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Brian J. Dlouhy, Olatilewa Awe, Rajesh C. Rao, Patricia A. Kirby and Patrick W. Hitchon

Over the last decade, human cell transplantation and neural stem cell trials have examined the feasibility and safety of these potential therapies for treatment of a variety of neurological disorders. However, significant safety concerns have surrounded these trials due to the possibility of ectopic, uncontrolled cellular growth and tumor formation.

The authors present the case of an 18-year-old woman who sustained a complete spinal cord injury at T10–11. Three years after injury, she remained paraplegic and underwent olfactory mucosal cell implantation at the site of injury. She developed back pain 8 years later, and imaging revealed an intramedullary spinal cord mass at the site of cell implantation, which required resection. Intraoperative findings revealed an expanded spinal cord with a multicystic mass containing large amounts of thick mucus-like material. Histological examination and immunohistochemical staining revealed that the mass was composed mostly of cysts lined by respiratory epithelium, submucosal glands with goblet cells, and intervening nerve twigs.

This is the first report of a human spinal cord mass complicating spinal cord cell transplantation and neural stem cell therapy. Given the prolonged time to presentation, safety monitoring of all patients with cell transplantation and neural stem cell implantation should be maintained for many years.

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Reinhold Scherer, Stavros P. Zanos, Kai J. Miller, Rajesh P. N. Rao and Jeffrey G. Ojemann

Electrocorticography (ECoG) offers a powerful and versatile platform for developing brain-computer interfaces; it avoids the risks of brain-invasive methods such as intracortical implants while providing significantly higher signal-to-noise ratio than noninvasive techniques such as electroencephalography. The authors demonstrate that both contra- and ipsilateral finger movements can be discriminated from ECoG signals recorded from a single brain hemisphere. The ECoG activation patterns over sensorimotor areas for contra- and ipsilateral movements were found to overlap to a large degree in the recorded hemisphere. Ipsilateral movements, however, produced less pronounced activity compared with contralateral movements. The authors also found that single-trial classification of movements could be improved by selecting patient-specific frequency components in high-frequency bands (> 50 Hz). Their discovery that ipsilateral hand movements can be discriminated from ECoG signals from a single hemisphere has important implications for neurorehabilitation, suggesting in particular the possibility of regaining ipsilateral movement control using signals from an intact hemisphere after damage to the other hemisphere.

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Tim Blakely, Kai J. Miller, Stavros P. Zanos, Rajesh P. N. Rao and Jeffrey G. Ojemann

All previous multiple-day brain-computer interface (BCI) experiments have dynamically adjusted the parameterization between the signals measured from the brain and the features used to control the interface. The authors present the results of a multiple-day electrocorticographic (ECoG) BCI experiment.

A patient with a subdural electrode array implanted for seizure localization performed tongue motor tasks. After an initial screening and feature selection on the 1st day, 5 consecutive days of cursor-based feedback were performed with a fixed parameterization. Control of the interface was robust throughout all days, with performance increasing to a stable state in which high-frequency ECoG signal could immediately be translated into cursor control.

These findings demonstrate that ECoG-based BCIs can be implemented for multiple-day control without the necessity for sophisticated retraining and adaptation.