Deep Brain Stimulation
Deep brain stimulation (DBS) is an effective neurosurgical approach for a variety of neurological and psychiatric disorders including Parkinson's disease, essential tremor, epilepsy and depression. This research project is intended to advance DBS technology by developing a novel intraoperative monitoring approach based on electrochemical monitoring at the brain-electrode interface by use of carbon nanofiber (CNF)-based electrode design. This approach utilizes technology developed at the Mayo Clinic called the Wireless Instantaneous Neurotransmitter Concentration Sensor (WINCS). This system combines digital telemetry with fast-scan cyclic voltammetry (FSCV) and amperometry, coupled to CNF-based electrode technology developed at National Aeronautic and Space Administration (NASA) called WINCSnanotrode. Under Mayo IRB-approved protocol, WINCS safety and feasibility has already been tested successfully in human patients undergoing DBS neurosurgery.
Our three specific aims are:
- Complete WINCS and WINCSnanotrode development to generate a device that is capable of use in humans for electrochemical sensing
- Establish WINCSnanotrode approach for intraoperative neurochemical monitoring in a large animal (pig) model of DBS neurosurgery
- Establish WINCS and WINCSnanotrode approach for intraoperative neurochemical monitoring in humans during DBS neurosurgery
WINCS and WINCSnanotrode technology engenders great potential to identify specific targets for DBS, to streamline the already long and difficult implantation procedure, to assess efficiency of the stimulation parameter, and to improve the accuracy and efficiency of the stimulating electrode.
Spinal Cord Injury
Spinal cord injury (SCI) is a profoundly debilitating disorder that affects hundreds of thousands of people, particularly young adults. Immobility following spinal cord injury is a major cause of morbidity and mortality in patients with SCI. The motor impairment and its complications, such as pressure ulcers, amputations, infections and depressive disorders, contribute to reduced quality of life and life expectancy in patients with SCI.
Current therapies aimed at restoring motor function in patients following SCI have shown unsatisfactory results. Innovations developed at the Neural Engineering Laboratory (NEL) at Mayo Clinic are primed to overcome these limitations. These innovations include a novel, highly sensitive and selective wireless device for electrochemical and electrophysiologic recording in the central nervous system named Wireless Instantaneous Neurotransmitter Concentration Sensor (WINCS) optically coupled to a wireless device for controlled and graded neurostimulation named Mayo Investigational Neuromodulation Control System (MINCS).
This WINCS-MINCS platform, named Butterfly, is a multiplexed sensor or stimulator system with bidirectional wireless communication incorporating an application-specific integrated circuit that allows for unprecedented insight into the neurobiology of disease in addition to modulation of neural function. Butterfly will be combined with a biocompatible, penetrating 3 by 3 nanoelectrode array for stimulation and sensing developed at National Aeronautic and Space Administration (NASA) called the WINCSnanotrode. This nanoelectrode neural interface supports ultrahigh monitoring sensitivity, high signal-to-noise ratio, and rapid sampling of neurochemical changes in addition to highly targeted and graded microstimulation. Furthermore, the use of spatially dispersed nanoarrays will allow for superior neurochemical and neurophysiological mapping and neurostimulation.
By combining ultraselective spinal microstimulation with WINCSnanotrode, daily pharmacologic therapy and intensive motor training, we expect significantly improved motor function in an animal model of SCI. These studies will facilitate the mapping of neural networks in the spinal cord for improved understanding of spinal neuroanatomy and neurophysiology. Given the robust capabilities of the devices designed at the NEL, these novel instruments are uniquely capable of serving as a platform for limb reanimation in humans.