CN117295450A - Nerve monitoring and diagnosing system - Google Patents

Abstract

The ability to access the brain's functional distributed network allows for direct access to, monitoring of, and/or communication with specific areas of the brain, which allows for technological improvements in many areas including, but not limited to, healthcare, quality of life, improving the use of technology by individuals, and improving the ability to communicate within the individual's networked clusters. For example, direct access to the neural distributed network allows for improved traditional healthcare procedures for individuals and/or improved individual control of machines.

Description

Nerve monitoring and diagnosing system

Cross Reference to Related Applications

The present application is a non-provisional application of U.S. provisional application 63/145,101 filed on 3 months 2 a 2021 and U.S. provisional application 63/266,763 filed on 13 months 1 a 2022, the entire contents of both U.S. provisional applications being incorporated by reference.

Background

It is currently understood that in most cases, the human brain serves as a well-coordinated network consisting of a collection of individual brain regions, each of which is a separate network of brain tissues and cells responsible for a particular purpose. Currently, statistical analysis of functional magnetic resonance imaging ("fMRI") allows neuroscientists to map areas of the brain responsible for specific tasks. Furthermore, it is understood that many cognitive tasks are performed through networking of several discrete brain regions that are "functionally connected". Thus, the brain may be considered as a distributed neural network that coordinates a series of subnetworks associated with various regions of the brain, each subnetwork being associated with a particular purpose.

Currently, existing conventional methods attempt to access these areas of the brain. These commonly known methods include deep brain stimulation ("DBS") which involves implanting electrodes in certain areas of the brain, wherein the electrodes generate electrical pulses in an attempt to stimulate or modulate brain activity for therapeutic or other purposes, and cortical electroencephalography ("ECoG") which enables neuromonitoring of brain areas for diagnostic purposes.

DBS involves creating a small hole in the skull to implant an electrode, and performing a surgical procedure to implant a controller or pacemaker analog that is electrically coupled to the electrode to control stimulation. Typically, the device is positioned under the skin of the chest. The amount of stimulation in deep brain stimulation may be controlled by a controller or pacemaker-like device, with wires/leads connecting the controller device to electrodes positioned in the brain.

DBS is useful in the treatment of a variety of neurological disorders such as tremor, parkinson's disease, dystonia, epilepsy, tourette's disease, chronic pain and obsessive-compulsive disorder. In addition, deep brain stimulation has the potential to treat major depression, stroke rehabilitation, addiction and dementia. In addition, in the case of the optical fiber,

ECoG can provide a way to record high fidelity brain activity (e.g., during an operation (in-operation nerve monitoring)), where real-time brain activity recording can enable the treating surgeon to make decisions immediately, thereby improving the safety of the treatment. Long-term recordings are used for seizure detection and to facilitate mapping to improve the safety of tumor resection by limiting resection of healthy brains. However, ECoG requires that the electrode array be placed directly on the surface of the brain after exposure of the brain by craniotomy, e.g., using an subdural or epidural array. Therefore, their use is very limited in applications.

Fig. 1 illustrates a conventional method of accessing a region of the brain using a brain stimulation device 20 that includes an electrode 22, the electrode 22 being implanted within the brain 12 of the individual 10. As shown, implantation requires surgical penetration of the device 20 through the skull 14 such that the device 20 is directed toward the region of interest 30. In addition, the leads 16 couple the device 20 to the controller/transceiver/generator 18.

In conventional DBS procedures, there are many associated risks associated with the general surgical procedures required to surgically implant the device 20. Furthermore, there is a risk during the DBS procedure itself, as conventional procedures require an approach or non-invasive attempt (approximation or non-invasive atempt) to locate the region of interest 30. The physician must then attempt to physically position the electrode 22 of the device 20 within or near the region of interest 30 so that the desired effect can be achieved. In some cases, the positioning of electrode 20 may be a trial and error approach requiring multiple surgical attempts and multiple surgical insertion sites. Regardless of the number of attempts, the act of inserting the device 20 to position the electrode 22 in the region of interest 30 can cause collateral damage to brain tissue located in the path between the region of interest and the insertion point in the skull.

Currently, the surgical risks involved in such procedures may include cerebral hemorrhage, stroke, infection, collateral damage to brain tissue, collateral damage to vascular structures in the brain, temporary pain, and inflammation at the surgical site. In addition to surgical risks, conventional DBS also involves the risk of DBS side effects if the electrodes stimulate or affect areas other than the region of interest 30. These risks include respiratory problems, nausea, heart problems, seizures (seizure), headache, confusion, etc. However, given that the device and the tissue surrounding the implantation site heal, additional risks may be introduced when attempting to remove the DBS device after a period of time.

However, conventional approaches to many subnetworks aimed at accessing the brain are deficient, such that conventional approaches do not maximize the benefits of accessing and communicating/stimulating these subnetworks directly.

Traditional invasive methods involving direct brain penetration result in sustained scar formation due to gliosis. Due to the invasive level nature of craniotomy and the evolving nature of scars formed by gliosis, removal and replacement of traditional DBS electrodes in the brain is not feasible.

SUMMARY

The ability to access the functional distributed network of the brain allows for direct access, monitoring and/or communication with specific areas of the brain, may allow for technological improvements in a number of areas, including but not limited to healthcare, quality of life, improving the use of technology by individuals, and improving the ability to communicate within the networked community of individuals. For example, direct access to the neural distributed network allows for improved traditional health care surgery for the individual and/or improved machine control by the individual. In further variations, the ability to directly access, monitor, and/or communicate with an individual's neural distributed network allows for improvements in communication with the individual and/or improvements in communication between individuals whose respective neural distributed networks are configured to be directly networked.

The present disclosure relates to systems and methods for facilitating direct interaction between a distributed neural network of an individual's brain and an external device, the method comprising: generating a plurality of feedback data from the external device, wherein the plurality of feedback data is related to an activity of the external device; establishing a connection from an external device to a control unit coupled to the individual, wherein the control unit includes a first neural implant previously positioned within a first cellular structure region of a distributed neural network of the brain of the individual; and transmitting the plurality of feedback data to the control unit, such that the control unit excites the first nerve implant to stimulate a first cellular structure area of the brain that produces an effect specific to the first cellular structure area within the individual, such that the individual is able to perceive the effect. The generation of data from the external device may include data in/generated by the external device and/or data generated or measured separately/apart from the external device (e.g., by observation, tracking, etc.).

In some variations, the techniques described herein relate to a method in which a plurality of feedback data are related to an activity of an external device caused by an action of an individual.

Variations of the technology described herein relate to a method in which a plurality of feedback data are transmitted over a network. Alternatively, or in combination, the plurality of feedback data is transmitted directly.

The methods and systems described herein may include variations in which an individual actively controls and interacts with an external device during generation of multiple feedback data.

Additional variations of the methods and systems include using the first neural implant to generate a plurality of output data from neural activity of the first cellular structure region, and transmitting the plurality of output data to an external device.

In some further aspects, the techniques described herein relate to a method wherein transmitting the plurality of output data to the external device includes transmitting at least one signal command representative of the plurality of output data.

The methods and techniques described herein may further include a second neural implant coupled to the control unit and positioned in a second cellular structure region of the distributed neural network of the brain of the individual, and wherein transmitting the plurality of feedback data to the control unit includes activating the first neural implant or the second neural implant to stimulate the first cellular structure region of the brain or the second cellular structure region of the brain.

In some aspects, the technology described herein relates to a method, wherein the external device comprises an external monitoring server, and wherein the plurality of feedback data facilitates decision making by the individual.

In a further aspect, the technology described herein relates to a method, wherein the external device comprises a second control unit or a second electronic device, wherein the second control unit and the second electronic device are coupled to a second individual.

In a further variation, the external device includes a camera system worn by the individual.

Additional variations of the systems and methods described herein include facilitating direct interaction between a distributed neural network of an individual's brain and an external device, the method comprising: generating a plurality of feedback data from an external device; establishing a connection from an external device to a control unit coupled to the individual, wherein the control unit includes a first neural implant previously positioned within a first cellular structure region of a distributed neural network of the brain of the individual; and transmitting the plurality of feedback data to the individual.

In some aspects, the technology described herein relates to a method, wherein transmitting the plurality of feedback data to the individual comprises transmitting the plurality of feedback data to a control unit, such that the control unit excites the first neural implant to stimulate a first cellular structure region of the brain, the first cellular structure region producing an effect specific to the first cellular structure region within the individual, such that the individual is able to perceive the effect.

Variations of the method and system include an external device comprising a position tracking system configured to monitor a position of an individual relative to an environment of the individual, wherein generating a plurality of feedback data from the external device comprises information about environmental conditions surrounding the individual.

Additional variations of the method and system include transmitting the plurality of feedback data to an external hardware component that produces an effect that the individual can perceive. For example, the external hardware components may include a camera system worn by the individual.

A further variation of the methods described herein includes a method of assessing the effect of a medical procedure on a region of interest in the brain of an individual, the method comprising: positioning at least one intravascular nerve monitoring implant within a blood vessel of the brain adjacent to a region of interest; causing the individual to perform one or more tasks that induce neural activity in the brain; and measuring neural activity with the at least one intravascular nerve monitoring implant to determine an association between the region of interest and brain activity for assessing the effect of the medical procedure on the region of interest.

Variations of the techniques described herein may relate to a method wherein positioning at least one intravascular nerve monitoring implant within a blood vessel adjacent a region of interest in the brain includes positioning a plurality of intravascular nerve monitoring implants within a plurality of blood vessels surrounding the region of interest in the brain.

The methods described herein may further comprise injecting a substance into the target area prior to measuring the neural activity. For example, the substance may include an anesthetic that is injected into an artery targeted for embolization. In addition, the methods and systems may additionally include measuring neural activity with at least one intravascular nerve monitoring implant after injecting the substance.

In some aspects, the technology described herein relates to a method further comprising mapping one or more tasks to one or more regions of the brain.

In some aspects, the technology described herein relates to a method wherein measuring neural activity further comprises measuring neural activity before and after the surgery.

Another variation of a method according to the present disclosure includes a method of monitoring an epileptic patient prone to seizures, the method comprising: positioning at least one intravascular nerve monitoring implant within a blood vessel in the brain; monitoring neural activity of the brain with at least one intravascular nerve monitoring implant for a period of time during which the individual ceases epileptic drug treatment; and analyzing neural activity to identify regions of the brain associated with seizures.

In some aspects, the technology described herein relates to a method wherein analyzing neural activity to identify a region of the brain includes identifying a region of the brain that is active prior to an epileptic seizure.

In some aspects, the technology described herein relates to a method of monitoring an individual in a clinically unresponsive state, the method comprising: positioning at least one intravascular nerve monitoring implant within a blood vessel in the brain of the individual; providing an external stimulus to the individual when the individual is in a clinically unresponsive state; measuring neural activity with at least one intravascular nerve monitoring implant during the providing of the external stimulus; neural activity is assessed to assess the condition of the individual.

In some aspects, the technology described herein relates to a method further comprising administering an anesthetic to the individual, measuring neural activity after administration of the anesthetic, and comparing the neural activity before and after administration of the anesthetic to obtain an indicator of brain function.

In some aspects, the technology described herein relates to a method that further includes communicating information about assessing neural activity to a user interface of a caregiver,

in some aspects, the technology described herein relates to a method, wherein assessing neural activity to assess the condition of the individual comprises assessing the individual for information selected from the group consisting of: a measure of outcome prediction, degree of recovery, and improvement in individuals over time.

In some aspects, the technology described herein relates to a method further comprising comparing, wherein the neural activity is assessed using the data set to assess the condition of the individual, thereby predicting a recovery pattern of the individual.

Brief Description of Drawings

Fig. 1 illustrates a conventional method of accessing a region of the brain with a brain stimulation device comprising electrodes implanted within the brain of an individual.

Fig. 2A shows a schematic representation of the cerebral cortex of a brain having a network of vasculature supplying various regions of the cerebral cortex of the brain.

Fig. 2B is a diagram of the brain with vasculature omitted from the individual cellular structure regions of the cerebral cortex.

Fig. 3A and 3B illustrate a variation of a neural implant that includes an intravascular electrode array as part of a microwire monitoring/stimulation probe.

Fig. 4A shows a first variant of the system, which directly enters and monitors a specific area or sub-network of the brain via a vascular access.

Fig. 4B shows a variation of the system that directly accesses and monitors discrete areas or sub-networks of the brain via vascular access.

Fig. 4C shows a variation of the system that directly accesses and monitors discrete areas or subnetworks of the brain in a non-invasive medical procedure.

Fig. 5 illustrates a variation of a system that includes a plurality of neural implants including a plurality of microwire monitoring probes coupled to one or more monitoring devices.

Fig. 6 illustrates an application of the system described herein that uses a distributed neural network of the brain to improve technical control, motor control, emotion monitoring, decision making monitoring, sensory feeds, auditory feeds, visual feeds, and communication with individuals.

Fig. 7 shows one example of a system that uses an individual's distributed neural network to improve data communication with the individual to improve interaction with any type of external device or machine.

Fig. 8 illustrates another variation of using a distributed neural network to improve data communication with an individual to monitor the individual.

Fig. 9 shows a variation of using a distributed neural network to create a brain-to-brain network (brain-to-brain network) between at least two individuals.

Fig. 10A and 10B show a first example of an individual having an implanted BCI vascular based system.

Fig. 11A shows a variation of the system of the present disclosure with a camera system.

Fig. 11B illustrates a variation of the system of the present disclosure that uses a computing device to generate signals for neural stimulation.

Fig. 12 illustrates an example of an individual in an environment in which a BCI stimulation device receives input through any number of sensors or cameras to produce sensory stimulation to the individual.

Detailed Description

The methods and apparatus of the present invention relate to electrodes that directly access, monitor and/or communicate with specific areas or sub-networks of the brain via vascular access with the purpose of transmitting data to and from individual sub-networks and associated nerves of the individual's brain using direct access. As described below, the use of such data communicated directly to and from these neural subnetworks may improve many areas, including but not limited to medical applications, control of machines and electronics, real-time feedback on targeted activities, and communication and consumer goods.

Fig. 2A shows a schematic representation of the cortex of the brain 12, the brain 12 having a network of vasculature 40 supplying various regions of the cortex of the brain 12. The methods and devices described herein use the vasculature 40 to position one or more electrodes adjacent a particular region of the brain. Variations of the method may include using veins and/or arteries to locate the device. In certain variations, the electrodes are positioned in veins to reduce inadvertent blood flow to brain tissue. Furthermore, as described below, these devices may be located entirely within a blood vessel. However, variations may include the use of devices or structures that penetrate the vessel wall.

Fig. 2B is an illustration of the brain 12, with vasculature omitted relative to the individual cellular structure regions (C1-C46) of the cerebral cortex. These regions correspond to the Brodmann areas, which are based on the organization of neurons corresponding to the various cortical functions of the cerebral cortex observed in the cerebral cortex. C1, C2 and C3 represent the primary somatosensory cortex of the central retrofocus; c4 is the primary motor cortex; c5 is the top leaflet; c6 is anterior and auxiliary motor cortex; c7 is the visual motor cortex; c8 includes frontal lobe eye movement zone; c9-dorsal lateral prefrontal cortex; c10-prefrontal cortex (the most anterior part of the upper and middle frontal returns); c11-orbitofrontal region (orbitofrontal, rectus plus a portion of the anterior side of the upper dorsum); c17-primary visual cortex (V1); c18-secondary visual cortex (V2); c19-visual united cortex (V3, V4, V5); c20-temporal gyrus; c21-temporal gyrus; a portion of the C22-temporal ascent, included in the weinike's area (Wernicke); c37-shuttle; c38-temporal region (the anterior-most part of superior temporal and medial gyrus); c39-angle back, considered by some to be part of the weinik region; c40-rim is returned and considered by some to be part of the Wernike region; c41 and C42-auditory cortex; c44 and C45-broka's area, including frontal island covers and triangles; and, C46-dorsal prefrontal cortex.

The devices, methods, and systems described herein may benefit from, or be combined with, the intravascular carriers and electrode arrays disclosed in the following patents and applications, as well as systems/methods that use neural signals. U.S. patent No.: US10485968 issued 11/26/2019, US10512555 issued 12/24/2020, US10575783 issued 3/2020, US10729530 issued 8/4/2020, US11093038 issued 8/17/2021, and US11141584 issued 10/12/2021. U.S. publication No.: US20210378595 published in 12 month 9 of 2021, US20210393948 published in 12 month 23 of 2021, US20200352697 published in 11 month 12 of 2020, US20200078195 published in 3 month 12 of 2020, US20190336748 published in 11 month 7 of 2019, US20200016396 published in 1 month 16 of 2020, US20210373665 published in 12 month 2 of 2021, US20210342004 published in 11 month 4 of 2021, US20210137542 published in 5 month 13 of 2021, US20210365117 published in 11 month 25 of 2021 and US20210361950 published in 11 month 25 of 2021. The contents of each of which are incorporated herein by reference in their entirety.

Fig. 3A shows a further variation of the nerve implant 100 that includes an intravascular electrode array as part of the microfilament monitoring/stimulation nerve implant 100. As shown, the nerve implant 100 includes one or more distal electrodes 108 located on a spiral or sinusoidal 106 portion of the microwire 102. As described below, the non-linear distal end portion 106 includes a non-traumatic tip 104, which non-traumatic tip 104 allows for temporary fixation of the electrode 108 and distal end portion 106 within a blood vessel within the brain without causing trauma to the blood vessel or brain. The non-linear shape 106 may be used to provide apposition of the wire against the vessel wall and to position the electrode 108 in contact with the vessel wall. The nonlinear distal section 106 may comprise a nitinol material or core that allows the device to assume the nonlinear shape when unconstrained or activated by an electrical current. The device may include one or more wires or cables configured to be wound or coiled. The wire or cable may be wound in a generally spiral. In some embodiments, at least one of the first intravascular carrier and the second intravascular carrier may be a wire or cable including a sharp distal end for penetrating a lumen or vessel wall. Further, at least one of the first intravascular carrier and the second intravascular carrier may be a wire or cable including an anchor. For example, the anchor may be at least one of a barbed anchor and a radially expandable anchor.

In further variations, the entirety of the microwire 102 may comprise a shape memory alloy. In most variations, the nerve implant 100 is configured to be removable from the blood vessel, such as by pulling on the proximal end of the microwire 102. Additional variations of the device 100 include a non-linear shape at the electrode region 106, which may range from a spiral shape to a simple curve, or any shape that allows anchoring in the fine blood vessels of the brain. Alternatively, the series of electrodes 108 may be positioned on any structure that provides anchoring but does not restrict intravascular blood flow.

Generally, the microwire 102 is sized in length and diameter such that it can be advanced into the remote vasculature within the brain. For example, the diameter of the microwire 102 may be in the range of 0.010 inch to 0.018 inch. However, the size of the microwire should be selected to allow the electrode portion to advance into a remote region of the brain. Alternatively, the proximal portion of the microwire 102 may have a larger diameter than the intermediate and distal regions to allow for increased pushability of the wire 102. The proximal end 112 of the microwire 102 is coupled to a connector base 110, and the connector base 110 communicates with monitoring software or other electronic/computing devices 120 using a wireless or wired connection.

In addition to being non-invasive, variations of the monitoring probes/implants 100 described herein are configured to be removable when used for a short period of time. Alternatively, variations of the monitoring probe may remain implanted over a span of months and/or years. In any event, the nerve implant 100 can have an antithrombotic coating (e.g., heparin) to inhibit blood clotting.

Fig. 3B shows another variation of the neural implant 100 that includes an intravascular carrier 200 (e.g., a stent structure) carrying different electrode arrays 202 and 204. Alternative variations may include a single electrode array or additional electrode arrays. As shown in fig. 3B, both electrode arrays 202, 204 may be coupled to the same expandable structure 200 or intravascular stent. In other embodiments, three or more electrode arrays may be coupled to the same expandable stent or intravascular stent. Although fig. 3B shows the electrodes 206 of the first electrode array 202 using black circles and the electrodes 206 of the second electrode array 204 using white circles, it should be understood by those of ordinary skill in the art that the difference in color is merely for ease of illustration.

Additional examples of neural implants can be found in the following U.S. patents: 6,260,458;6,428,489;6,431,039;6,440,088;6,553,880;6,579,246 and 6,766,720, the entire contents of each of these patents are incorporated by reference.

Additional neural implant

Fig. 4A shows a first variation of a system for directly accessing and monitoring a specific area or sub-network of the brain 12 via a vascular access. In this variation, the microfilament monitoring nerve implant 100 is advanced through the vasculature into the blood vessel 40 within the brain 12. The illustrated variation is shown implanted during an operative procedure to provide brain monitoring during the procedure. In this variation, the nerve implant 100 may be removed post-operatively or may remain implanted during a post-operative monitoring cycle. Thus, the proximal portion of the microwire 102 extends through one or more cutouts 8 in the individual 10 for coupling to the controller 110 or another wire holder. For illustrative purposes, the system shown in fig. 4A includes a single nerve implant 100. In practice, any number of microwire monitoring probe devices may be used. In addition, the nerve implant 100 may be positioned using a microcatheter (not shown) that constrains the electrode portion 106 until the electrode portion 106 is deployed. Alternatively, the caregiver may advance the nerve implant 100 directly in a linear configuration. Once positioned within the desired area, the caregiver can apply a current to the device to convert the electrode portion 106 from a linear configuration to a non-linear configuration so that the device remains anchored in the desired location.

As shown, the distal portion 106 of the device is configured to detect neural activity and remain temporarily anchored within a blood vessel. The nerve implant 100 is deployed within a blood vessel and adjacent to the region of interest 50. In this example, the region of interest 50 represents a region of brain tissue that is intended to be resected or inactivated. Such surgery may include tumor resection, brain tissue resection to reduce seizures, treatment of arteriovenous malformations in the brain, and the like. In conventional methods, dyes are used to identify the target area 50. Positioning one or more neural implants 100 in a blood vessel adjacent to or surrounding a target region 50 allows for monitoring of neural signals at the site of device deployment. Nerve signals may be monitored before, during and after injection of the dye to observe the effect of the dye or the procedure.

In further variations, as shown in fig. 4B, the devices described herein may replace or augment the Wada test performed on epileptic patients taking into account surgery. In the Wada test (also known as sodium isopentobarbital Injection (ISAP) in carotid arteries), it establishes a brain language and memory characterization for each hemisphere. In a test performed while the patient is awake, the physician introduces barbiturate (e.g., sodium isopentobarbital) into one of the internal carotid arteries via a cannula or intra-arterial catheter. The physician then injects the drug into the right or left internal carotid artery of one hemisphere at a time to inhibit the corresponding side of the brain. For example, if a drug is injected into the right carotid artery, the right side of the brain is inhibited and cannot communicate with the left side of the brain. This allows the physician to observe the effect on any language and/or memory function in that hemisphere in order to evaluate the other hemisphere. The test may also include EEG recordings to confirm that the affected side of the brain is inactive. The physician may then engage the patient in language and memory related testing. The present device may allow the positioning of the neural implant 100 within specific cellular structural regions of the brain (see fig. 2B) to record activity while the physician manages various memory, language, or mental exercises that activate the brain. Detecting neural activity during testing may allow mapping to locations within the brain where tasks occur. Once mapped, the physician can determine whether treatment/ablation of the region of interest 50 can be performed and the potential consequences of doing so. In addition, the nerve implant 100 can be used to monitor various areas of the brain during and after the procedure.

Fig. 4C illustrates additional uses of the methods and systems described herein for non-invasive treatment of a region of interest 50. The region 50 may represent a region of brain tissue that is intended to be resected or inactivated. Such surgery may include tumor resection, brain tissue resection to reduce seizures, treatment of arteriovenous malformations in the brain, treatment of essential tremors, and the like. As described above, prior to treating tissue, one or more nerve implants 100 are positioned in a blood vessel adjacent to or surrounding the target area 50 to allow for monitoring of nerve signals at the site of device deployment. Since the implant 100 is positioned using the vasculature, no invasive penetration of the skull is required. However, variations of the method may include electrode implantation (as shown in fig. 1) to assist in the procedure. Fig. 4C shows an example of a focused ultrasound array 170 having a plurality of transducers 172 that transmit focused ultrasound energy 174 to a target region 50 to ablate the target region 50 or a portion thereof. As described herein, the implant 100 and system can monitor neural activity before, during, and/or after the application of energy 174 to assess therapeutic effects or to assess indirect effects on brain activity due to therapy.

In another variation, similar to fig. 4A-4C, the nerve implant 100 may be placed in a specific cellular structure region of the brain (see fig. 2B) to aid in safe intra-arterial or intravenous embolization of arteriovenous malformations or malignancies. Using nerve monitoring during endovascular embolization surgery includes recording evoked potentials from the brain using scalp-based EEG techniques. Somatosensory evoked potentials are triggered by electrical pulses delivered via electrical stimulation to the lower limb and recorded from the sensory cortex via EEG. To ensure that the artery targeted for embolization does not provide the necessary brain function, an anesthetic (e.g., lidocaine) is injected into the artery. If an embolic agent is subsequently injected into the target artery, any decrease in evoked potential recorded during or immediately after the injection of lidocaine may represent a potential brain injury that may occur. Intracranial intravascular ECoG recordings have significantly higher sensitivity than scalp-based EEG and may represent an opportunity to improve the safety of intraoperative nerve monitoring during arterial embolism surgery.

The system described in fig. 4A-4C is well suited for intra-and post-operative monitoring of a patient with little patient movement (such that the microwire 120 may extend from one or more incisions 8 of the individual 10). Fig. 5 illustrates a variation of a system that includes a plurality of microwire monitoring nerve implants 100 coupled to one or more monitoring devices 130. The monitoring device 130 may be fully or partially implanted within the patient 10. Alternatively, the monitoring device 130 may be positioned extracorporeally, but allows coupling with the nerve implant 100 in a sterile manner. One of the purposes of the system shown in fig. 5 is to provide hospitalization or dynamic monitoring of the individual 10. In this case, the nerve implant 100 remains in a specific area of the brain 12 for days or even months.

One application of the system shown in fig. 5 includes monitoring epileptic patients, particularly those who do not respond positively to medication. In this case, any number of neural implants 100 are positioned within various regions of the brain 12. The nerve implant 100 is coupled to a monitoring device that communicates 150 via a wired or wireless connection with any number of electronic interface devices (e.g., personal electronic device 140 or computer system 120). Patient 10 then deactivates the epileptic medication for a period of time during which the system monitors brain activity through nerve implant 100. The activity is then analyzed to determine regions of the brain associated with seizures, including regions of pre-seizure activity and/or regions responsible for seizures. The implanted system allows for monitoring for days or even months. Current methods of determining brain regions associated with seizures include craniotomy, which resects portions of the skull or cranium to access regions of the brain. The system shown in fig. 5 uses vascular access to perform brain region seizure mapping. In further variations, the systems described herein may be used in addition to traditional surgery.

The implant unit 130 may include amplifiers, filters, controllers, data storage, power supplies, wireless communication devices (e.g., RF, bluetooth, etc.). Such a device allows capturing data over a relatively long period of time in order to provide mobility to the individual when performing the assessment.

In addition to brain mapping, the systems described herein may provide a warning system for patients suffering from seizures by being implanted for a longer duration. For example, the implant 100 may monitor various areas of the brain 12 and provide notification via an external device (e.g., 140) or via the monitoring device 130 if the system detects that the individual is at high risk of seizures. In this case, the individual may be placed in a armed state and protected from the environment (e.g., driving, bathing, exercising, etc.) where seizures may lead to additional risks. The system may also give different levels of warning, such as low, medium, high seizure risk, which will allow the affected individual more freedom with respect to sudden unexpected seizures.

In another variation, the systems described herein can also be used as a neuromonitoring diagnostic system that detects electrophysiological biomarkers in a patient suffering from brain injury, wherein the patient is otherwise unresponsive. The detection of the biomarker may be an indicator of patient recovery. An example of such a reaction is discussed in Classen, j. (2019). Brain activation detection in patients with acute brain injury and unresponsiveness. New England journal of medicine (New England Journal of Medicine), 380 (26) 2497-2505.

For example, in some cases, where coma, stroke, hypoxic brain injury, or any brain injury results in clinical unresponsiveness of the patient. Use of the systems described herein may use ECoG in response to external stimuli, including auditory stimuli (e.g., verbal commands, familiar sounds, etc.) and/or physical stimuli to assess unresponsive patients for evidence of brain activation. In one variant, the purpose of the stimulation is to induce a change in brain state by interacting with a non-responsive patient. The nerve monitoring system may then provide a user interface/user exchange for the caregiver to provide the caregiver with various information regarding the patient's condition. For example, the user interface may provide a prediction of outcome, a degree of recovery, and/or measure improvement over time in non-responsive patients. The measured response to the external stimulus may be compared to the data set to predict the recovery pattern of the patient. The data set may be cloud-based and updated based on a machine learning algorithm that provides data normalization to provide a rating of the condition of the patient, such as likely or unlikely to improve.

The nerve monitoring system may also be combined with a challenge test (provocative testing) in which the patient is monitored in a resting state to determine activity and then again after administration of anesthesia to a specific area of the patient or the patient's brain. The difference in the measured signals can be used as an indicator of brain function.

Using the systems described herein as a nerve monitoring system allows for positioning one or more intravascular electrode arrays in a region of motion, such as the brain. However, the array may be positioned in any number of areas of the brain. The implantation of the electrode array may be temporary, wherein the array is removed after monitoring the patient. Alternatively, the array may be implanted for a long period of time to increase patient monitoring. In either case, it may be desirable for the proximal end of the array to be directly coupled to a controller/transceiver/generator that is not implanted in the patient (see, e.g., fig. 3).

Fig. 6 illustrates another application of the system described herein that uses a distributed neural network of the brain to improve technical control, motor control, sensory feeds, and communication with individuals. For example, FIG. 6 shows an enlarged view of brain 12 of individual 10, with individual 10 having any number of microwire nerve implants 100 positioned within blood vessels 40 associated with specific discrete cellular structure regions (e.g., C1, C19, and C42) of brain 12. Positioning the implant in discrete areas or networks of the brain allows sensory stimulation or nerve signal measurements to be made in different areas of the brain to improve data communication with the individual. In the example shown, the cellular structure regions are associated with auditory, sensory, and visual regions of the brain 12. However, these areas are chosen for illustration purposes only. Additional variations of the systems and methods disclosed herein include any number of neural implants 100 positioned to be associated with any number of cellular structure regions of the brain.

As shown in fig. 6, the nerve implant 100 is coupled to the control unit 130 via a microwire 102 extending through the additional vasculature 40. As described below, the neural implant 100 allows for data transfer with various regions of the brain 12 to provide improved information communication with the individual 10 and improved control of electronics networked to the neural implant 100 and the control unit 130. The area shown in fig. 6 may be used to cause data to be entered into an individual. In further variations, the brain regions for outputting data from the individual may include the same or different regions of the brain. For example, these regions may include regions in the brain responsible for language, decision prediction, motion control, emotion, etc.

FIG. 7 shows one example of a system described herein that uses a distributed neural network of individuals 10 to improve data communication with individuals 10 to improve interaction with any type of external device or machine 70. To illustrate improved communication or data delivery, FIG. 7 shows a vehicle such as an aircraft, drone 72, or automobile 74. It should be apparent that the present disclosure may include any machine or device configured to interact with individual 10.

In conventional systems, an operator controls the drone using a remote control device and an electronic interface that includes a screen that provides various data (e.g., speed, altitude, fuel, direction, etc.) of the drone's operating parameters. The operator must observe these parameters in order to respond to any changing conditions of the operating parameters. Next, the operator must formulate a concept for any subsequent actions and then perform any corrective actions. The operator must perform the physical actions that provide corrective action for the drone. Although the operator may perform these actions quickly, there is a time delay between the change in condition of the drone, observing the change in condition, and then performing a physical corrective action to control the drone. The reaction rate of the vehicle operator requires the idea to be transmitted from the origin of the cortex through the spinal cord, peripheral nerves, and ultimately trigger muscle activity to execute the mental command. The device (fig. 5) is capable of information delivery at a speed that is superior to that of an unmodified human body.

In a system as shown in fig. 7, data 64 regarding the operating parameters of the drone may be transmitted to the network 62 or directly 63 to the electronics 140, which electronics 140 interfaces with the control unit 130 of the system described herein via a wired or wireless connection. (As discussed above, the use of a separate electronic unit 140 is optional for all of the examples discussed herein.) As discussed above (see FIG. 6), the various probes may be positioned in different cellular structure regions such that the information 62 transmitted to the individual may trigger stimulation of a particular cellular structure region. For example, if the drone is increasing in altitude, the system may stimulate a first region of the brain, while if the drone loses airspeed, the system may stimulate a second region of the brain. The operator will be trained to recognize the various stimuli to respond accordingly. This direct transfer of data from machine 70 to system and individual 10 allows for a high degree of control of the drone.

In addition, the system may allow individual 10 to issue control commands to the drone using brain activity generated in specific cellular structure regions. For example, if the individual 10 determines that the drone requires heading correction (e.g., moves to the right), then an implant positioned in the individual's region of motion will pick up the individual's brain activity, which may generate the idea of his right side of the motion activity (e.g., push down with the right foot or activate the right side of the muscle). The neural activity is then transmitted via data 62, either through network 60 or directly to drone 72, so that the drone receives data 64 to automatically correct the heading. In both examples described herein, the system allows direct communication between discrete areas of the brain and the external machine 70 that needs to be controlled. Alternatively or additionally, transmitting data from the individual to external device 70 may include transmitting signal commands determined by neural activity of individual 10. For example, if the system is configured such that when an individual generates a concept of athletic activity (as described above) to provide directional control to external device 70, the implant sensing that athletic activity will generate output data representative of that athletic activity. Once the control unit 130 and/or the electronics 140 recognize the particular output data, these components may issue a particular signal command (e.g., a directional command) to the external device to be recognized by the external device.

The system allows for improved control of the machine 70 and improved perception of the operating conditions of the machine. Although the above description discusses the use of cellular structure regions that control athletic activity, any number of cellular structure regions may be used, including but not limited to regions that control mood transmission, language, decision prediction, visual space perception, auditory perception, and sensory perception (e.g., touch, smell, taste, etc.).

In yet another variation, the system shown in FIG. 7 may use artificial intelligence or external data generated by network 60 independently of machine 70 or indirectly from the machine. For example, if the implant is positioned in a sensory area of the brain, triggering the implant may produce a perception of smell, taste, or similar sensory feed associated with an alert of some predetermined condition. As one example, if individual 10 is in an hostile area and drone 72 or satellite has identified an area with actual or potential risk, the implant may be triggered to generate a particular perception associated with the area with actual or potential risk. This perception may be triggered to increase when the individual moves toward the area and decrease when away. Alternatively or additionally, the additional data may be used to feed the location of the enemy through the visual cortex and through the brain representation of the individual 10 onto the geospatial representation to produce a direct visual feed from the control station to the brain.

Fig. 8 illustrates another variation of using a distributed neural network to improve data communication with individuals 10. In this variant, an implanted neural implant (shown as a microfilament sensor) may be implanted in the brain in an area corresponding to the prefrontal cortex, which is responsible for decision making. Thus, the implanted probe may generate a signal that predicts decision making. This feature may be used when individual 10 is in a situation where difficult decisions are being made (e.g., soldiers, law enforcement officers, firefighters, etc.). The system may transmit the data 66, 68 to a monitoring site or server 80, the monitoring site or server 80 attempting to actually predict the manner in which the individual makes a decision, and may then engage with the individual to assist, or even prevent action. Although fig. 8 illustrates data transfers 66 and 68 occurring over network 60, the data transfers may also include direct data transfers with control unit 130 and/or electronics 140.

In another variation, a hit tactical object, such as an astronaut, that is restricted from communicating with the base director utilizes the system for advanced communications (e.g., with another astronaut or command center (Mission Control)). The device (fig. 5) is capable of monitoring the astronauts' real-time cognitive activities across the distributed cognitive domain (fig. 2B), which aids in decision making. For example, emotional arousal broadcasting, decision prediction, and athletic functions may be monitored. The command center or another individual can also provide information to the cognitive domain of the subject, which can be received in various forms of perception, including sensation, hearing, vision, and smell. For example, geospatial information that aids in decision making during life may be provided directly to the visual cortex and auditory feeds directly to the auditory cortex. The astronaut can then perform the mission with greater accuracy using the information flow directly into and out of the cerebral cortex.

Fig. 9 shows another variation of using a distributed neural network by creating a brain-to-brain network between at least two individuals 10, 11, each having microwire monitoring/stimulating neural implants 100 that are each positioned in a specific cellular structure region of their respective brains. For illustration purposes, the book 9 shows two bodies 10, 11. However, the present disclosure may include any number of individuals. As described herein, data transfer 66 and 68 between individuals may rely on the network 60 or may occur directly through a local or private network. As also discussed, the system may include one or more electronics 140, 142 in communication with the control units 130, 132 of the coupled probes, or the electronics 140, 142 may be integrated into the control units 130, 132, respectively. The example shown in fig. 9 allows linking the two individuals 10, 11 in any number of ways, depending on the placement of the device in a particular cellular structure region of the brain. In one example, the implant may be positioned in an area of the brain responsible for the emotional response so that each individual may be aware of the emotional component of the other individual. Such networking is not limited to emotion and may include connecting any region of the brain to provide direct data communication between individuals for sensation, movement, language, hearing, vision, taste, smell, etc.

In one variation, a group of tactical objects utilize networked brain functions to achieve a higher level of information flow throughout the community. Can be coordinated as one linked organism, enabling better mass capacity to achieve a common goal. In one example, the bright flare emitted by explosives can be seen not only by the direct witness of the explosion, but also by the entire community. Injury to a member of a community is felt by the entire community. Shared awareness across cognitive domains enables communities to perform higher functions.

Fig. 10A illustrates an individual having a portion of a brain-computer interface (BCI) as described in the patents and/or patent applications listed above.

Fig. 10A shows a first example of an individual 10 having an implanted BCI vascular based system. It is noted that variations of the methods described herein may be applied to non-vascular based BCI systems, including, but not limited to, placement of electrodes directly into brain/nerve regions, placement of external electrodes on the scalp or under the epidermis layer. Fig. 10A shows an individual 10 having a pulse generator 160 with a wire 162 or other electrical connection that transmits an electrical signal to a stent (stent not shown in fig. 10A) positioned within the cerebral vasculature. In further variations, the connection between the pulser 160 and the cradle may be wireless, eliminating the need for the lead 102.

Stents are typically implanted near various sensory tissues. In this embodiment, as shown in fig. 10B, the stent 164 with electrodes 166 is positioned within the vessel 40 of the vasculature of the brain 12 such that it is adjacent to the neural tissue 14, which neural tissue 14 may be stimulated to produce a recognizable effect within the individual. In one example, the implanted stent 164 may be implanted in a sinus or venous branch adjacent to the visual (occipital) cortex. Additional areas include venous sinus: transverse sinus, straight sinus, superior sagittal sinus; superficial cortical vein: upper anastomotic veins, lower anastomotic veins; cortical deep veins, rosenstar basal veins (basal vein of Rosenthal); and the posterior cerebral arteries. Further, variations of the methods and systems may position the stent into a non-visual region of the brain, as described below. Regardless, additional variations allow placement of the stent 164 in any vessel adjacent other areas of the brain.

As described in the above-incorporated patents and publications, the stent 164 includes any number of electrodes that may be used to stimulate the neural tissue 14 to produce stimulation in an individual.

Fig. 11A shows a variation of the system of the present disclosure. As shown, individual 10 may have a BCI system similar to that discussed above, with pulse generator 160 coupled by wire 162 (or wirelessly) to a stent positioned within the brain tissue of the individual. The BCI may be coupled to an optional transmission unit 170, which transmission unit 170 relays the signal to the pulse generator 160 for stimulation. Alternatively, any external hardware component may be configured to communicate (either wirelessly or by wire) directly with the pulse generator.

In the example shown, the camera system 172 includes a visual input/camera component 174 in communication with a signal processor 176. The camera system 172 may include any number of power supplies 178 or other desired electronics. During use, the camera system 172 is able to obtain information about the surroundings of the user 10 and transmit image data to the signal processor 176, which signal processor 176 in turn generates signals to cause the pulse generator 160 to ultimately stimulate a region of the brain of the individual.

The camera system 172 may include any optical or other imaging system. For example, the camera system may use a lidar or other three-dimensional imaging system. The camera system 172 may include a plurality of cameras or lenses 174 as desired in the corresponding technology. Alternatively or in combination, the camera system 172 may include an ultrasound-based system. Regardless of the imaging or sensing mode, the system generates inputs (direct or signal processor) such that for any given condition, the pulse generator 160 stimulates the brain of the patient 2.

The systems described herein may provide stimuli sufficient to attempt to replicate vision in a patient. Alternatively or in combination, the system may be configured to provide stimulation based on certain environmental information. For example, if the camera system detects that the individual is approaching an object, the system may stimulate neural tissue in the brain of the individual so that the individual perceives a sensory event. If the stimulus occurs in the visual (occipital) cortex, the sensory event will be a visual event, such as a flashing or pulsing of the individual's perception. In this case, the sensory event may be a general event with any particular environmental sensory input (meaning that it must be associated with any particular environmental sensory input). For example, the system may be configured such that if the camera system 160 identifies an object or obstacle at a distance from the individual, the system delivers a particular stimulus or series of stimuli that enable the individual to associate with the obstacle. Further, the system may be configured to identify common environmental items such as stop lights, walking signals, etc., and generate sensory stimuli that an individual may associate with the respective environmental items. In each case, the sensory signal triggered within the individual is generally independent of the environmental item/barrier, but is associated with a particular item/barrier by the configuration of the system.

The present system allows any sensory stimulus triggered within an individual to become a generalized stimulus that can be associated with any range of environmental conditions. Furthermore, the combination and/or duration of sensory stimuli may be further assigned to additional environmental conditions. In one basic example, the system may stimulate neural tissue so that the individual perceives a flash, where a rapid series of flashes may indicate that the individual should not proceed further, such as in the case where the individual is facing a red light or is prohibited from walking signals. A slower series of flashes may be interpreted as a non-emergency alert.

Fig. 11A and 11B each illustrate a computing device 190, which computing device 190 may include a smart phone, tablet, or other computer that is also configured to interact with the pulse generator 160 directly or using the intermediate component 118. Wherein the intermediate component 170 may optionally be coupled to the camera system 172 via a wireless or wired 180 connection. In either case, the system contemplates using computing device 190 with or without camera system 172 (shown in FIG. 12A) or without camera system (shown in FIG. 11B). In a variation using BCI without a camera system, computing device 190 may provide environmental information to pulse generator 160 (pulse generator 160 ultimately providing stimulus to individual 2) by using GPS positioning information or by using an onboard camera on computing device 190.

Fig. 12 illustrates an example of an individual 10 in an environment in which BCI stimulation device 168 receives input through any number of sensors, cameras, or position tracking systems 192 to produce sensory stimulation to individual 2. In the illustrated example, sensor/camera 192 may provide environmental information as well as tracking information to monitor individual 10 and relay that information to system 168 and/or the computing devices described above. Furthermore, the systems described herein may be combined with any electronic virtual mapping.

Note that the concepts described above, although shown as separate applications, may be combined in whole or in part.

All prior art subject matter (e.g., publications, patents, patent applications) mentioned herein is incorporated by reference in its entirety, unless such subject matter might conflict with the subject matter of the present disclosure (in which case the disclosure herein controls). The referenced items are provided for their disclosure only prior to the filing date of the present application. Nothing herein is to be construed as an admission that the invention is not entitled to antedate such material by virtue of prior art.

Reference to an item in the singular includes the possibility that there are plural of the same items present. More specifically, as used herein and in the appended claims, the singular forms "a," "an," and "the" include plural referents unless the context clearly dictates otherwise. It is also noted that the claims may be drafted to exclude any optional element. Accordingly, this statement is intended to serve as antecedent basis for use of such exclusive terminology as "solely," "only," and the like in connection with the recitation of claim elements, or use of a "negative" limitation. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs.

In understanding the scope of the present disclosure, the term "comprising" and its derivatives, as used herein, are intended to be open ended terms that specify the presence of the stated features, elements, components, groups, integers, and/or steps, but do not exclude the presence of other unstated features, elements, components, groups, integers and/or steps. The above also applies to words having similar meanings such as the terms "including", "having" and their derivatives. Furthermore, the terms "part," "section," "portion," "member," "element" or "component" when used in the singular can have the dual meaning of a single part or a plurality of parts. As used herein, the following directional terms "forward, rearward, above, downward, vertical, horizontal, below, transverse, lateral and vertical" as well as any other similar directional terms refer to those positions of a device or an article of equipment or those directions in which the device or article of equipment is translated or moved. Finally, terms of degree such as "substantially", "about" and "approximately" as used herein mean a reasonable amount of deviation from the specified value (e.g., up to ±0.1%, ±1%, ±5% or ±10% as such a change is appropriate) such that the end result is not significantly or materially changed.

The disclosure is not intended to be limited to the scope of the particular forms set forth, but is intended to cover alternatives, modifications, and equivalents of the variations or embodiments described herein. Furthermore, the scope of the present disclosure fully encompasses other variations or embodiments that may be apparent to those skilled in the art in view of the present disclosure.

Claims (32)

1. A method of facilitating direct interaction between a distributed neural network of an individual's brain and an external device, the method comprising:

generating a plurality of feedback data from the external device, wherein the plurality of feedback data is related to activity of the external device;

establishing a connection from the external device to a control unit coupled to the individual, wherein the control unit includes a first neural implant previously positioned within a first cellular structural region of the distributed neural network of the brain of the individual; the method comprises the steps of,

transmitting the plurality of feedback data to the control unit such that the control unit excites the first nerve implant to stimulate the first cellular structure area of the brain that produces an effect within the individual that is specific to the first cellular structure area such that the individual is able to perceive the effect.

2. The method of claim 1, wherein the plurality of feedback data relates to an activity of the external device resulting from an action of the individual.

3. The method of claim 1, wherein the plurality of feedback data is transmitted over a network.

4. The method of claim 1, wherein the plurality of feedback data is transmitted directly.

5. The method of claim 1, wherein the individual actively controls and interacts with the external device during generation of the plurality of feedback data.

6. The method of claim 5, wherein the external device is a vehicle.

7. The method of claim 1, further comprising generating a plurality of output data from neural activity of the first cellular structure region using the first neural implant and transmitting the plurality of output data to the external device.

8. The method of claim 7, wherein transmitting the plurality of output data to the external device comprises transmitting at least one signal command representative of the plurality of output data.

9. The method of claim 1, wherein the control unit comprises a second neural implant positioned in a second cellular structure region of the distributed neural network of the brain of the individual, and wherein transmitting the plurality of feedback data to the control unit comprises activating the first neural implant or the second neural implant to stimulate the first cellular structure region of the brain or the second cellular structure region of the brain.

10. The method of claim 1, wherein the external device comprises an external monitoring server, and wherein the plurality of feedback data facilitates decision making by the individual.

11. The method of claim 1, wherein the external device comprises a second control unit or a second electronic device, wherein the second control unit and the second electronic device are coupled to a second individual.

12. The method of claim 1, wherein the external device comprises a camera system worn by the individual.

13. A method of facilitating direct interaction between a distributed neural network of an individual's brain and an external device, the method comprising:

generating a plurality of feedback data from the external device;

establishing a connection from the external device to a control unit coupled to the individual, wherein the control unit includes a first neural implant previously positioned within a first cellular structural region of the distributed neural network of the brain of the individual; and

transmitting the plurality of feedback data to the individual.

14. The method of claim 13, wherein transmitting the plurality of feedback data to the individual comprises transmitting the plurality of feedback data to the control unit such that the control unit excites the first nerve implant to stimulate the first cellular structure region of the brain that produces an effect within the individual that is specific to the first cellular structure region such that the individual is able to perceive the effect.

15. The method of claim 14, wherein the external device comprises a location tracking system configured to monitor a location of the individual relative to an environment of the individual, wherein generating the plurality of feedback data from the external device comprises information regarding environmental conditions surrounding the individual.

16. The method of claim 13, wherein transmitting the plurality of feedback data to the individual comprises transmitting the plurality of feedback data to an external hardware component that produces an effect that the individual is able to perceive.

17. The method of claim 16, wherein the external hardware component comprises a camera system worn by the individual.

18. A method of assessing the effect of a medical procedure on a region of interest in the brain of an individual, the method comprising:

positioning at least one intravascular nerve monitoring implant within a blood vessel in the brain adjacent the region of interest;

causing the individual to perform one or more tasks that induce neural activity in the brain; the method comprises the steps of,

measuring the neural activity with the at least one intravascular nerve monitoring implant to determine an association between the region of interest and brain activity for use in assessing the effect of the medical procedure on the region of interest.

19. The method of claim 18, wherein positioning the at least one intravascular nerve monitoring implant within the brain adjacent the region of interest comprises positioning a plurality of intravascular nerve monitoring implants within a plurality of vessels in the brain surrounding the region of interest.

20. The method of claim 18, further comprising injecting a substance into the target area prior to measuring the neural activity.

21. The method of claim 20, wherein injecting a substance comprises injecting an anesthetic into an artery targeted for embolization.

22. The method of claim 20, further comprising measuring the neural activity with the at least one intravascular nerve monitoring implant after injecting the substance.

23. The method of claim 18, further comprising mapping the one or more tasks to one or more regions of the brain.

24. The method of claim 18, wherein measuring the neural activity further comprises measuring the neural activity before and after the surgery.

25. The method of claim 18, wherein the medical procedure comprises ablation of a tissue region.

26. A method of monitoring an epileptic patient prone to seizures, the method comprising:

positioning at least one intravascular nerve monitoring implant within a blood vessel in the brain;

monitoring neural activity of the brain with the at least one intravascular nerve monitoring implant for a period of time during which the individual ceases epileptic drug treatment; the method comprises the steps of,

the neural activity is analyzed to identify regions of the brain associated with seizures.

27. The method of claim 25, wherein analyzing the neural activity to identify the region of the brain includes identifying a region of the brain that is active prior to a seizure.

28. A method of monitoring an individual in a clinically unresponsive state, the method comprising:

positioning at least one intravascular nerve monitoring implant within a blood vessel in the brain of the individual;

providing an external stimulus to the individual when the individual is in the clinically unresponsive state;

measuring neural activity with the at least one intravascular nerve monitoring implant during provision of the external stimulus;

assessing the neural activity to assess the condition of the individual.

29. The method of claim 28, further comprising administering an anesthetic to the individual, measuring the neural activity after administration of the anesthetic, and comparing the neural activity before and after administration of the anesthetic to obtain an indication of brain function.

30. The method of claim 28, further comprising communicating information about assessing the neural activity to a user interface of a caregiver.

31. The method of claim 28, wherein assessing the neural activity to assess the condition of the individual comprises assessing the individual for information selected from the group consisting of: a measure of outcome prediction, degree of recovery, and improvement over time in the individual.

32. The method of claim 28, further comprising comparing, wherein the neural activity is assessed using a dataset to assess the condition of the individual to predict a recovery pattern of the individual.