Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Neurology and Neurosurgery, Utrecht University, Utrecht, Utrecht, The Netherlands.
J Neurointerv Surg. 2024 Apr 23;16(5):443-446. doi: 10.1136/jnis-2023-020316.
In recent years, the majority of the population has become increasingly reliant on continuous and independent control of smart devices to conduct activities of daily living. Upper extremity movement is typically required to generate the motor outputs that control these interfaces, such as rapidly and accurately navigating and clicking a mouse, or activating a touch screen. For people living with tetraplegia, these abilities are lost, significantly compromising their ability to interact with their environment. Implantable brain computer interfaces (BCIs) hold promise for restoring lost neurologic function, including motor neuroprostheses (MNPs). An implantable MNP can directly infer motor intent by detecting brain signals and transmitting the motor signal out of the brain to generate a motor output and subsequently control computer actions. This physiological function is typically performed by the motor neurons in the human body. To evaluate the use of these implanted technologies, there is a need for an objective measurement of the effectiveness of MNPs in restoring motor outputs. Here, we propose the concept of digital motor outputs (DMOs) to address this: a motor output decoded directly from a neural recording during an attempted limb or orofacial movement is transformed into a command that controls an electronic device. Digital motor outputs are diverse and can be categorized as discrete or continuous representations of motor control, and the clinical utility of the control of a single, discrete DMO has been reported in multiple studies. This sets the stage for the DMO to emerge as a quantitative measure of MNP performance.
近年来，大多数人越来越依赖持续和独立控制智能设备来进行日常生活活动。通常需要上肢运动来产生控制这些接口的运动输出，例如快速准确地导航和点击鼠标，或激活触摸屏。对于患有四肢瘫痪的人来说，这些能力丧失了，严重影响了他们与环境互动的能力。植入式脑机接口（BCI）有望恢复失去的神经功能，包括运动神经假体（MNP）。植入式 MNP 可以通过检测大脑信号并将运动信号传出大脑来产生运动输出，从而控制计算机操作，从而直接推断运动意图。人体中的运动神经元通常执行这种生理功能。为了评估这些植入技术的使用情况，需要客观衡量 MNP 恢复运动输出的效果。在这里，我们提出了数字运动输出（DMO）的概念来解决这个问题：直接从尝试的肢体或口面部运动期间的神经记录中解码的运动输出被转换为控制电子设备的命令。数字运动输出多种多样，可以分为离散或连续的运动控制表示，并且已经有多项研究报道了控制单个离散 DMO 的临床实用性。这为 DMO 作为 MNP 性能的定量测量标准奠定了基础。
