BenAveling. Strubin. Rsabbatini. NeuronExMachina. Orvilleduck. 11 anonymous edits Optogenetics  Source: http://en. Chris the speller. Micahbrwn. Brownstone Mr. Million Moments. Sintaku. 24 anonymous edits Chronic electrode implants  Source: http://en. Holon67. Rtdixon86. Alex. Ethics&Integrity. Deaf dude. Michael Hardy. Ground Zero. Dana boomer. Always a student. Deskana. CarlKenner. Samir. Chsh. JForget. Bezapt. Style. InvictaHOG. Mchorost. Twirligig. Mike Rosoft. DocWatson42. Mashi2. Alexjcharlton. Alvin Seville. Christopher Parham. Elmaynardo. JoshPearce1993. Wodawik. Ian Pitchford. 8 anonymous edits Cochlear implant  Source: http://en. Tgeller. Ragib. Nectarflowed. Joseph Solis in Australia. Jay. Edwtie. Zoombla. 30 anonymous edits Neural Impulse Actuator  Source: http://en. Derek. TheAMmollusc. Benbest. J04n.org/w/index.chen. Funandtrvl. Foxmarks.org/w/index. Robert K S. Millichip. Eric Jack Nash. J. Can't sleep.cashman. Gunnar Hendrich. 6 anonymous edits Neuroprosthetics  Source: http://en. RDBrown.org/w/index. Bugnot. Deodar. Metju. Wavelength. Rainer Wasserfuhr. Trelos physikos. MWadwell. Luuknam. BladeRunner99.php?oldid=413510175  Contributors: ***Ria777. Estudies. Mcks. MoodyGroove. Ecnassianer. Intangir. Jlujan69. Yonatan. Mamaberry11. Mervyn. JJL. L'Aquatique. Simon-in-sagamihara. David Gerard. WVhybrid. Mboverload.php?oldid=427901044  Contributors: 168. Cmdrjameson. Thumperward. Section6. JefeMixtli. Mossig. Dillard421. Wouterstomp. Neurotechie. Adrigon. Deglr6328. La Pianista. Hmains. Chowbok. THEN WHO WAS PHONE?. Odissea. Mira. Joeyo. AB.org/w/index. Jesse Shearin.house. Hooperbloob. Arichnad. Azzayan. Anthonyhcole. Aseemb. Jamie sommers. DirkvdM.miranda. Leszek Jańczuk. Polylerus. Nephron. Rjwilmsi. Barneca. Smylere Snape. Drsamir. R'n'B. Closedmouth. Waithought. Jake Nelson. Moshe cohen7. Angus. Leonard G. Deafgeek. Darkspots. Plasticmars. Belanidia. Ap. Mr Tan. Horsten. GCorvera. Discpad. CliffC. Spoon!. Matilda. Wavehunter. Xacto. Finan3. RupertMillard. Gurch. Bearcat. Mrdini. Millancad. YUL89YYZ. Sceptre. Geoffrey Wickham. LilHelpa. Laubzega. Erth64net.ham123. Mac. John Vandenberg. Nbauman. Kalaong. AVRS. AbsolutDan. Katharineamy. Woohookitty. Wapcaplet. Camw. Hearingpocket. Gboggs. Maxschmelling. Wojder. Dblantau9001. Sberger11604.Hull. GiggsHammouri. 434 anonymous edits Auditory brainstem implant  Source: http://en. Norealname. Rama. LittleHow. Ashdod. JeanneMish. Boleyn2.r. ClockworkSoul. Jake Nelson. Timrollpickering. SallyForth123. Stephen Henry Davies.org/w/index. Xero. Nedrutland. Jmh649. Adair2324. Tristanb. Blehfu. Ezra Wax. Anlace. Wingman4l7. Erik. Ha-reed. Karonaway.wikipedia. PseudoSudo. Duncan. Jbushnell. Saganaki-. Wernher. QRS.wikipedia. Emersoni. Molimaging. Mrs 204 . Mcld.org/w/index.wikipedia. DRGrim. Radon210. Leidiot. MetalModem. OnePt618.php?oldid=410459206  Contributors: Altermike. Dominus.php?oldid=405766179  Contributors: Chanakal. Jaime Sommers 2008. Iassaiias. Malo. HexaChord. BenFrantzDale. Ceyockey. MentalModem. Jmlk17. Joyous!. Airplaneman. Orangebodhi.a.org/w/index. Boleyn.php?oldid=421842103  Contributors: Bugnot. Foobar. The Thing That Should Not Be. Sam8. Ulrichcunctator. The undertow. Colonies Chris. Cckkab. Bobo192. Lexw. Epdocdp. Woohookitty. Gobbleswoggler. Chrisny2. Igoldste. Explicit. J. JonathonReinhart. Lodders. Chaos421. Cedtheman. Madhero88. AD1971. Dlodge. Skysmith. Ashfordian. Capricorn42. L Kensington. Simbamford. JDoorjam. HaeB. 56 anonymous edits Eduardo Reck Miranda  Source: http://en. Amiralia. Zhenghegatech.php?oldid=426578964  Contributors: Arjun024.org/w/index. Gertlex. Ethidium. LachlanA. Oleg Alexandrov.. Alanwkelly. Blurpeace. Joeyo. Desoto10. Pointer2948.php?oldid=422778789  Contributors: A314268. Ronhjones. LodeRunner. CapitalR. Neuberliner. Casliber. Kevin143. KVDP. Father Time89. Bearcat. Gaius Cornelius. Saganaki-. Erebus555. Tremilux.org/w/index. Jasfkldfjkslda. Radagast83. Tryptofish. SWAdair.org/w/index. Micru. 20 anonymous edits Giles Brindley  Source: http://en. Bugnot. Antonrojo. MaxSem. Peterjmag. 59 anonymous edits Neurochip  Source: http://en. Smithfarm. Dolfrog. Mossig. Arch dude. Hxq. Gak. Ageslome. Majukutaj. Mikemoral. Dinnerbone.h333. Y1n x1. Itinerant1. Serrin. Joshk93. Ageekgal. MissTravelGirl. Scheibelhofer. Eastlaw. Jake Nelson. Davidovic. Carnildo. MisterDives. Marasmusine. Mandarax. Samasamas. Taxidermacat. Studerby. Neilbeach. 1 anonymous edits Neil Weste  Source: http://en. Xbcj0843hck3. Tgies.wikipedia. clown will eat me. JacobWWP. Nargalzius. Drbreznjev. Finlay McWalter. Nesa 1224. Marek69. Rich Farmbrough. Katefan0. Muddyphuddy. Brighterorange. Rjwilmsi. PFHLai. Deodar. Deor. Onebravemonkey. AbsolutDan. CommonsDelinker. Kurt.org/w/index. Pearle.org/w/index. SFairchild. Hede2000. Kslays. Ascidian. PhilDWraight. Majurawombat. Ghyom. JulesH. Willstrong2010. HonestGeorgeWashington.. JForget. Emmjade. InternetMeme. Rjwilmsi. Hdt83.wikipedia. MPerel. Layraud. Camembert.heikkinen.org/w/index. Sir sigurd. Snowolf. 87 anonymous edits Artificial pacemaker  Source: http://en. Squids and Chips. Conscious. Katharineamy. Ihcoyc. Florentino floro. Xaosflux. MonoAV. Danaman5.wikipedia. JoeSmack. Santryl. Gurch. Bdakter. Vlad. Trent Allen. Rexbannon. Gfeet24. Bryan Derksen. Edward. Avono. Jonas Mur. EdwardBlake. Correogsk. ChangLimbang. AndrewTJ31. RDBrown. Banaticus. Someone else.php?oldid=420745202  Contributors: Darkwind. CopperKettle. Chungclan. Waldir. Sausagerooster. Haseo9999. Deansson. Andrev.wikipedia.wikipedia. CommonsDelinker. Aznbasebalplaya. Rodhullandemu. Malcolma.wikipedia. Epbr123. David. Dcreemer. Zaphod-Swe. ThaddeusB. Full Shunyata. Zachary. Gaff.php?oldid=419656812  Contributors: A10brown. Verne Equinox. Mattbr. Kozzak. Wikipelli. Materialscientist. Closedmouth.org/w/index. Bezapt. Earlgrey29. KieferSkunk. Gyrobo.php?oldid=409159853  Contributors: Toussaint Transcranial alternating current stimulation  Source: http://en. Steven Walling. Lenborje. Urod. Gaius Cornelius. Mogilner.wikipedia. JYi. December21st2012Freak. Plucas58. JamesHenstridge. Rjwilmsi. Flage. DabMachine.org/w/index. BoojiBoy. Mikael Häggström. Fences and windows. Jreferee. AlphaEta. 17 anonymous edits NeuroSky  Source: http://en. Wikibofh. Maghnus. Disavian. JackofOz. Interik. Clarityfiend. Facts707. Heds. Primate1.org/w/index. Gamer 2k4.wikipedia. Dcclark. Gene Hobbs. Fan-1967. Arganoid. LDerr. Pathless. Everton137. AED. John Carter. Iqbal. Lynsmi. Deodar. Gnusmas. Reyk. Vasil16. Davidruben. May0104. Phil Bridger.org/w/index. No bagel. Montrealais.davies. CardinalDan. NeuralBionics. MaineLander. Bobblewik. Dispenser. Imtiazchow. Zinger0. McGovern MIT neuroengineer. DocWatson42. NeD80. Lukee1234. Doug Bell. Yashgaroth. Kerowyn. Jjoensuu. Download. Ruhparwar. ArrhythmiaAlliance. Kjramesh. WadeSimMiser. ClockworkLunch. Lidagreg. Queenmomcat. Richardelainechambers. FunnyMan3595. BillGates12345. Guillom. Kurtfairfield. Urod.php?oldid=423974497  Contributors: AED.php?oldid=427978963  Contributors: 11nextweek.php?oldid=424622413  Contributors: Bezenek. Skysmith. Rich Farmbrough. Premeditated Chaos. Jonkerz.delanoy. Nonlinearity. DrJCPC.php?oldid=411694144  Contributors: Deodar. Karl 334. Andycjp. Leffe00. Fair Deal. Sibian. Ground Zero. Jim2710. Irbisgreif. Rjwilmsi. Mobial. Rsabbatini.רואיל‬anonymous edits Thought recording and reproduction device  Source: http://en. Tiak. Simbamford. OwenX. Kleinzach. Toussaint. Nono64. 2 anonymous edits Biological pacemaker  Source: http://en. InternetMeme. Stephen Morley. Danielle simon. Geoffrey Wickham. BecauseImAwesomeThatsWhy. Sabbe. Bugnot. CarlKenner. Ksheka.php?oldid=406062765  Contributors: AED. Vpace1. Berserkerz Crit. Muhandes. Fabrictramp. Thingg. Bitte Hanell.php?oldid=426062849  Contributors: 2over0. David Eppstein. Yug. 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Druidhills. Belovedfreak. Dodger67.org/w/index. Frap. Jeff3000. Adavis444. Tabletop. I'm the Cavalry. Wikkieddit. Jensgb. The Thing That Should Not Be. Hugh2414. Tsetsalullu. Tea with toast. MikeVitale. Falsepositives. Tonlist. SJS1971. Pgr94. Wik. NHRHS2010. Paranoid. Qaz. Stewartadcock. Sierrafarris. Bovlb. Sir Coolio. Chase me ladies. Emelon8. Clicketyclack. TheParanoidOne. Richard Arthur Norton (1958. Hfarmer. Mikebpac. Michael Hardy. ST47. Stifle. Snalwibma. Redwood57. Bmeguru. Casliber. Finlay McWalter. Ohms law. Deodar. Centrx. ArrhythmiaAlliance. Bhouston.wikipedia. Ombudsman 205 . Rich Farmbrough. BruceJGluckman. Arch dude.fd. Rjwilmsi. Deodar. Zotel. Wduch. Englishnerd. Lipothymia. Njan. Jag123. VBGFscJUn3. Minority Report. Tim Starling. Dbachmann. Tjerks. Michael Hardy. Dennis Myts. Corwinlw. ZimZalaBim. Freakofnurture. Bubba hotep. Wtp512. Tassedethe. Philippe. AxelBoldt. Brucewestfall. Viking59. Anthonymsweeney. Dave Muscato. AxelBoldt. Versageek. Mostlyharmless. 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org/w/index. Evrik. Nonlinearity. Tuttt. Pegship. Gwern. Cabalamat. Noclevername. Melchoir. Hyung5kim. Arria Belli. AndrewTJ31. BP2. Rsabbatini. Seb az86556. WhatamIdoing. Pacula. Katomin. Frogprof. Facts707.Article Sources and Contributors Spinal cord stimulator  Source: http://en. Fordmadoxfraud.wikipedia. Fences and windows. Ensign768. 87 anonymous edits Wirehead (science fiction)  Source: http://en.wikipedia. Kalaong. Denverpaindoc. Nono64.php?oldid=420833316  Contributors: Amalas. 9 anonymous edits 206 . Anthonyhcole. Robert1947. Ohnoitsjamie. Tim1357. Looie496. WLU.php?oldid=387043730  Contributors: Againme. Where next Columbus?. AndySimpson. Stevenson214. Debonair23. Hemlock Martinis. Bender235. BehnazYousefi. Xanzzibar. Wouterstomp. Spacestevie. Denverpaindoc80021. MeekMark. RJHall. WilliamMorgan.org/w/index. Benlast. Wknight94.

jpg  License: Public Domain  Contributors: Original uploader was PaulWicks at en.org/w/index. Hgamboa.php?title=File:Eeg_gamma. Brazil File:Pacemaker GuidantMeridianSR.org/w/index.svg  Source: http://en. Maxim Razin.org/w/index.php?title=File:Herzschrittmacher_auf_Roentgenbild.php?title=File:Cochearimplants.php?title=File:EPOC_IGN.wikipedia.org/w/index.org/w/index.org/w/index.php?title=File:Visual_stimulus_reconstruction_using_fMRI.0  Contributors: Юрий Петрович Маслобоев / Yury Petrovich Masloboev File:eeg raw.org/w/index.svg  License: GNU Free Documentation License  Contributors: Hugo Gamboa File:eeg gamma.wikipedia.jpg  License: Creative Commons Attribution 3.5  Contributors: KH251.jpg  License: Creative Commons Attribution-Sharealike 2.0  Contributors: Der Lange.wikipedia. MAS.php?title=File:EEG_mit_32_Electroden.jpg  License: Creative Commons Attribution-Sharealike 3. Fpentimalli.org/w/index.jpg  Source: http://en. Magnus Manske. 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FACC File:Herzschrittmacher auf Roentgenbild.org/w/index.org/w/index.org/w/index.org/w/index.wikipedia. 2 anonymous edits Image:EPOC.jpg  Source: http://en.0  Contributors: User:Edwtie Image:Cochlear implant2.jpg  License: GNU Free Documentation License  Contributors: User:JHeuser File:St Jude Medical pacemaker with ruler.php?title=File:BrainGate.svg  License: GNU Free Documentation License  Contributors: Hugo Gambo Image:EEG mit 32 Electroden.org/w/index.jpg  Source: http://en.svg  Source: http://en.php?title=File:Monkey_using_a_robotic_arm.jpg  Source: http://en. MD.org/w/index. NEUROtiker.wikipedia.jpg  License: unknown  Contributors: User:SaganakiFile:Monkey using a robotic arm.org/w/index.0  Contributors: User:Stevenfruitsmaak File:Fluoroscopy pacemaker leads right atrium ventricle.wikipedia.jpg  License: Creative Commons Attribution-Sharealike 2.png  Source: http://en.wikipedia.0  Contributors: Avron.jpg  Source: http://en.jpeg  License: unknown  Contributors: BrokenSphere. 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coza Image:Wtcrun-001. Ktr101.jpg  License: Creative Commons Attribution-Sharealike 3.wikipedia.jpg  Source: http://en.JPG  License: Creative Commons Attribution-Sharealike 3.jpg  License: Creative Commons Attribution 2. 1 anonymous edits Image:WorkNC-Knee prosthesis.wikipedia.org/w/index. Xiong Chiamiov Image:Prosthetic toe.jpg  Source: http://en.jpg  Source: http://en.php?title=File:Low_cost_prosthetic_limbs.php?title=File:ICD.0  Contributors: User:Coda.php?title=File:Army_prosthetic.php?title=File:CLegProfile.jpg  License: unknown  Contributors: Notmorgan Image:Oscar Pistorius-2. Martin H.php?title=File:AICD.jpg  Source: http://en.jpg  License: Creative Commons Attribution-Sharealike 2. MD.org/w/index.0  Contributors: Mohamad Sawan 208 .org/w/index.jpg  License: Creative Commons Attribution 2.php?title=File:Myoelectric_prosthetic_arm.org/w/index.org/w/index.jpg  Source: http://en. Andre Engels.JPG  Source: http://en.jpg  License: GNU Free Documentation License  Contributors: Chris 73.php?title=File:WorkNC-Knee_prosthesis.jpg  License: Public Domain  Contributors: User:Gejordan Image:Torsades converted by AICD ECG strip Lead II. Meelar.org/w/index.0  Contributors: User:Hellerhoff Image:Parkinson surgery. Licenses and Contributors File:Tiefe Hirnstimulation .0  Contributors: User:Afurse Image:ImplantSawan.wikipedia.php?title=File:ImplantSawan.php?title=File:Implantable_cardioverter_defibrillator_chest_X-ray.php?title=File:Wtcrun-001.org/w/index.wikipedia.wikipedia.jpg  Source: http://en. Thuresson.org/w/index.Image Sources. El.wikipedia.jpg  Source: http://en.wikipedia. Lipothymia. Nobunaga24.JPG  License: Public Domain  Contributors: User:Displaced Image:Implantable cardioverter defibrillator chest X-ray.0  Contributors: Sescoi CAD/CAM Image:Myoelectric prosthetic arm..jpg  Source: http://en.wikipedia.wikipedia..php?title=File:Oscar_Pistorius-2.jpg  Source: http://en.org/w/index.php?title=File:Prosthetic_toe.org/w/index. Thomasbg. Avron.wikipedia.jpg  License: Public Domain  Contributors: AgnosticPreachersKid.php?title=File:Parkinson_surgery.0  Contributors: n28ive1 on Flickr File:AICD. Themfromspace.wikipedia.org/w/index.Sonden RoeSchaedel ap.jpg  License: Public Domain  Contributors: Bahamut0013. 1 anonymous edits Image:ICD.jpg  License: Creative Commons Attribution 3.org/w/index.jpg  Source: http://en.org/w/index.jpg  License: Public Domain  Contributors: Petty Officer 2nd Class Greg Mitchell of the United States Navy File:Low cost prosthetic limbs. FACC Image:Army prosthetic.jpg  License: unknown  Contributors: Jon Bodsworth Image:CLegProfile.wikipedia. MAS.wikipedia.JPG  Source: http://en.jpg  Source: http://en.wikipedia.jpg  License: Creative Commons Attribution-Sharealike 3. Electron. Ratamacue.jpg  Source: http://en.jpg  Source: http://en.php?title=File:Tiefe_Hirnstimulation_-_Sonden_RoeSchaedel_ap.0  Contributors: Gregory Marcus.org/w/index.php?title=File:Torsades_converted_by_AICD_ECG_strip_Lead_II.org/w/index.wikipedia.

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Giles Brindley. Jorge Cham. Comparison of consumer brain–computer interfaces. The field of BCI research and development has since focused primarily on neuroprosthetics applications that aim at restoring damaged hearing. analysis. Optogenetics. Functional electrical stimulation. Thought recording and reproduction device. Here you will find the most up-to-date information. RNS System. Emotiv Systems. Neuroprosthetics. Neurotrophic electrode. Eduardo Reck Miranda. covering: Brain–computer interface. NeuroSky. Research on BCIs began in the 1970s at the University of California Los Angeles (UCLA) under a grant from the National Science Foundation. with extensive references and links to get you to know all there is to know about Brain-Computer Interface right away. Exocortex. Intracranial EEG. time and resources investment decisions by enabling you to compare your understanding of Computer-Brain Interface with the objectivity of experienced professionals. Chronic electrode implants. Transcranial alternating current stimulation. Neil Weste. Diaphragmatic pacemaker. Bereitschaftspotential. Artificial pacemaker. BrainGate. Implantable Gastric Stimulation. Neural engineering. Neurochip. Intracortical visual prosthesis. Mindball. . Sacral anterior root stimulator. Biological pacemaker. Implantable cardioverter-defibrillator. In easy to read chapters. Auditory brainstem implant. Thanks to the remarkable cortical plasticity of the brain. sight and movement. Wirehead This book explains in-depth the real drivers and workings of Computer-Brain Interface. Thalamic stimulator. followed by a contract from DARPA. It reduces the risk of your technology. signals from implanted prostheses can. Electrocorticography.A brain–computer interface (BCI). sometimes called a direct neural interface or a brain–machine interface (BMI). Force Trainer. This book is your ultimate resource for Brain-Computer Interface. The papers published after this research also mark the first appearance of the expression brain–computer interface in scientific literature. Neurally controlled animat. Cyberkinetics. Deep brain stimulation. augmenting or repairing human cognitive or sensory-motor functions. after adaptation. Cyberware. Vagus nerve stimulation. Neural Impulse Actuator. Brain implant. BCIs are often aimed at assisting. Neurotechnology Industry Organization. Brain pacemaker. Visual prosthesis. Sensory substitution. Comparison of neurofeedback software. the first neuroprosthetic devices implanted in humans appeared in the mid-nineties. Following years of animal experimentation. background and everything you need to know. Cultured neuronal network. EABR. Prosthesis. Miguel Nicolelis. Retinal implant. is a direct communication pathway between the brain and an external device. Cochlear implant. Spinal cord stimulator. be handled by the brain like natural sensor or effector channels. OpenVibe. Electroencephalography.

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