About

Stephen T Mernoff is an Associate Professor of Neurology and a Clinician Educator at Brown University. He holds an MD degree from New York University, obtained in 1988, and a Bachelor of Science from the State University of New York at Stony Brook, earned in 1984. His professional role involves both teaching and clinical responsibilities within the field of neurology, contributing to the academic and medical community at Brown University.

Research topics

• Internal medicine
• Physical medicine and rehabilitation
• Medicine
• Surgery

Selected publications

• Interim Safety Profile From the Feasibility Study of the BrainGate Neural Interface System

  Neurology · 2023 · 71 citations

  • Medicine
  • Physical medicine and rehabilitation
  • Surgery

  BACKGROUND AND OBJECTIVES: Brain-computer interfaces (BCIs) are being developed to restore mobility, communication, and functional independence to people with paralysis. Though supported by decades of preclinical data, the safety of chronically implanted microelectrode array BCIs in humans is unknown. We report safety results from the prospective, open-label, nonrandomized BrainGate feasibility study (NCT00912041), the largest and longest-running clinical trial of an implanted BCI. METHODS: Adults aged 18-75 years with quadriparesis from spinal cord injury, brainstem stroke, or motor neuron disease were enrolled through 7 clinical sites in the United States. Participants underwent surgical implantation of 1 or 2 microelectrode arrays in the motor cortex of the dominant cerebral hemisphere. The primary safety outcome was device-related serious adverse events (SAEs) requiring device explantation or resulting in death or permanently increased disability during the 1-year postimplant evaluation period. The secondary outcomes included the type and frequency of other adverse events and the feasibility of the BrainGate system for controlling a computer or other assistive technologies. RESULTS: From 2004 to 2021, 14 adults enrolled in the BrainGate trial had devices surgically implanted. The average duration of device implantation was 872 days, yielding 12,203 days of safety experience. There were 68 device-related adverse events, including 6 device-related SAEs. The most common device-related adverse event was skin irritation around the percutaneous pedestal. There were no safety events that required device explantation, no unanticipated adverse device events, no intracranial infections, and no participant deaths or adverse events resulting in permanently increased disability related to the investigational device. DISCUSSION: The BrainGate Neural Interface system has a safety record comparable with other chronically implanted medical devices. Given rapid recent advances in this technology and continued performance gains, these data suggest a favorable risk/benefit ratio in appropriately selected individuals to support ongoing research and development. TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov Identifier: NCT00912041. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that the neurosurgically placed BrainGate Neural Interface system is associated with a low rate of SAEs defined as those requiring device explantation, resulting in death, or resulting in permanently increased disability during the 1-year postimplant period.

  PublisherDOI

• P369. First-in-Human Use of Low Intensity Focused Ultrasound in Depressed Patients: Safety and Tolerability Outcomes

  Biological Psychiatry · 2022-04-28 · 6 citations

  article
  PublisherDOI

• Contributors

  Elsevier eBooks · 2020-09-04

  book-chapter
  PublisherDOI

• Neurodegeneration and dementia

  Elsevier eBooks · 2020-09-04

  book-chapterSenior author
  PublisherDOI

• Retinal Emboli from Vascular Disease: A Brief Review

  CRO (Clinical & Refractive Optometry) Journal · 2020-08-30

  reviewOpen access

  Retinal emboli have various distinguishing presentations. It is important to be able to differentiate the characteristics of retinal emboli, such as their appearance and location, in order to determine the orgin of the embolus. This determination is key to the management of the ocular and systemic health of the patient. In this paper we will review how the identification of each of these retinal emboli will aid in the management of these patients. CE Notification: This article is available as a COPE accredited CE course. You may take this course for 1-hour credit. Read the article and take the qualifying test to earn your credit. Click here to Enroll (https://www.crojournal.com/retinal-emboli-from-vascular-disease-a-brief-review) Please check COPE course expiry date prior to enrollment. The COPE course test must be taken before the course expiry date.

  PublisherOA PDFDOI

• Cortical control of a tablet computer by people with paralysis

  PLoS ONE · 2018-11-21 · 179 citations

  articleOpen access

  General-purpose computers have become ubiquitous and important for everyday life, but they are difficult for people with paralysis to use. Specialized software and personalized input devices can improve access, but often provide only limited functionality. In this study, three research participants with tetraplegia who had multielectrode arrays implanted in motor cortex as part of the BrainGate2 clinical trial used an intracortical brain-computer interface (iBCI) to control an unmodified commercial tablet computer. Neural activity was decoded in real time as a point-and-click wireless Bluetooth mouse, allowing participants to use common and recreational applications (web browsing, email, chatting, playing music on a piano application, sending text messages, etc.). Two of the participants also used the iBCI to "chat" with each other in real time. This study demonstrates, for the first time, high-performance iBCI control of an unmodified, commercially available, general-purpose mobile computing device by people with tetraplegia.

  PublisherOA PDFDOI

• From TBI to CTE: A Review and Update on Diagnosis, Management and Pathophysiology of Mild TBI and Chronic Traumatic Encephalopathy

  American Journal of Geriatric Psychiatry · 2016-03-01 · 2 citations

  review
  PublisherDOI

• Driving policy after seizures and unexplained syncope: a practice guide for RI physicians.

  PubMed · 2014-01-03 · 2 citations

  article

  Physicians in Rhode Island sometimes find it difficult to advise patients about returning to driving after they present with a seizure or syncopal episode due to lack of statutory or professional guidance on the issue. We provide an overview of the medical literature on public policies and recommendations regarding driving after seizures or syncope. We also present the laws in Rhode Island regarding physician notification of the medical advisory board of the Department of Motor Vehicles, legal obligations, and immunity from prosecution for those who report. Finally, we present the results of a survey of current practice by Rhode Island neurologists when they advise patients who have had a recent seizure or unexplained syncopal event. Based upon this information, we hope local practitioners are empowered in their decision making on driving restrictions and we hope this data informs future public policy efforts.

  Publisher

• Learning, Not Adaptation, Characterizes Stroke Motor Recovery: Evidence From Kinematic Changes Induced by Robot-Assisted Therapy in Trained and Untrained Task in the Same Workspace

  IEEE Transactions on Neural Systems and Rehabilitation Engineering · 2011-12-16 · 99 citations

  articleOpen access

  Both the American Heart Association and the VA/DoD endorse upper-extremity robot-mediated rehabilitation therapy for stroke care. However, we do not know yet how to optimize therapy for a particular patient's needs. Here, we explore whether we must train patients for each functional task that they must perform during their activities of daily living or alternatively capacitate patients to perform a class of tasks and have therapists assist them later in translating the observed gains into activities of daily living. The former implies that motor adaptation is a better model for motor recovery. The latter implies that motor learning (which allows for generalization) is a better model for motor recovery. We quantified trained and untrained movements performed by 158 recovering stroke patients via 13 metrics, including movement smoothness and submovements. Improvements were observed both in trained and untrained movements suggesting that generalization occurred. Our findings suggest that, as motor recovery progresses, an internal representation of the task is rebuilt by the brain in a process that better resembles motor learning than motor adaptation. Our findings highlight possible improvements for therapeutic algorithms design, suggesting sparse-activity-set training should suffice over exhaustive sets of task specific training.

  PublisherOA PDFDOI

• Novel stroke rehabilitation interventions.

  PubMed · 2011-12-01 · 1 citations

  article1st authorCorresponding

  Stephen T. Mernoff, MD, FAAN, and Albert C. Lo, MD, PhD  stroke Is A mAjor cAuse of neurologIcAl impairment; over half of stroke survivors have persistent upper limb impairment, and 25-50% of stroke survivors have persistent moderate to severe disability, especially in the realms of motor and language functions after completion of standard rehabilitation. The prevalence of stroke survivors was over six million in 2006, and is expected to increase as the population ages despite advances in stroke prophylaxis and acute treatment such as tPA. There is a pressing need to improve the neurologic function of stroke survivors. The neurorehabilitation interventions employed by physical, occupational, and speech therapists on a practical level have changed little over the last 40 years. This is not for lack of trying. Determining efficacy of traditional and novel interventions has been hampered by methodological challenges including heterogeneous functional neuroanatomy and neuropathology, inadequate outcome measures (subjective, questionable ecological relevance), and logistical difficulties in studying a population with disabilities (impaired mobility and increased risk of medical problems to name only two which cause study subjects being easily lost to follow-up). Fortunately, recent progress in neuroscience, particularly the discovery that the adult brain has surprising potential for plasticity especially after injury; and in the development of new technologies (computer science, biomechanics, cell and tissue manipulation, neuropharmacology) have driven the development of multiple promising interventions which could improve the function of those with neurological impairments. Efforts are underway worldwide to determine how these techniques can be applied clinically. Critical questions include: which patients are most likely to benefit from interventions? Are there certain windows of opportunity during which an intervention would be most effective? Should different interventions be utilized in certain sequences? Until recently the prospect of being able to answer these questions scientifically in a reasonable period of time was fantasy. However, new tools and novel techniques such as functional imaging and relevant surrogate outcome measures are helping to rapidly answer many of these questions and improve our understanding of neurological recovery. We describe some of the most promising new restorative interventions for stroke rehabilitation currently being investigated. (Compensatory approaches, such as brain-computer interfaces, are beyond the scope of this paper.) Some, or all of them may, in some form, become standard components of neurorehabilitation programs in the coming years. Many of these techniques are being investigated for the rehabilitation of other neurologic conditions (TBI, MS, Parkinsons, etc.) but this report focuses on stroke.

  Publisher

Frequent coauthors

• Krishna V. Shenoy

  Howard Hughes Medical Institute

  41 shared

• Leigh R. Hochberg

  Harvard University

  37 shared

• John D. Simeral

  30 shared

• Jaimie M. Henderson

  26 shared

• Emad N. Eskandar

  22 shared

• John P. Donoghue

  Rehabilitation Research and Development Service

  20 shared

• Robert F. Kirsch

  Case Western Reserve University

  20 shared

• Ziv M. Williams

  Harvard University

  20 shared

Education

• M.D.

  New York University

  1988

• B.S.

  State University of New York at Stony Brook

  1984