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Cortical implants are a subset of neuroprosthetics that are in direct connection with the cerebral cortex of the brain. By directly interfacing with different regions of the cortex, these devices can provide stimulation to an immediate area and provide different benefits depending on their design and placement. A typical cortical implant is an implantable multielectrode array, which is a small device through which a neural signal can be received or transmitted.

The goal of cortical implants and neuroprosthetics in general is "to replace neural circuitry in the brain that no longer functions appropriately." [1]

History[edit]

Some early work in cortical implants involved stimulation of the visual cortex, using implants made from silicone rubber [2]


Types[edit]

Cortical implants have a wide variety of potential uses, ranging from restoring vision to blind patients or helping patients suffering from dementia. With the complexity of the brain, the possibilities for these brain implants to expand their usefulness are nearly endless. There are two ways that cortical implants can interface with the brain, either intracortically (direct) or epicortically (indirect).[3] Intracortical implants have electrodes that penetrate into the brain, while epicortical implants have electrodes that stimulate along the surface.

Visual Implants[edit]

Certain types of cortical implants can partially restore vision by directly stimulating the visual cortex.[4] Early work to restore vision through cortical stimulation began in 1970 with the work of Brindley and Dobelle. With their initial experimentation, some patients were able to recognize small images at fairly close distances. Their initial implant was based on the surface of the visual cortex and it did not provide as clear of images that it could, with an added downside of damage to surrounding tissues. More recent models, such as the "Utah" Electrode Array use deeper cortical stimulation that would hypothetically provide higher resolution images with less power needed, thus causing less damage. One of the major benefits to this method of artificial vision over any other visual prosthetic is that it bypasses many neurons of the visual pathway that could be damaged, potentially restoring vision to a greater number of blind patients.[4]

However, there are some issues that come with direct stimulation of the visual cortex. As with all implants, the impact of their presence over extended periods of time must be monitored. If an implant needs to be removed or re-positioned after a few years, complications can occur. The visual cortex is much more complex and difficult to deal with than the other areas where artificial vision are possible, such as the retina or optic nerve. The visual field is much easier to process in different locations other than the visual cortex. In addition, each areas of the cortex is specialized to deal with different aspects of vision, so simple direct stimulation will not provide complete images to patients. Lastly, surgical operations dealing with brain implants are extremely high-risk for patients, so the research needs to be further improved. However, cortical visual prostheses are important to people who have a completed damaged retina, optic nerve or lateral geniculate body, as they are one of the only ways they would be able to have their vision restored, so further developments will need to be sought out.[4]

Auditory Implants[edit]

While there has been little development in developing an effective auditory prosthesis that directly interfaces with the auditory cortex, there are some devices such as an auditory brainstem implant and a cochlear implant that have been successful in restoring hearing to deaf patients. There have also been some studies that have used multi-electrode arrays to take readings from the auditory cortex in animals. One study has been performed on rats to develop an implant that enabled simultaneous readings from both the auditory cortex and the thalamus. The readings from this new multi-electrode array were similar in clarity to other readily available devices that did not provide the same simultaneous readings.[5] With studies like this, advancements can be made that could lead to new auditory prostheses.

Cognitive Implants[edit]

Some cortical implants have been designed improve cognitive function. These implants are placed in the prefrontal cortex or the hippocampus. Implants in the prefrontal cortex help restore attention, decision-making and movement selection by duplicating the minicolumnar organization of neural firings.[6]. A hippocampal prosthetic aims to help with restoration of a patient's full long-term memory capabilities. Researchers are trying to determine the neural basis for memory by finding out how the brain encodes different memories in the hippocampus. By mimicking the natural coding of the brain with electrical stimulation, researchers look to replace compromised hippocampal regions and restore function.[7] Treatment for several conditions that impact cognition such as stroke, Alzheimer's disease and head trauma can benefit from the development of a hippocampal prosthetic.[8]

Brain-Computer Interfaces[edit]

A Brain-computer interface (BCI) is a type of implant that allows for a direct connection between a patient's brain and some form of external hardware. Since the mid-1990's, the amount of research done on BCI's in both animal and human models has grown exponentially. Most brain-computer interfaces are used for some form of neural signal extraction, while some attempt to return sensation through an implanted signal.[3] As an example of signal extraction, a BCI may take a signal from a paraplegic patient's brain and use it to move a robotic prosthetic. Paralyzed patients get a great amount of utility from these devices because they allow for a return of control to the patient. Current research for brain-computer interfaces is focused on determining which regions of the brain can be manipulated by an individual. Some studies have sought to determine if the cognitive control network would be a suitable location for implantations. [9]



A current example of a brain-computer interface would be the BrainGate, a device developed by Cyberkinetics.

  1. Use knowledge from Amazon book "Man with the Bionic Brain"
  2. Everyday uses for devices
  • BrainGate (would like to include a figure/image here)

Advantages[edit]

Perhaps one of the biggest advantages that cortical implants have over other neuroprostheses is being directly interfaced with the cortex. Bypassing damaged tissues in the visual pathway allows for a wider range of treatable patients. These implants can also act as a replacement for damage tissues in the cortex. Biomimicry

Disadvantages[edit]

Having any sort of implant that is directly connected to the cortex presents some issues. A major issue with cortical implants is biocompatibility, or how the body will respond to a foreign object. If the body rejects the implant, then the implant will be more of a detriment to the patient instead of a boon. In addition to biocompatibility, once the implant is in place, the body may have an adverse reaction to it over an extended period of time, rendering the implant useless. [10] Implanting a multielectrode array can cause damage to the surrounding tissue. Development of scar tissue around the electrodes can prevent some signals from reaching the neurons the implant is meant to. Most multielectrode arrays require neuronal cell bodies to be with 50 μm of the electrodes to provide the best function, and studies have shown that chronically implanted animals have significantly reduced cell density within this range.[10] Implants have been shown to cause neurodegeneration at the site of implantation as well.

Neural coding represents a difficulty faced by cortical implants, and in particular, implants dealing with cognition. Researchers have found difficulty in determining how the brain codes distinct memories. For example, the way the brain codes the memory of a chair is vastly different from the way it codes for a lamp. If there were to be any

Due to the uniqueness of every patient's cortex, it is difficult to standardize procedures involving direct implantation.[4] There are many common physical features between brains, but an individual gyrus or sulcus (neuroanatomy) can be different when compared. This leads to difficulties because it causes each procedure to be unique, thus taking longer to perform.

Future Developments[edit]

As more research is performed on , further developments will be made that will increase the viability and usability of cortical implants









References[edit]

  1. ^ Berger, T. W., Hampson, R. E., Song, D., Goonawardena, A., Marmarelis, V. Z., & Deadwyler, S. A. (2011). A cortical neural prosthesis for restoring and enhancing memory. Journal of Neural Engineering, 8(4). doi: 10.1088/1741-2560/8/4/046017
  2. ^ Hassler, C., Boretius, T., & Stieglitz, T. (2011). Polymers for Neural Implants. Journal of Polymer Science Part B-Polymer Physics, 49(1), 18-33. doi: 10.1002/polb.22169
  3. ^ a b Konrad, P., & Shanks, T. (2010). Implantable brain computer interface: Challenges to neurotechnology translation. Neurobiology of Disease, 38(3), 369-375. doi: 10.1016/j.nbd.2009.12.007
  4. ^ a b c d Fernandes, R. A. B., Diniz, B., Ribeiro, R., & Humayun, M. (2012). Artificial vision through neuronal stimulation. Neuroscience Letters, 519(2), 122-128. doi: 10.1016/j.neulet.2012.01.063
  5. ^ McCarthy, P. T., Rao, M. P., & Otto, K. J. (2011). Simultaneous recording of rat auditory cortex and thalamus via a titanium-based, microfabricated, microelectrode device. Journal of Neural Engineering, 8(4). doi: 10.1088/1741-2560/8/4/046007
  6. ^ Hampson, R. E., Gerhardt, G. A., Marmarelis, V., Song, D., Opris, I., Santos, L., . . . Deadwyler, S. A. (2012). Facilitation and restoration of cognitive function in primate prefrontal cortex by a neuroprosthesis that utilizes minicolumn-specific neural firing. Journal of Neural Engineering, 9(5). doi: 10.1088/1741-2560/9/5/056012
  7. ^ Hampson, R. E., Song, D., Chan, R. H. M., Sweatt, A. J., Riley, M. R., Gerhardt, G. A., . . . Deadwyler, S. A. (2012). A Nonlinear Model for Hippocampal Cognitive Prosthesis: Memory Facilitation by Hippocampal Ensemble Stimulation. Ieee Transactions on Neural Systems and Rehabilitation Engineering, 20(2), 184-197. doi: 10.1109/tnsre.2012.2189163
  8. ^ Berger, T. W., Ahuja, A., Courellis, S. H., Deadwyler, S. A., Erinjippurath, G., Gerhardt, G. A., . . . Wills, J. (2005). Restoring lost cognitive function. Ieee Engineering in Medicine and Biology Magazine, 24(5), 30-44. doi: 10.1109/memb.2005.1511498
  9. ^ Vansteensel, M. J., Hermes, D., Aarnoutse, E. J., Bleichner, M. G., Schalk, G., van Rijen, P. C., . . . Ramsey, N. F. (2010). Brain-Computer Interfacing Based on Cognitive Control. Annals of Neurology, 67(6), 809-816. doi: 10.1002/ana.21985
  10. ^ a b Potter, K. A., Buck, A. C., Self, W. K., & Capadona, J. R. (2012). Stab injury and device implantation within the brain results in inversely multiphasic neuroinflammatory and neurodegenerative responses. Journal of Neural Engineering, 9(4). doi: 10.1088/1741-2560/9/4/046020