Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École polytechnique fédérale de Lausanne, 1202, Geneva, Switzerland.
J Neural Eng. 2021 Feb 22;18(1). doi: 10.1088/1741-2552/abcd6f.
Retinal stimulation in blind patients evokes the sensation of discrete points of light called phosphenes, which allows them to perform visually guided tasks, such as orientation, navigation, object recognition, object manipulation and reading. However, the clinical benefit of artificial vision in profoundly blind patients is still tenuous, as several engineering and biophysical obstacles keep it far away from natural perception. The relative preservation of the inner retinal neurons in hereditary degenerative retinal diseases, such as retinitis pigmentosa, supports artificial vision through the network-mediated stimulation of retinal ganglion cells (RGCs). However, the response of RGCs to repeated electrical stimulation rapidly declines, primarily because of the intrinsic desensitisation of their excitatory network. In patients, upon repetitive stimulation, phosphenes fade out in less than half of a second, which drastically limits the understanding of the percept.A more naturalistic stimulation strategy, based on spatiotemporal modulation of electric pulses, could overcome the desensitisation of RGCs. To investigate this hypothesis, we performed network-mediated epiretinal stimulations paired to electrophysiological recordings in retinas explanted from both male and female retinal degeneration 10 mice.The results showed that the spatial and temporal modulation of the network-mediated epiretinal stimulation prolonged the persistence of the RGC's response from 400 ms up to 4.2 s.A time-varied, non-stationary and interrupted stimulation of the retinal network, mimicking involuntary microsaccades, might reduce the fading of the visual percept and improve the clinical efficacy of retinal implants.
在失明患者中进行视网膜刺激会引起离散光点的感觉,称为光幻视,这使他们能够执行视觉引导的任务,如定向、导航、物体识别、物体操作和阅读。然而,人工视觉在深度失明患者中的临床效果仍然很不确定,因为有几个工程和生物物理障碍使其远未达到自然感知。遗传性退行性视网膜疾病(如色素性视网膜炎)中内视网膜神经元的相对保留支持通过网络介导的视网膜节细胞(RGC)刺激来实现人工视觉。然而,RGC 对重复电刺激的反应迅速下降,主要是因为其兴奋性网络的内在脱敏。在患者中,重复刺激时,光幻视在不到半秒的时间内消失,这极大地限制了对感知的理解。基于电脉冲的时空调制的更自然的刺激策略可以克服 RGC 的脱敏。为了验证这一假设,我们对雄性和雌性视网膜变性 10 型小鼠的视网膜进行了网络介导的视网膜外刺激,并结合电生理记录进行了研究。结果表明,网络介导的视网膜外刺激的时空调制将 RGC 反应的持续时间从 400 毫秒延长至 4.2 秒。对视网膜网络进行时变、非平稳和间断刺激,模拟无意识的微扫视,可能会减少视觉感知的消失,并提高视网膜植入物的临床效果。