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Dario J. Englot

Publications and source records attributed to Dario J. Englot.

5 recordsLinked to original sources

An MRI-Guided Robotic System to Improve Hippocampal Access for Epilepsy Interventions

This paper presents an MRI-guided robotic system that improves hippocampal access by delivering a curved needle-like laser ablator through the foramen ovale, a natural opening in the base of the skull. Both the delivery path and the curved nature of the needle improve upon current clinical straight-line laser interstitial thermal therapy (LITT) as measured by hippocampal cannulation percentage. We describe the design of the robotic system which includes positioning, aiming, and curved needle deployment stages, followed by experimental results assessing cannulation percentages using MRI images in phantoms. In three curvilinear, single-insertion experiments, we achieved cannulation percentages of 93.5%, 96.5%, and 60.4%, exceeding reported clinical averages of 50-60%. Seizure control is believed by physicians to be a function of hippocampal volume treated, and our system provides a means of treating a greater volume of the hippocampus with LITT-based interventions.

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Principles of Physiological Closed-Loop Controllers in Neuromodulation

As neurostimulation devices increasingly incorporate closed-loop functionality, the greater design complexity brings additional requirements for risk management and special considerations to optimise benefit. This manuscript creates a common framework upon which all current and planned neuromodulation-based physiological closed-loop controllers (PCLCs) can be mapped including integration of the Technical Considerations of Medical Devices with Physiologic Closed-Loop Control Technology guidance published in 2023 by the United States Food and Drug Administration (FDA), a classification of feedback (reactive) and feedforward (predictive) biomarkers, and control systems theory. We explain risk management in the context of this framework and illustrate its applications for three exemplary technologies. This manuscript serves as guidance to the emerging field of PCLCs in neuromodulation, mitigating risk through standardized nomenclature and a systematic outline for rigorous device development, testing, and implementation.

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NeuroBOLT: Resting-state EEG-to-fMRI Synthesis with Multi-dimensional Feature Mapping

Functional magnetic resonance imaging (fMRI) is an indispensable tool in modern neuroscience, providing a non-invasive window into whole-brain dynamics at millimeter-scale spatial resolution. However, fMRI is constrained by issues such as high operation costs and immobility. With the rapid advancements in cross-modality synthesis and brain decoding, the use of deep neural networks has emerged as a promising solution for inferring whole-brain, high-resolution fMRI features directly from electroencephalography (EEG), a more widely accessible and portable neuroimaging modality. Nonetheless, the complex projection from neural activity to fMRI hemodynamic responses and the spatial ambiguity of EEG pose substantial challenges both in modeling and interpretability. Relatively few studies to date have developed approaches for EEG-fMRI translation, and although they have made significant strides, the inference of fMRI signals in a given study has been limited to a small set of brain areas and to a single condition (i.e., either resting-state or a specific task). The capability to predict fMRI signals in other brain areas, as well as to generalize across conditions, remain critical gaps in the field. To tackle these challenges, we introduce a novel and generalizable framework: NeuroBOLT, i.e., Neuro-to-BOLD Transformer, which leverages multi-dimensional representation learning from temporal, spatial, and spectral domains to translate raw EEG data to the corresponding fMRI activity signals across the brain. Our experiments demonstrate that NeuroBOLT effectively reconstructs unseen resting-state fMRI signals from primary sensory, high-level cognitive areas, and deep subcortical brain regions, achieving state-of-the-art accuracy with the potential to generalize across varying conditions and sites, which significantly advances the integration of these two modalities.

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A Multi-rater Comparative Study of Automatic Target Localization Methods for Epilepsy Deep Brain Stimulation Procedures

Epilepsy is the fourth most common neurological disorder and affects people of all ages worldwide. Deep Brain Stimulation (DBS) has emerged as an alternative treatment option when anti-epileptic drugs or resective surgery cannot lead to satisfactory outcomes. To facilitate the planning of the procedure and for its standardization, it is desirable to develop an algorithm to automatically localize the DBS stimulation target, i.e., Anterior Nucleus of Thalamus (ANT), which is a challenging target to plan. In this work, we perform an extensive comparative study by benchmarking various localization methods for ANT-DBS. Specifically, the methods involved in this study include traditional registration method and deep-learning-based methods including heatmap matching and differentiable spatial to numerical transform (DSNT). Our experimental results show that the deep-learning (DL)-based localization methods that are trained with pseudo labels can achieve a performance that is comparable to the inter-rater and intra-rater variability and that they are orders of magnitude faster than traditional methods.

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Uncertainty Estimation in Medical Image Localization: Towards Robust Anterior Thalamus Targeting for Deep Brain Stimulation

Atlas-based methods are the standard approaches for automatic targeting of the Anterior Nucleus of the Thalamus (ANT) for Deep Brain Stimulation (DBS), but these are known to lack robustness when anatomic differences between atlases and subjects are large. To improve the localization robustness, we propose a novel two-stage deep learning (DL) framework, where the first stage identifies and crops the thalamus regions from the whole brain MRI and the second stage performs per-voxel regression on the cropped volume to localize the targets at the finest resolution scale. To address the issue of data scarcity, we train the models with the pseudo labels which are created based on the available labeled data using multi-atlas registration. To assess the performance of the proposed framework, we validate two sampling-based uncertainty estimation techniques namely Monte Carlo Dropout (MCDO) and Test-Time Augmentation (TTA) on the second-stage localization network. Moreover, we propose a novel uncertainty estimation metric called maximum activation dispersion (MAD) to estimate the image-wise uncertainty for localization tasks. Our results show that the proposed method achieved more robust localization performance than the traditional multi-atlas method and TTA could further improve the robustness. Moreover, the epistemic and hybrid uncertainty estimated by MAD could be used to detect the unreliable localizations and the magnitude of the uncertainty estimated by MAD could reflect the degree of unreliability for the rejected predictions.

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