Trans-Sulcal Access Offers Advantages for Brain Implants

by James Cavuoto, editor

October 2023 issue

Manufacturers of surgically implanted brain devices have generally had to make a compromise between the level of invasiveness and the ability to access deep brain structures. Most DBS systems on the market today are able to reach brain centers such as the subthalamic nucleus or the GPi only by penetrating through several layers of cerebral cortex and other brain structures. Most BCI systems on the market or under development minimize penetration deep in the brain but only come into contact with cortical neurons on the surface of the brain.

Newly published research from a Chicago-area institution may lead to a new form of brain implants that offers the best of both worlds. Julian Bailes and colleagues at the NorthShore University HealthSystem recently published a first study demonstrating successful deep-brain placement of a brain computer interface microchip into a living animal with no apparent neurological effects. Bailes’ work has addressed the long-standing challenge of safely accessing subcortical regions of the brain for the purpose of microchip implantation without disrupting surrounding tissue.

“This study had two intentions,” Bailes explained. “The first to describe the methodology for the successful implantation of an integrated circuit into the deep subcortical brain space, and secondly, to investigate how the mammalian brain would accept or reject the IC. We wanted to learn about potential damage to the neural architecture, whether infection would arise, and if the animal could survive with minimal or no functional change after subcortical placement of the IC.”

The proof-of-concept study was published in Brain-Computer Interfaces last month. It used a modified and miniaturized NICO BrainPath, the world’s first navigated trans-sulcal access technology widely used in minimally invasive parafascicular surgery for access in the removal of brain tumors and evacuation of hemorrhagic stroke.

BCI devices thus far are placed at or just below the cortical surface; however, the majority of the brain’s functional architecture is in the brain’s interior. NICO technologies remove the barrier of deep-brain access by providing a safe pathway for delivery of a BCI into those subcortical regions, leading to possible treatments for many neurological disorders.

“It’s such an exciting time in neurosurgery and the neurosciences,” said Jim Pearson, president and CEO of NICO. “We are successfully leading the industry with our innovations that enable new opportunities not just for improved patient care and better outcomes, but also for merging the latest in minimally invasive technologies with the exploding area of artificial intelligence and a new generation of therapeutic and diagnostic technologies.”

NICO Corp. has led the minimally invasive neurosurgical field for more than a decade with its patented technologies that use the natural folds of the brain to reach and remove subcortical abnormalities. It is the sponsor of ENRICH, a positive surgical trial for hemorrhagic stroke in which BrainPath and the NICO Myriad were used to achieve statistically significant and clinically meaningful improvements with early surgical intervention of spontaneous intracerebral hemorrhage versus medical management.

NICO advocates for and supports development of scientific evidence promoting safe and novel approaches to brain disorders and expanding clinical research efforts in pursuit of improved patient outcomes using MIPS. Its technologies have been featured in more than 180 peer-reviewed published papers with over 550 unique authors from major academic centers.