21, 22 For closed-loop BMIs, a high-density ECoG (hd-ECoG) array can maximize the opportunity of identifying finger-specific sensory activations at a high spatial resolution. It has been used to define eloquent cortex in the epilepsy monitoring unit 17– 20 and intraoperatively. OFM displays task-based cortical activity gathered from electrocorticography (ECoG) electrodes placed on the surface of the brain. Online functional mapping (OFM) can provide high temporal and spatial information to clinicians in real-time to assist in functional localization. 16 However, the development of fully dexterous neuroprostheses requires novel surgical approaches to precisely place stimulating electrode arrays in finger eloquent cortex. 13 To guide implant placement within hand or arm representations in somatosensory cortex, BMI researchers have traditionally relied on preoperative neuroimaging in humans 14, 15 or surgical atlases in non-human primates (NHP). 6– 11 Building on evidence demonstrating the importance of finger and fingertip sensations in upper-limb control 12, sensory feedback through cortical stimulation has been incorporated into closed-loop BMIs to improve motor control. Brain-machine interfaces (BMIs) have the potential to restore function to paralyzed patients via brain control of neuroprostheses. 1– 5 However, novel neurotechnologies can utilize functional localization for targeting of restorative neural implants. This work demonstrates the utility of intraoperative OFM and will inform future studies of closed-loop BMIs in humans.įunctional localization has long been utilized by neurosurgeons primarily to spare eloquent cortex during resection surgeries. In conjunction with traditional pre- and intraoperative targeting approaches, this technique enabled accurate implantation of stimulating microelectrodes, which was confirmed by post-implantation intra-cortical stimulation of finger and fingertip sensations. In our study, we demonstrated the use of a novel intraoperative online functional mapping (OFM) technique with high-density electrocorticography (ECoG) to localize finger representations in human primary somatosensory cortex. Beyond motor decoding from recording arrays, precise placement of stimulating electrodes in cortical areas associated with finger and fingertip sensations allows for the delivery of sensory feedback that could improve dexterous control of prosthetic hands. Brain-machine interfaces (BMIs) have the potential to restore upper-limb motor control to paralyzed patients but require accurate placement of recording and stimulating electrodes to enable functional control of a prosthetic limb. Defining eloquent cortex intraoperatively, traditionally performed by neurosurgeons to preserve patient function, can now help target electrode implantation for restoring function.
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