Ahn Jungryul, Yoo Yongseok, Goo Yong Sook
Department of Physiology, Chungbuk National University School of Medicine, Cheongju 28644, Korea.
School of Computer Science and Engineering, Soongsil University, Seoul 06978, Korea.
Korean J Physiol Pharmacol. 2023 Nov 1;27(6):541-553. doi: 10.4196/kjpp.2023.27.6.541.
Retinal prostheses have shown some clinical success in restoring vision in patients with retinitis pigmentosa. However, the post-implantation visual acuity does not exceed that of legal blindness. The reason for the poor visual acuity might be that (1) degenerate retinal ganglion cells (RGCs) are less responsive to electrical stimulation than normal RGCs, and (2) electrically-evoked RGC spikes show a more widespread not focal response. The single-biphasic pulse electrical stimulation, commonly used in artificial vision, has limitations in addressing these issues. In this study, we propose the benefit of multiple consecutive-biphasic pulse stimulation. We used C57BL/6J mice and C3H/HeJ () mice for the normal retina and retinal degeneration model. An 8 × 8 multi-electrode array was used to record electrically-evoked RGC spikes. We compared RGC responses when increasing the amplitude of a single biphasic pulse versus increasing the number of consecutive biphasic pulses at the same stimulus charge. Increasing the amplitude of a single biphasic pulse induced more RGC spike firing while the spatial resolution of RGC populations decreased. For multiple consecutive-biphasic pulse stimulation, RGC firing increased as the number of pulses increased, and the spatial resolution of RGC populations was well preserved even up to 5 pulses. Multiple consecutive-biphasic pulse stimulation using two or three pulses in degenerate retinas induced as much RGC spike firing as in normal retinas. These findings suggest that the newly proposed multiple consecutive-biphasic pulse stimulation can improve the visual acuity in prosthesis-implanted patients.
视网膜假体在恢复色素性视网膜炎患者的视力方面已取得了一些临床成效。然而,植入后的视力并未超过法定失明的视力水平。视力不佳的原因可能是:(1)退化的视网膜神经节细胞(RGCs)对电刺激的反应不如正常RGCs灵敏;(2)电诱发的RGCs尖峰显示出更广泛而非局部的反应。人工视觉中常用的单双相脉冲电刺激在解决这些问题方面存在局限性。在本研究中,我们提出了多次连续双相脉冲刺激的益处。我们使用C57BL/6J小鼠和C3H/HeJ()小鼠作为正常视网膜和视网膜退化模型。使用8×8多电极阵列记录电诱发的RGCs尖峰。我们比较了在相同刺激电荷下增加单个双相脉冲幅度与增加连续双相脉冲数量时RGCs的反应。增加单个双相脉冲的幅度会诱发更多的RGCs尖峰放电,而RGCs群体的空间分辨率会降低。对于多次连续双相脉冲刺激,RGCs放电随着脉冲数量的增加而增加,并且即使多达5个脉冲,RGCs群体的空间分辨率仍能得到很好的保留。在退化视网膜中使用两个或三个脉冲的多次连续双相脉冲刺激诱发的RGCs尖峰放电与正常视网膜中的一样多。这些发现表明,新提出的多次连续双相脉冲刺激可以提高假体植入患者的视力。