Invasive brain-computer interfaces hold promise to alleviate disabilities in individuals with neurologic injury, with fully implantable brain-computer interface systems expected to reach the clinic in the upcoming decade. Children with severe neurologic disabilities, like quadriplegic cerebral palsy or cervical spine trauma, could benefit from this technology. However, they have been excluded from clinical trials of intracortical brain-computer interface to date. In this manuscript, we discuss the ethical considerations related to the use of invasive brain-computer interface in children with severe neurologic disabilities. We first review the technical hardware and software considerations for the application of intracortical brain-computer interface in children. We then discuss ethical issues related to motor brain-computer interface use in pediatric neurosurgery. Finally, based on the input of a multidisciplinary panel of experts in fields related to brain-computer interface (functional and restorative neurosurgery, pediatric neurosurgery, mathematics and artificial intelligence research, neuroengineering, pediatric ethics, and pragmatic ethics), we then formulate initial recommendations regarding the clinical use of invasive brain-computer interfaces in children.

https://journals.sagepub.com/doi/pdf/10.1177/08830738231167736

Use of Invasive Brain-Computer Interfaces in Pediatric Neurosurgery: Technical and Ethical Considerations

Electronic skins (e-skins) have seen intense research and rapid development in the past two decades. To mimic the capabilities of human skin, a multitude of flexible/stretchable sensors that detect physiological and environmental signals have been designed and integrated into functional systems. Recently, researchers have increasingly deployed machine learning and other artificial intelligence (AI) technologies to mimic the human neural system for the processing and analysis of sensory data collected by e-skins. Integrating AI has the potential to enable advanced applications in robotics, healthcare, and human–machine interfaces but also presents challenges such as data diversity and AI model robustness. In this review, we first summarize the functions and features of e-skins, followed by feature extraction of sensory data and different AI models. Next, we discuss the utilization of AI in the design of e-skin sensors and address the key topic of AI implementation in data processing and analysis of e-skins to accomplish a range of different tasks. Subsequently, we explore hardware-layer in-skin intelligence before concluding with an analysis of the challenges and opportunities in the various aspects of AI-enabled e-skins. 

Toward an AI Era: Advances in Electronic Skins

Cone-beam CT: an additional imaging tool in the interventional treatment and management of low-flow vascular malformations.

Individuals with complete cervical spinal cord injury suffer from a permanent paralysis of upper limbs which prevents them from achieving most of the activities of daily living. We developed a neuroprosthetic solution to restore hand motor function. Electrical stimulation of the radial and median nerves by means of two epineural electrodes enabled functional movements of paralyzed hands. We demonstrated in two participants with complete tetraplegia that selective stimulation of nerve fascicles by means of optimized spreading of the current over the active contacts of the multicontact epineural electrodes induced functional and powerful grasping movements which remained stable over the 28 days of implantation. We also showed that participants were able to trigger the activation of movements of their paralyzed limb using an intuitive interface controlled by voluntary actions and that they were able to perform useful functional movements such as holding a can and drinking through a straw. 

/pdf/activating-effective-functional-hand-movements-in-2whp62w0.pdf

Activating effective functional hand movements in individuals with complete tetraplegia through neural stimulation

Objective To evaluate the performance of cross-modality image registration procedure between magnetic resonance imaging (MRI) and cone beam computed tomography (CBCT). Methods In vitro diagnostic MRI and CBCT images of 5 cadaver swine heads were obtained prospectively. Five radiopaque fiducial markers were attached to each cadaver skull by using resin screws. Automatic MRI-CBCT rigid registrations were performed. The specimens were then scanned using a 3-dimensional (3-D) laser scanner. The 3-D coordinate points for the centroid of the attached fiducial markers from laser scan were identified and considered ground truth. The distances between marker centroids were measured with MRI, CBCT, and MRI-CBCT. Accuracy was calculated by using repeated measures analysis of variance and mean difference values. The registration method was repeated 10 times for each specimen in MRI to measure the average error. Results There was no significant difference ( P  > .05) in mean distances of the markers between all images and the ground truth. The distances' mean difference between MRI, CBCT, and MRI-CBCT and the ground truth were 0.2 ± 1.1 mm, 0.3 ± 1.0 mm, 0.2 ± 1.2 mm, respectively. The detected method error ranged between 0.06 mm and 0.1 mm. Conclusion The cross-modality image registration algorithm is accurate for head MRI-CBCT registration.

Accuracy of magnetic resonance imaging-cone beam computed tomography rigid registration of the head: an in-vitro study

Restoring dexterous hand control is critical for people with paralysis. Approaches based on surface or intramuscular stimulation provide limited finger control, generate insufficient force to recov...

Intrafascicular peripheral nerve stimulation produces fine functional hand movements in primates

The "triple-overlay" technique for percutaneous diagnosis and treatment of lesions of the head and neck: combined three-dimensional guidance with magnetic resonance imaging, cone-beam computed tomography, and fluoroscopy.

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Intrafascicular peripheral nerve stimulation produces fine functional hand movements in primates

The "triple-overlay" technique for percutaneous diagnosis and treatment of lesions of the head and neck: combined three-dimensional guidance with magnetic resonance imaging, cone-beam computed tomography, and fluoroscopy.