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首页> 美国卫生研究院文献>Frontiers in Neuroscience >Dexterous Control of Seven Functional Hand Movements Using Cortically-Controlled Transcutaneous Muscle Stimulation in a Person With Tetraplegia
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Dexterous Control of Seven Functional Hand Movements Using Cortically-Controlled Transcutaneous Muscle Stimulation in a Person With Tetraplegia

机译：四肢瘫痪患者使用皮质控制的经皮肌肉刺激对七种功能性手部动作的灵巧控制

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Individuals with tetraplegia identify restoration of hand function as a critical, unmet need to regain their independence and improve quality of life. Brain-Computer Interface (BCI)-controlled Functional Electrical Stimulation (FES) technology addresses this need by reconnecting the brain with paralyzed limbs to restore function. In this study, we quantified performance of an intuitive, cortically-controlled, transcutaneous FES system on standardized object manipulation tasks from the Grasp and Release Test (GRT). We found that a tetraplegic individual could use the system to control up to seven functional hand movements, each with >95% individual accuracy. He was able to select one movement from the possible seven movements available to him and use it to appropriately manipulate all GRT objects in real-time using naturalistic grasps. With the use of the system, the participant not only improved his GRT performance over his baseline, demonstrating an increase in number of transfers for all objects except the Block, but also significantly improved transfer times for the heaviest objects (videocassette (VHS), Can). Analysis of underlying motor cortex neural representations associated with the hand grasp states revealed an overlap or non-separability in neural activation patterns for similarly shaped objects that affected BCI-FES performance. These results suggest that motor cortex neural representations for functional grips are likely more related to hand shape and force required to hold objects, rather than to the objects themselves. These results, demonstrating multiple, naturalistic functional hand movements with the BCI-FES, constitute a further step toward translating BCI-FES technologies from research devices to clinical neuroprosthetics.
机译：患有四肢瘫痪的人将恢复手部功能视为恢复其独立性和改善生活质量的一项关键而未满足的需求。脑机接口（BCI）控制的功能性电刺激（FES）技术通过使大脑与瘫痪的肢体重新连接以恢复功能来满足这一需求。在这项研究中，我们从抓握和释放测试（GRT）中量化了直观，皮质控制的经皮FES系统在标准化对象操作任务上的性能。我们发现，四肢瘫痪的人可以使用该系统控制多达七个功能性手部动作，每个动作的个人准确率均> 95％。他能够从可用的七种机芯中选择一种机芯，并使用它来利用自然主义的抓取力实时地适当地操纵所有GRT对象。通过使用该系统，参与者不仅提高了GRT的性能（超过了其基准），表明除“块”之外的所有对象的传输次数都增加了，而且还大大缩短了最重的对象（录像带（VHS）， ）。与抓握状态相关的基础运动皮层神经表示的分析表明，影响BCI-FES性能的形状相似的物体在神经激活模式中存在重叠或不可分离性。这些结果表明，功能性抓握的运动皮层神经表示可能与握持物体所需的手形和力有关，而不是与物体本身有关。这些结果展示了BCI-FES的多种自然功能性手部动作，构成了将BCI-FES技术从研究设备转化为临床神经假体的又一步。

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