The sensitivity of ECG contamination to surgical implantation site in brain computer interfaces

Background: Brain sensing devices are approved today for Parkinson's, essential tremor, and epilepsy therapies. Clinical decisions for implants are often influenced by the premise that patients will benefit from using sensing technology. However, artifacts, such as ECG contamination, can render such treat-ments unreliable. Therefore, clinicians need to understand how surgical decisions may affect artifact probability. Objectives: Investigate neural signal contamination with ECG activity in sensing enabled neuro -stimulation systems, and in particular clinical choices such as implant location that impact signal fidelity. Methods: Electric field modeling and empirical signals from 85 patients were used to investigate the relationship between implant location and ECG contamination. Results: The impact on neural recordings depends on the difference between ECG signal and noise floor of the electrophysiological recording. Empirically, we demonstrate that severe ECG contamination was more than 3.2x higher in left-sided subclavicular implants (48.3%), when compared to right-sided im -plants (15.3%). Cranial implants did not show ECG contamination. Conclusions: Given the relative frequency of corrupted neural signals, we conclude that implant location will impact the ability of brain sensing devices to be used for closed-loop algorithms. Clinical ad-justments such as implant location can significantly affect signal integrity and need consideration. (c) 2021 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

This study investigates the impact of ECG activity on neural signal contamination in neuro-stimulation systems, particularly focusing on how implant location affects signal fidelity. The results show that severe ECG contamination was more prominent in left-sided subclavicular implants compared to right-sided implants and cranial implants. It is concluded that implant location significantly influences the integrity of neural signals and should be considered in clinical decisions for brain sensing devices.