From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL.
Neurology. 2022 Feb 15;98(7):e679-e687. doi: 10.1212/WNL.0000000000013173. Epub 2021 Dec 8.
The restoration of touch to fingers and fingertips is critical to achieving dexterous neuroprosthetic control for individuals with sensorimotor dysfunction. However, localized fingertip sensations have not been evoked via intracortical microstimulation (ICMS).
Using a novel intraoperative mapping approach, we implanted electrode arrays in the finger areas of left and right somatosensory cortex and delivered ICMS over a 2-year period in a human participant with spinal cord injury.
Stimulation evoked tactile sensations in 8 fingers, including fingertips, spanning both hands. Evoked percepts followed expected somatotopic arrangements. The subject was able to reliably identify up to 7 finger-specific sites spanning both hands in a finger discrimination task. The size of the evoked percepts was on average 33% larger than a finger pad, as assessed via manual markings of a hand image. The size of the evoked percepts increased modestly with increased stimulation intensity, growing 21% as pulse amplitude increased from 20 to 80 µA. Detection thresholds were estimated on a subset of electrodes, with estimates of 9.2 to 35 µA observed, roughly consistent with prior studies.
These results suggest that ICMS can enable the delivery of consistent and localized fingertip sensations during object manipulation by neuroprostheses for individuals with somatosensory deficits.
NCT03161067.
对于感觉运动功能障碍的个体,实现神经假体灵巧控制的关键在于恢复手指和指尖的触觉。然而,通过皮层内微刺激(ICMS)尚未能诱发局部指尖感觉。
我们使用一种新的术中绘图方法,在一位脊髓损伤的患者的左右体感皮层的手指区域植入电极阵列,并在 2 年内进行 ICMS 刺激。
刺激可诱发 8 只手指(包括指尖)的触觉感知,这些手指分布在双手。诱发的感觉知觉遵循预期的躯体感觉排列。在手指识别任务中,该患者能够可靠地识别出双手上多达 7 个特定手指的位置。通过对手的图像进行手动标记评估,诱发的感觉知觉的大小平均比手指垫大 33%。随着刺激强度的增加,诱发的感觉知觉大小略有增加,当脉冲幅度从 20µA 增加到 80µA 时,其大小增加了 21%。在部分电极上估计了检测阈值,观察到 9.2µA 至 35µA 的估计值,与先前的研究大致一致。
这些结果表明,ICMS 可通过神经假体为感觉缺陷的个体在操纵物体期间提供一致和局部的指尖感觉。
NCT03161067。