McMullen David P, Thomas Tessy M, Fifer Matthew S, Candrea Daniel N, Tenore Francesco V, Nickl Robert W, Pohlmeyer Eric A, Coogan Christopher, Osborn Luke E, Schiavi Adam, Wojtasiewicz Teresa, Gordon Chad R, Cohen Adam B, Ramsey Nick F, Schellekens Wouter, Bensmaia Sliman J, Cantarero Gabriela L, Celnik Pablo A, Wester Brock A, Anderson William S, Crone Nathan E
1National Institute of Mental Health, National Institutes of Health, Bethesda.
Departments of2Biomedical Engineering.
J Neurosurg. 2021 Mar 26;135(5):1493-1500. doi: 10.3171/2020.9.JNS202675. Print 2021 Nov 1.
Defining eloquent cortex intraoperatively, traditionally performed by neurosurgeons to preserve patient function, can now help target electrode implantation for restoring function. Brain-machine interfaces (BMIs) have the potential to restore upper-limb motor control to paralyzed patients but require accurate placement of recording and stimulating electrodes to enable functional control of a prosthetic limb. Beyond motor decoding from recording arrays, precise placement of stimulating electrodes in cortical areas associated with finger and fingertip sensations allows for the delivery of sensory feedback that could improve dexterous control of prosthetic hands. In this study, the authors demonstrated the use of a novel intraoperative online functional mapping (OFM) technique with high-density electrocorticography to localize finger representations in human primary somatosensory cortex. In conjunction with traditional pre- and intraoperative targeting approaches, this technique enabled accurate implantation of stimulating microelectrodes, which was confirmed by postimplantation intracortical stimulation of finger and fingertip sensations. This work demonstrates the utility of intraoperative OFM and will inform future studies of closed-loop BMIs in humans.
术中定义明确的皮质区域，传统上由神经外科医生进行以保留患者功能，现在有助于为恢复功能而靶向电极植入。脑机接口（BMI）有潜力恢复瘫痪患者的上肢运动控制，但需要精确放置记录和刺激电极以实现对假肢的功能控制。除了从记录阵列进行运动解码外，在与手指和指尖感觉相关的皮质区域精确放置刺激电极可提供感觉反馈，从而改善对假肢手的灵巧控制。在这项研究中，作者展示了一种使用新型术中在线功能映射（OFM）技术结合高密度皮层脑电图来定位人类初级体感皮层中手指表征的方法。结合传统的术前和术中靶向方法，该技术能够精确植入刺激微电极，植入后通过皮质内刺激手指和指尖感觉得到了证实。这项工作证明了术中OFM的实用性，并将为未来人类闭环BMI的研究提供参考。
