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基于生物安全性考虑的视网膜上植体刺激参数的优化。

Optimization of stimulation parameters for epi-retinal implant based on biosafety consideration.

机构信息

Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.

Shenzhen Aier Eye Hospital, Shenzhen, China.

出版信息

PLoS One. 2020 Jul 22;15(7):e0236176. doi: 10.1371/journal.pone.0236176. eCollection 2020.

DOI:10.1371/journal.pone.0236176
PMID:32697792
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7375526/
Abstract

BACKGROUND

Optimizing stimulation protocol is essential for clinical application of retinal prosthesis. Elongating stimulation pulse width (~25ms /phase) has been proposed as an effective method to improve spatial resolution of epi-retinal implants. However, it is unknown whether longer stimulus pulse width will increase the risk of damaging the retina. In addition, with the advent of next generation retinal prosthesis featuring high-density microelectrode array, it is tempting to optimizing a single set of parameters for all electrodes instead of optimizing parameters of each electrode, but this approach raised biosafety concern. We sought to study the effect of stimulus pulse width on the response of retinal ganglion cells to electrical stimulation, and evaluate if the single parameter set approach was valid based on biosafety measures.

METHODS

We stimulated mouse retina using biphasic pulse waveform generated by chosen electrodes (single or a 3x3 assembly) from multiple microelectrode arrays, recorded their action potentials and performed spike sorting. We tested various stimulus intensity with two fixed pulse width: a short one for 1 millisecond per phase, and a long one for 25 milliseconds per phase. All these assays were performed on two mouse models: the wildtype C57BL/6J mice and the photoreceptor degenerated rd10 mice. The action-potential-frequency vs stimulus amplitude profiles were plotted, and three parameters were extracted: the threshold (the lowest stimulus amplitude activating RGC units), safety-limit (stimulus amplitude that attenuated the firing rate to half of the maximum response), and the stimulation amplitude range (the difference between threshold and safety limit parameters).

RESULTS

In single-electrode stimulation experiment, we found that on average 85% of the recorded units showed attenuated response to extreme stimulation; among those units, an average of 51% stopped responding during stimulation ramping and failed to recover after one-hour post-stimulation, indicating extreme stimulation can damage RGC units. Twenty-five-millisecond pulse stimulation significantly reduced safety-limit and stimulation-amplitude-range parameters of recorded RGC units compared to 1ms pulse stimulation. During stimulus amplitude ramping, the maximum proportion of responsive healthy RGC units was 51% on average in 25ms pulse condition, and 76% on average in 1ms pulse condition, indicating long pulse may inflict more strain on RGCs, and a significant amount of inappropriately stimulated RGCs always exist. The contrast of these proportions could be explained by the tight correlation between the threshold and safety-limit parameter in 25ms pulse condition. These results were corroborated by those from 3x3 array stimulation experiments.

CONCLUSION

Base on a biosafety measure (RGCs' evoked firing rate in response to electrical stimulation), we proposed that longer stimulation pulse width could lead to reduced retinal response and thus highlighted the importance of carefully setting the stimulation amplitude in this case. Our results also suggested that optimizing a single set of parameters for all electrodes without individual tweaking always generated a significant amount of inappropriately stimulated RGCs, especially in the long pulse stimulation condition.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7255/7375526/ce757585ffe3/pone.0236176.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7255/7375526/dbe43ade0fdc/pone.0236176.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7255/7375526/a62f98406a7a/pone.0236176.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7255/7375526/d0cae426ff42/pone.0236176.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7255/7375526/c94cbc4611e5/pone.0236176.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7255/7375526/ce757585ffe3/pone.0236176.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7255/7375526/dbe43ade0fdc/pone.0236176.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7255/7375526/a62f98406a7a/pone.0236176.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7255/7375526/d0cae426ff42/pone.0236176.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7255/7375526/c94cbc4611e5/pone.0236176.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7255/7375526/ce757585ffe3/pone.0236176.g005.jpg
摘要

背景

优化刺激方案对于视网膜假体的临床应用至关重要。延长刺激脉冲宽度(~25ms/相位)已被提出作为提高视网膜上植入物空间分辨率的有效方法。然而,目前尚不清楚更长的刺激脉冲宽度是否会增加对视网膜损伤的风险。此外,随着具有高密度微电极阵列的下一代视网膜假体的出现,人们很想为所有电极优化一组单一的参数,而不是为每个电极优化参数,但这种方法引起了生物安全方面的担忧。我们试图研究刺激脉冲宽度对视网膜神经节细胞对电刺激反应的影响,并根据生物安全措施评估单一参数集方法是否有效。

方法

我们使用来自多个微电极阵列的选定电极(单个或 3x3 组件)产生双相脉冲波形来刺激小鼠视网膜,记录它们的动作电位并进行尖峰分类。我们用两种固定的脉冲宽度测试了各种刺激强度:一种是每相 1 毫秒的短脉冲,另一种是每相 25 毫秒的长脉冲。所有这些检测都是在两种小鼠模型上进行的:野生型 C57BL/6J 小鼠和光感受器退化 rd10 小鼠。绘制动作电位频率与刺激幅度的关系曲线,并提取三个参数:阈值(激活 RGC 单位的最低刺激幅度)、安全限(将放电率衰减至最大响应的一半的刺激幅度)和刺激幅度范围(阈值和安全限参数之间的差异)。

结果

在单电极刺激实验中,我们发现平均有 85%的记录单位对极端刺激表现出减弱的反应;在这些单位中,平均有 51%在刺激斜坡期间停止反应,并且在刺激后一小时后无法恢复,表明极端刺激会损伤 RGC 单位。与 1ms 脉冲刺激相比,25ms 脉冲刺激显著降低了记录的 RGC 单位的安全限和刺激幅度范围参数。在刺激幅度斜坡期间,25ms 脉冲条件下响应健康 RGC 单位的最大比例平均为 51%,1ms 脉冲条件下平均为 76%,表明长脉冲可能对 RGC 施加更大的压力,并且总是存在大量不合适刺激的 RGC。这种比例的差异可以用 25ms 脉冲条件下阈值和安全限参数之间的紧密相关性来解释。这些结果得到了 3x3 阵列刺激实验的证实。

结论

基于生物安全措施(RGC 对电刺激的诱发放电率),我们提出较长的刺激脉冲宽度可能导致视网膜反应降低,因此在这种情况下强调仔细设置刺激幅度的重要性。我们的结果还表明,为所有电极优化一组单一的参数而不进行单独调整总是会产生大量不合适刺激的 RGC,尤其是在长脉冲刺激条件下。

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本文引用的文献

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Improving the spatial resolution of epiretinal implants by increasing stimulus pulse duration.通过增加刺激脉冲持续时间提高视网膜前植入物的空间分辨率。
Sci Transl Med. 2015 Dec 16;7(318):318ra203. doi: 10.1126/scitranslmed.aac4877.
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Effect of Stimulus Waveform of Biphasic Current Pulse on Retinal Ganglion Cell Responses in Retinal Degeneration (rd1) mice.双相电流脉冲刺激波形对视网膜变性(rd1)小鼠视网膜神经节细胞反应的影响。
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