Motor neuroprosthesis implanted with neurointerventional surgery improves capacity for activities of daily living tasks in severe paralysis: first in-human experience
| Autor: | Ivan Vrljic, Christopher MacIsaac, Peter Mitchell, Christin Bird, Susan Mathers, Yan T. Wong, J Mocco, Rahul Sharma, Timothy J. Denison, Peter E. Yoo, Sam E. John, Frank Weissenborn, Clive N. May, David A. Friedenberg, Victoria Hampshire, Gil S. Rind, Bruce C.V. Campbell, Nicholas L. Opie, Mark E Howard, Leigh R. Hochberg, Terence J. O'Brien, Anna H. Balabanski, Patricia Desmond, Douglas J. Weber, L. Irving, Katharine J. Drummond, Stephen M. Ronayne, Thomas J Oxley, Cameron Williams, D. L. Williams, Andrew P. Morokoff, David B. Grayden, Madeleine Dazenko, Anthony N. Burkitt, C M Sarah Lee |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Activities of daily living Neuroprosthetics brain medicine.medical_treatment 0206 medical engineering 02 engineering and technology Severity of Illness Index 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine Physical medicine and rehabilitation vein Activities of Daily Living Paralysis medicine Humans Prospective Studies device Electrocorticography intervention Aged Brain–computer interface Rehabilitation medicine.diagnostic_test business.industry Motor Cortex General Medicine Middle Aged 020601 biomedical engineering New Devices and Techniques Implantable Neurostimulators medicine.anatomical_structure Brain-Computer Interfaces technology Feasibility Studies Female Surgery Neurology (clinical) medicine.symptom Primary motor cortex business 030217 neurology & neurosurgery Motor cortex |
| Zdroj: | Journal of Neurointerventional Surgery |
| Popis: | BackgroundImplantable brain–computer interfaces (BCIs), functioning as motor neuroprostheses, have the potential to restore voluntary motor impulses to control digital devices and improve functional independence in patients with severe paralysis due to brain, spinal cord, peripheral nerve or muscle dysfunction. However, reports to date have had limited clinical translation.MethodsTwo participants with amyotrophic lateral sclerosis (ALS) underwent implant in a single-arm, open-label, prospective, early feasibility study. Using a minimally invasive neurointervention procedure, a novel endovascular Stentrode BCI was implanted in the superior sagittal sinus adjacent to primary motor cortex. The participants undertook machine-learning-assisted training to use wirelessly transmitted electrocorticography signal associated with attempted movements to control multiple mouse-click actions, including zoom and left-click. Used in combination with an eye-tracker for cursor navigation, participants achieved Windows 10 operating system control to conduct instrumental activities of daily living (IADL) tasks.ResultsUnsupervised home use commenced from day 86 onwards for participant 1, and day 71 for participant 2. Participant 1 achieved a typing task average click selection accuracy of 92.63% (100.00%, 87.50%–100.00%) (trial mean (median, Q1–Q3)) at a rate of 13.81 (13.44, 10.96–16.09) correct characters per minute (CCPM) with predictive text disabled. Participant 2 achieved an average click selection accuracy of 93.18% (100.00%, 88.19%–100.00%) at 20.10 (17.73, 12.27–26.50) CCPM. Completion of IADL tasks including text messaging, online shopping and managing finances independently was demonstrated in both participants.ConclusionWe describe the first-in-human experience of a minimally invasive, fully implanted, wireless, ambulatory motor neuroprosthesis using an endovascular stent-electrode array to transmit electrocorticography signals from the motor cortex for multiple command control of digital devices in two participants with flaccid upper limb paralysis. |
| Databáze: | OpenAIRE |
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