G. Worrell

Aug 2026

Pulvinar and anterior nucleus of the thalamus dual-network neuromodulation for complex epilepsies.

OBJECTIVE Anterior nucleus of the thalamus (ANT) deep brain stimulation (DBS) is an effective therapy for frontotemporal and limbic drug-resistant focal epilepsies. The pulvinar nucleus (PUL) is an emerging neuromodulation target for seizure networks involving the posterior quadrant and temporal lobe. This study evaluates the safety and effectiveness of combined bilateral ANT plus PUL DBS for posterior quadrant and temporal lobe epilepsies. METHODS We conducted a single-center retrospective cohort study of patients receiving combined ANT/PUL DBS between 2021 and 2025. Outcomes included median seizure rate reduction (MSR), responder rate (RR; >50% seizure frequency reduction), and stimulation-related side effects, assessed across ANT, PUL, and concurrent ANT/PUL stimulation settings. Acute surgical complications were evaluated. Statistical significance was assessed using two-sided Wilcoxon signed-rank tests with Holm-Bonferroni correction. RESULTS Nine patients with combined ANT/PUL DBS were identified, and eight patients had sufficient follow-up for inclusion (median follow-up = 20 months). Posterior predominant structural abnormalities were present in eight of nine patients. There were no acute surgical complications. Three instances of transient stimulation-related side effects resolved with parameter adjustments, whereas one patient required rescue antiseizure medication in addition to programming changes. Eight patients received periods of ANT stimulation, six PUL stimulation, and seven combined ANT/PUL stimulation. Regarding overall outcome, at last follow-up, there was a significant 80.8% MSR (p = .0078) and 87.5% RR, with two patients receiving ANT and six ANT/PUL stimulation. Regarding target-specific MSR, concurrent ANT/PUL DBS (68.8% MSR) showed a trend toward superior performance relative to ANT (43.3%) and PUL DBS (17.5%) alone, although subgroup analysis of target-specific performance did not reach statistical significance. SIGNIFICANCE Combined four-lead ANT/PUL DBS appears safe and effective for patients with drug-resistant posterior quadrant and temporal lobe epilepsies. Dual-network neuromodulation may provide greater flexibility to individually optimize neuromodulation for complex seizure networks.

Gloria Ortiz-Guerrero, Asra Tanwir, Ashar Farooqi et al. · Epilepsia · 0 citations

Open access Aug 2026

A Translational Platform for Brain-Computer Interfaces and Adaptive Neuromodulation: Technical Characterization, Long-Term Validation, and Implementation of the CorTec Brain Interchange–BCI2000 Ecosystem

Objective Adaptive neuromodulation systems and implantable brain-computer interfaces (BCIs) are promising therapies for neurological and psychiatric disorders. However, their broader translation into research and clinical practice remains limited by technological complexity, restricted access to implantable research platforms, and the lack of standardized, reproducible experimental workflows. We therefore aimed to develop and validate an open, general-purpose translational ecosystem that enables rapid development, evaluation, and dissemination of novel neuromodulation and implantable BCI paradigms. Approach The CorTec Brain Interchange (BIC) implantable neural sensing and stimulation device was integrated with the open-source BCI2000 platform to create a modular, extensible neuromodulation ecosystem. We established a standardized battery of quantitative assessments to characterize implantable neuromodulation systems to comprehensively evaluate the CorTec BIC device through benchtop characterization, long-term preclinical in vitro and in vivo validation, and a human proof-of-concept demonstration. Results Benchtop and saline testing provided a comprehensive technical ex vivo characterization of the BIC device, independently validating previously reported performance while extending its characterization through quantification of the recording noise floor, stimulation and acquisition latencies and impedance measurement accuracy. Long-term in vivo validation in five canines, with the longest implantation exceeding three years, demonstrated stable chronic recordings while capturing progressive channel deterioration and its underlying mechanical causes. The ecosystem enabled active functional decoding more than two years after implantation, implementation of closed-loop stimulation using arbitrary spectral biomarkers, detection and modulation of epilepsy-associated biomarkers, and brain stimulation evoked potential recordings. In addition, we translated an established one-dimensional BCI cursor control paradigm to the BIC benchtop evaluation kit and demonstrated its feasibility in a human participant. Finally, we openly provide standardized surgical, © Year Copyright holder imaging, and analysis pipelines together with datasets and software to facilitate reproducible neuromodulation research. Significance We present a versatile, open-source translational ecosystem that supports a wide range of neuromodulation and implantable BCI applications with minimal modification. This battery of quantitative assessments can be applied generally as a blueprint for systematic characterization of implantable neuromodulation systems. By combining comprehensive hardware characterization with standardized software tools and experimental workflows, this work provides both an essential reference for researchers adopting the Brain Interchange platform. The ecosystem lowers technical barriers to implantable neurotechnology research, promotes reproducibility, and provides a foundation for accelerating the development and clinical translation of next-generation adaptive neuromodulation and implantable BCI therapies for patients with neurological and psychiatric disorders.

Frederik Lampert, Matthew R. Baker, Fillip Mivalt et al. · bioRxiv · 0 citations