Remote Gait Analysis Using Ultra-Wideband Radar Technology Based on Joint Range-Doppler-Time Representation.

OBJECTIVE: In recent years, radar technology has been extensively utilized in contactless human behavior monitoring systems. The unique capabilities of ultra-wideband (UWB) radars compared to conventional radar technologies, due to time-of-flight measurements, present new untapped opportunities for in-depth monitoring of human movement during overground locomotion. This study aims to investigate the deployability of UWB radars in accurately capturing the gait patterns of healthy individuals with no known walking impairments. METHODS: A novel algorithm was developed that can extract ten clinical spatiotemporal gait features using the Doppler information captured from three monostatic UWB radar sensors during a 6-meter walking task. Key gait events are detected from lower-extremity movements based on the joint range-Doppler-time representation of recorded radar data. The estimated gait parameters were validated against a gold-standard optical motion tracking system using 12 healthy volunteers. RESULTS: On average, nine gait parameters can be consistently estimated with 90-98% accuracy, while capturing 94.5% of participants' gait variability and 90.8% of inter-limb symmetry. Correlation and Bland-Altman analysis revealed a strong correlation between radar-based parameters and the ground-truth values, with average discrepancies consistently close to 0. CONCLUSION: Results prove that radar sensing can provide accurate biomarkers to supplement clinical human gait assessment, with quality similar to gold standard assessment. SIGNIFICANCE: Radars can potentially allow a transition from expensive and cumbersome lab-based gait analysis tools toward a completely unobtrusive and affordable solution for in-home deployment, enabling continuous long-term monitoring of individuals for research and healthcare applications.

Brain clearance is reduced during sleep and anesthesia.

It has been suggested that the function of sleep is to actively clear metabolites and toxins from the brain. Enhanced clearance is also said to occur during anesthesia. Here, we measure clearance and movement of fluorescent molecules in the brains of male mice and show that movement is, in fact, independent of sleep and wake or anesthesia. Moreover, we show that brain clearance is markedly reduced, not increased, during sleep and anesthesia.

Surgical Implantation of Brain Computer Interfaces.

This article discusses the function and capabilities of brain computer interfaces as a novel approach to rehabilitation for a variety of neurological disorders.

Towards Real-time Multiplexed Bioimpedance Tumour-Tissue Margin Analysis.

Bioimpedance varies with physical tissue characteristics. As such it can be used for real-time tissue discrimination. This has led to its application as a surgical mapping tool to differentiate between healthy and abnormal tissue intraoperatively during tumour resection. Here, we build on previous work implementing a probe-based tetrapolar bioimpedance systems demonstrator, now extracting additional information for margin analysis with imperfect bioimpedance visibility. Through finite element analysis, we show preliminary findings using a single measurement with a multiplexed tetrapolar bioimpedance probe for identifying tissue boundaries, applied to porcine tissue as a surrogate for a tumour-tissue interface.

Calibration-Free and Hardware-Efficient Neural Spike Detection for Brain Machine Interfaces.

Recent translational efforts in brain-machine interfaces (BMI) are demonstrating the potential to help people with neurological disorders. The current trend in BMI technology is to increase the number of recording channels to the thousands, resulting in the generation of vast amounts of raw data. This in turn places high bandwidth requirements for data transmission, which increases power consumption and thermal dissipation of implanted systems. On-implant compression and/or feature extraction are therefore becoming essential to limiting this increase in bandwidth, but add further power constraints - the power required for data reduction must remain less than the power saved through bandwidth reduction. Spike detection is a common feature extraction technique used for intracortical BMIs. In this article, we develop a novel firing-rate-based spike detection algorithm that requires no external training and is hardware efficient and therefore ideally suited for real-time applications. Key performance and implementation metrics such as detection accuracy, adaptability in chronic deployment, power consumption, area utilization, and channel scalability are benchmarked against existing methods using various datasets. The algorithm is first validated using a reconfigurable hardware (FPGA) platform and then ported to a digital ASIC implementation in both 65 nm and 0.18 µm CMOS technologies. The 128-channel ASIC design implemented in a 65 nm CMOS technology occupies 0.096 mm2 silicon area and consumes 4.86 µW from a 1.2 V power supply. The adaptive algorithm achieves a 96% spike detection accuracy on a commonly used synthetic dataset, without the need for any prior training.

Firing-rate-modulated spike detection and neural decoding co-design.

Objective. Translational efforts on spike-signal-based implantable brain-machine interfaces (BMIs) are increasingly aiming to minimise bandwidth while maintaining decoding performance. Developing these BMIs requires advances in neuroscience and electronic technology, as well as using low-complexity spike detection algorithms and high-performance machine learning models. While some state-of-the-art BMI systems jointly design spike detection algorithms and machine learning models, it remains unclear how the detection performance affects decoding.Approach. We propose the co-design of the neural decoder with an ultra-low complexity spike detection algorithm. The detection algorithm is designed to attain a target firing rate, which the decoder uses to modulate the input features preserving statistical invariance in long term (over several months).Main results. We demonstrate a multiplication-free fixed-point spike detection algorithm with an average detection accuracy of 97% across different noise levels on a synthetic dataset and the lowest hardware complexity among studies we have seen. By co-designing the system to incorporate statistically invariant features, we observe significantly improved long-term stability, with decoding accuracy degrading by less than 10% after 80 days of operation. Our analysis also reveals a nonlinear relationship between spike detection and decoding performance. Increasing the detection sensitivity improves decoding accuracy and long-term stability, which means the activity of more neurons is beneficial despite the detection of more noise. Reducing the spike detection sensitivity still provides acceptable decoding accuracy whilst reducing the bandwidth by at least 30%.Significance. Our findings regarding the relationship between spike detection and decoding performance can provide guidance on setting the threshold for spike detection rather than relying on training or trial-and-error. The trade-off between data bandwidth and decoding performance can be effectively managed using appropriate spike detection settings. We demonstrate improved decoding performance by maintaining statistical invariance of input features. We believe this approach can motivate further research focused on improving decoding performance through the manipulation of data itself (based on a hypothesis) rather than using more complex decoding models.

Selecting an effective amplitude threshold for neural spike detection.

This paper assesses and challenges whether commonly used methods for defining amplitude thresholds for spike detection are optimal. This is achieved through empirical testing of single amplitude thresholds across multiple recordings of varying SNR levels. Our results suggest that the most widely used noise-statistics-driven threshold can suffer from parameter deviation in different noise levels. The spike-noise-driven threshold can be an ideal approach to set the threshold for spike detection, which suffers less from the parameter deviation and is robust to sub-optimal settings.

Development of an Ultra Low-Cost SSVEP-based BCI Device for Real-Time On-Device Decoding.

This study details the development of a novel, approx. £20 electroencephalogram (EEG)-based brain-computer interface (BCI) intended to offer a financially and operationally accessible device that can be deployed on a mass scale to facilitate education and public engagement in the domain of EEG sensing and neurotechnologies. Real-time decoding of steady-state visual evoked potentials (SSVEPs) is achieved using variations of the widely-used canonical correlation analysis (CCA) algorithm: multi-set CCA and generalised CCA. All BCI functionality is executed on board an inexpensive ESP32 microcontroller. SSVEP decoding accuracy of 95.56 ± 3.74% with an ITR of 102 bits/min was achieved with modest calibration.

A Multilevel Synchronized Optical Pulsed Modulation for High Efficiency Biotelemetry.

The paper describes the design, implementation, and characterization of a novel multilevel synchronized pulse position modulation paradigm for high efficiency optical biotelemetry links. The entire optoelectronic architecture has been designed with the aim to improve the efficiency of the data transmission and decrease the overall power consumption that are key factors for the fabrication of implantable and wearable medical devices. By employing specially designed digital architectures, the proposed modulation technique automatically transmits more than one bit per symbol together with the reference clock signal enabling the decoding process of the received coded data. In the present case, the paper demonstrates the capability of the modulation technique to transmit symbols composed by 3 and 4 bits. This has been achieved by developing a prototype of an optical biotelemetry system implemented on an FPGA board that, making use of 500 ps laser pulses, operates under the following two working conditions: (i) 40 MHz clock signal corresponding to a baud rate of 40 Mega symbol per second for symbols composed by 3 bits; (ii) 30 MHz clock signal corresponding to a baud rate of 30 Mega symbol per second for symbols composed by 4 bits. Thus, for both these two configurations the transmission data rate is 120 Mbps and the measured BER was lower than 10-10. Finally, the power consumption was found to be 1.95 and 1.8 mW and the resulting energy efficiencies were 16.25 and 15 pJ/bit for transmitted symbols composed by 3 and 4 bits/symbol, respectively.

Preparation of Rat Sciatic Nerve for Ex Vivo Neurophysiology.

Ex vivo preparations enable the study of many neurophysiological processes in isolation from the rest of the body while preserving local tissue structure. This work describes the preparation of rat sciatic nerves for ex vivo neurophysiology, including buffer preparation, animal procedures, equipment setup and neurophysiological recording. This work provides an overview of the different types of experiments possible with this method. The outlined method aims to provide 6 h of stimulation and recording on extracted peripheral nerve tissue in tightly controlled conditions for optimal consistency in results. Results obtained using this method are A-fibre compound action potentials (CAP) with peak-to-peak amplitudes in the millivolt range over the entire duration of the experiment. CAP amplitudes and shapes are consistent and reliable, making them useful to test and compare new electrodes to existing models, or the effects of interventions on the tissue, such as the use of chemicals, surgical alterations, or neuromodulatory stimulation techniques. Both conventional commercially available cuff electrodes with platinum-iridium contacts and custom-made conductive elastomer electrodes were tested and gave similar results in terms of nerve stimulus strength-duration response.

HFAC Dose Repetition and Accumulation Leads to Progressively Longer Block Carryover Effect in Rat Sciatic Nerve.

This paper describes high-frequency nerve block experiments carried out on rat sciatic nerves to measure the speed of recovery of A fibres from block carryover. Block carryover is the process by which nerve excitability remains suppressed temporarily after High Frequency Alternative (HFAC) block is turned off following its application. In this series of experiments 5 rat sciatic nerves were extracted and prepared for ex-vivo stimulation and recording in a specially designed perfusion chamber. For each nerve repeated HFAC block and concurrent stimulation trials were carried out to observe block carryover after signal shutoff. The nerve was allowed to recover fully between each trial. Time to recovery from block was measured by monitoring for when relative nerve activity returned to within 90% of baseline levels measured at the start of each trial. HFAC block carryover duration was found to be dependent on accumulated dose by statistical test for two different HFAC durations. The carryover property of HFAC block on A fibres could enable selective stimulation of autonomic nerve fibres such as C fibres for the duration of carryover. Block carryover is particularly relevant to potential chronic clinical applications of block as it reduces power requirements for stimulation to provide the blocking effect. This work characterizes this process toward the creation of a model describing its behavior.

Dynamic Microwave Imaging of the Cardiovascular System Using Ultra-Wideband Radar-on-Chip Devices.

OBJECTIVE: Microwave imaging has been investigated for medical applications such as stroke and breast imaging. Current systems typically rely on bench-top equipment to scan at a variety of antenna positions. For dynamic imaging of moving structures, such as the cardiovascular system, much higher imaging speeds are required than what has thus far been reported. Recent innovations in radar-on-chip technology allow for simultaneous high speed data collection at multiple antenna positions at a fraction of the cost of conventional microwave equipment, in a small and potentially portable system. The objective of the current work is to provide proof of concept of dynamic microwave imaging in the body, using radar-on-chip technology. METHODS: Arrays of body-coupled antennas were used with nine simultaneously operated coherent ultra-wideband radar chips. Data were collected from the chest and thigh of a volunteer, with the objective of imaging the femoral artery and beating heart. In addition, data were collected from a phantom to validate system performance. Video data were constructed using beamforming. RESULTS: The location of the femoral artery could successfully be resolved, and a distinct arterial pulse wave was discernable. Cardiac activity was imaged at locations corresponding to the heart, but image quality was insufficient to identify individual anatomical structures. Static and differential imaging of the femur bone proved unsuccessful. CONCLUSION: Using radar chip technology and an imaging approach, cardiovascular activity was detected in the body, demonstrating first steps towards biomedical dynamic microwave imaging. The current portable and modular system design was found unsuitable for static in-body imaging. SIGNIFICANCE: This first proof of concept demonstrates that radar-on-chip could enable cardiovascular imaging in a low-cost, small and portable system. Such a system could make medical imaging more accessible, particularly in ambulatory or long-term monitoring settings.

Algorithm and hardware considerations for real-time neural signal on-implant processing.

Objective.Various on-workstation neural-spike-based brain machine interface (BMI) systems have reached the point of in-human trials, but on-node and on-implant BMI systems are still under exploration. Such systems are constrained by the area and battery. Researchers should consider the algorithm complexity, available resources, power budgets, CMOS technologies, and the choice of platforms when designing BMI systems. However, the effect of these factors is currently still unclear.Approaches.Here we have proposed a novel real-time 128 channel spike detection algorithm and optimised it on microcontroller (MCU) and field programmable gate array (FPGA) platforms towards consuming minimal power and memory/resources. It is presented as a use case to explore the different considerations in system design.Main results.The proposed spike detection algorithm achieved over 97% sensitivity and a smaller than 3% false detection rate. The MCU implementation occupies less than 3 KB RAM and consumes 31.5 µW ch-1. The FPGA platform only occupies 299 logic cells and 3 KB RAM for 128 channels and consumes 0.04 µW ch-1.Significance.On the spike detection algorithm front, we have eliminated the processing bottleneck by reducing the dynamic power consumption to lower than the hardware static power, without sacrificing detection performance. More importantly, we have explored the considerations in algorithm and hardware design with respect to scalability, portability, and costs. These findings can facilitate and guide the future development of real-time on-implant neural signal processing platforms.

DyNeuMo Mk-1: Design and pilot validation of an investigational motion-adaptive neurostimulator with integrated chronotherapy.

There is growing interest in using adaptive neuromodulation to provide a more personalized therapy experience that might improve patient outcomes. Current implant technology, however, can be limited in its adaptive algorithm capability. To enable exploration of adaptive algorithms with chronic implants, we designed and validated the 'Picostim DyNeuMo Mk-1' (DyNeuMo Mk-1 for short), a fully-implantable, adaptive research stimulator that titrates stimulation based on circadian rhythms (e.g. sleep, wake) and the patient's movement state (e.g. posture, activity, shock, free-fall). The design leverages off-the-shelf consumer technology that provides inertial sensing with low-power, high reliability, and relatively modest cost. The DyNeuMo Mk-1 system was designed, manufactured and verified using ISO 13485 design controls, including ISO 14971 risk management techniques to ensure patient safety, while enabling novel algorithms. The system was validated for an intended use case in movement disorders under an emergency-device authorization from the Medicines and Healthcare Products Regulatory Agency (MHRA). The algorithm configurability and expanded stimulation parameter space allows for a number of applications to be explored in both central and peripheral applications. Intended applications include adaptive stimulation for movement disorders, synchronizing stimulation with circadian patterns, and reacting to transient inertial events such as posture changes, general activity, and walking. With appropriate design controls in place, first-in-human research trials are now being prepared to explore the utility of automated motion-adaptive algorithms.

Trends in volumetric-energy efficiency of implantable neurostimulators: a review from a circuits and systems perspective.

This paper presents a comprehensive review of state-of-the-art, commercially available neurostimulators. We analyse key design parameters and performance metrics of 45 implantable medical devices across six neural target categories: deep brain, vagus nerve, spinal cord, phrenic nerve, sacral nerve and hypoglossal nerve. We then benchmark these alongside modern cardiac pacemaker devices that represent a more established market. This work studies trends in device size, electrode number, battery technology (i.e., primary and secondary use and chemistry), power consumption and longevity. This information is analysed to show the course of design decisions adopted by industry and identifying opportunity for further innovation. We identify fundamental limits in power consumption, longevity and size as well as the interdependencies and trade-offs. We propose a figure of merit to quantify volumetric efficiency within specific therapeutic targets, battery technologies/capacities, charging capabilities and electrode count. Finally, we compare commercially available implantable medical devices with recently developed systems in the research community. We envisage this analysis to aid circuit and system designers in system optimisation and identifying innovation opportunities, particularly those related to low power circuit design techniques.

Translating node of Ranvier currents to extraneural electrical fields: a flexible FEM modeling approach.

Simulations of electroneurogram recording could help find the optimal set of electrodes and algorithms for selective neural recording. However, no flexible methods are established for selective neural recording as for neural stimulation. This paper proposes a method to couple a compartmental and a FEM nerve model, implemented in NEURON and COMSOL, respectively, to translate Node of Ranvier currents into extraneural electric fields. The study simulate ex-vivo experimental conditions, and the method allows flexibility in electrode geometries and nerve topologies. This model has been made available in a public repository4. So far, the model behavior complies with available experimental results and expectations from literature. There is good agreement in terms of signal amplitude and waveform, and computational times are acceptable, leaving room for flexible simulation studies complementary to animal tests.

Tiresias: A low-cost networked UWB radar system for in-home monitoring of dementia patients.

This paper describes Tiresias, a low-cost, unobtrusive networked radar system designed to monitor vulnerable patients in domestic environments and provide high quality behavioural and health data. Dementia is a disease that affects millions worldwide and progressively degrades an individual's ability to care for themselves. Eventually most people living with dementia will need to reside in assisted living facilities as they become unable to care for themselves. Understanding the effects dementia has on ability to self-care and extending the length of time people living with dementia can remain living independently are key goals of dementia research and care. The networked radar system proposed in this paper is designed to provide high quality behavioural and health data from domestic environments. This is achieved using multiple radar sensors networked together with their data outputs integrated and processed to produce high confidence measures of position and movement. It is hoped the data produced by this system will both provide insights into how dementia progresses, and also help monitor vulnerable individuals in their own homes, allowing them to remain independent longer than would otherwise be possible.

Eye Accommodation Sensing for Adaptive Focus Adjustment.

Over 2 billion people across the world are affected by some visual impairment - mostly related to optical issues, and this number is estimated to grow. Often, particularly in the elderly, more than one condition can affect the eyes at the same time, e.g., myopia and presbyopia. Bifocal or multifocal lenses can be used, these however may become uncomfortable or disturbing and are not adapted to the user. There is therefore a need and opportunity for a new type of glasses able to adaptively change the lenses' focus. This paper explores the feasibility of recording the eye accommodation process in a non-invasive way using a wearable device. This can provide a way to measure eye convergence in real-time to determine what a person's eye is focused on. In this study, Electro-oculography (EoG) is used to observe eye muscle activity and estimate eye movement. To assess this, a group of 11 participants we each asked to switch their gaze from a near to far target and vice versa, whilst their EoG was measured. This revealed two distinct waveforms: one for the transition from a far to near target, and one for the transition from a near to far target. This informed the design of a correlation-based classifier to detect which signals are related to a far to near, or near to far transition. This achieved a classification accuracy of 97.9±1.37% across the experimental results gathered from our 11 participants. This pilot data provides a basic starting point to justify future device development.

Implantable brain machine interfaces: first-in-human studies, technology challenges and trends.

Implantable brain machine interfaces (BMIs) are now on a trajectory to go mainstream, wherein what was once considered last resort will progressively become elective at earlier stages in disease treatment. First-in-human successes have demonstrated the ability to decode highly dexterous motor skills such as handwriting, and speech from human cortical activity. These have been used for cursor and prosthesis control, direct-to-text communication and speech synthesis. Along with these breakthrough studies, technology advancements have enabled the observation of more channels of neural activity through new concepts for centralised/distributed implant architectures. This is complemented by research in flexible substrates, packaging, surgical workflows and data processing. New regulatory guidance and funding has galvanised the field. This culmination of resource, efforts and capability is now attracting significant investment for BMI commercialisation. This paper reviews recent developments and describes the paradigm shift in BMI development that is leading to new innovations, insights and BMI translation.

Nitric Oxide Synthase Neurons in the Preoptic Hypothalamus Are NREM and REM Sleep-Active and Lower Body Temperature.

When mice are exposed to external warmth, nitric oxide synthase (NOS1) neurons in the median and medial preoptic (MnPO/MPO) hypothalamus induce sleep and concomitant body cooling. However, how these neurons regulate baseline sleep and body temperature is unknown. Using calcium photometry, we show that NOS1 neurons in MnPO/MPO are predominantly NREM and REM active, especially at the boundary of wake to NREM transitions, and in the later parts of REM bouts, with lower activity during wakefulness. In addition to releasing nitric oxide, NOS1 neurons in MnPO/MPO can release GABA, glutamate and peptides. We expressed tetanus-toxin light-chain in MnPO/MPO NOS1 cells to reduce vesicular release of transmitters. This induced changes in sleep structure: over 24 h, mice had less NREM sleep in their dark (active) phase, and more NREM sleep in their light (sleep) phase. REM sleep episodes in the dark phase were longer, and there were fewer REM transitions between other vigilance states. REM sleep had less theta power. Mice with synaptically blocked MnPO/MPO NOS1 neurons were also warmer than control mice at the dark-light transition (ZT0), as well as during the dark phase siesta (ZT16-20), where there is usually a body temperature dip. Also, at this siesta point of cooled body temperature, mice usually have more NREM, but mice with synaptically blocked MnPO/MPO NOS1 cells showed reduced NREM sleep at this time. Overall, MnPO/MPO NOS1 neurons promote both NREM and REM sleep and contribute to chronically lowering body temperature, particularly at transitions where the mice normally enter NREM sleep.