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Restoring cortical control of functional movement in a human with quadriplegia

机译：恢复四肢瘫痪患者的功能运动的皮质控制

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Millions of people worldwide suffer from diseases that lead to paralysis through disruption of signal pathways between the brain and the muscles. Neuroprosthetic devices are designed to restore lost function and could be used to form an electronic 'neural bypass' to circumvent disconnected pathways in the nervous system. It has previously been shown that intracortically recorded signals can be decoded to extract information related to motion, allowing non-human primates and paralysed humans to control computers and robotic arms through imagined movements(1-11). In non-human primates, these types of signal have also been used to drive activation of chemically paralysed arm muscles(12,13). Here we show that intracortically recorded signals can be linked in real-time to muscle activation to restore movement in a paralysed human. We used a chronically implanted intracortical microelectrode array to record multiunit activity from the motor cortex in a study participant with quadriplegia from cervical spinal cord injury. We applied machine-learning algorithms to decode the neuronal activity and control activation of the participant's forearm muscles through a custom-built high-resolution neuromuscular electrical stimulation system. The system provided isolated finger movements and the participant achieved continuous cortical control of six different wrist and hand motions. Furthermore, he was able to use the system to complete functional tasks relevant to daily living. Clinical assessment showed that, when using the system, his motor impairment improved from the fifth to the sixth cervical (C5-C6) to the seventh cervical to first thoracic (C7-T1) level unilaterally, conferring on him the critical abilities to grasp, manipulate, and release objects. This is the first demonstration to our knowledge of successful control of muscle activation using intracortically recorded signals in a paralysed human. These results have significant implications in advancing neuroprosthetic technology for people worldwide living with the effects of paralysis.
机译：全球数百万人患有疾病，这些疾病通过破坏大脑和肌肉之间的信号通路而导致瘫痪。神经假体设备旨在恢复失去的功能，可用于形成电子“神经旁路”，以规避神经系统中断开的通路。先前已经表明，皮层内记录的信号可以被解码以提取与运动有关的信息，从而允许非人类的灵长类动物和瘫痪的人类通过想象的运动来控制计算机和机器人手臂（1-11）。在非人类的灵长类动物中，这些类型的信号也已被用来驱动化学性瘫痪的手臂肌肉的激活（12,13）。在这里，我们表明皮质内记录的信号可以实时链接到肌肉激活，以恢复瘫痪的人的运动。我们使用长期植入的皮质内微电极阵列记录了运动性颈椎损伤四肢瘫痪参与者的运动皮质多单元活动。我们应用了机器学习算法，通过定制的高分辨率神经肌肉电刺激系统来解码神经元活动并控制参与者前臂肌肉的激活。该系统提供了孤立的手指运动，并且参与者实现了对六种不同腕部和手部运动的连续皮质控制。此外，他能够使用该系统完成与日常生活相关的功能性任务。临床评估表明，使用该系统时，他的运动障碍单方面从第五至第六个颈椎（C5-C6）改善到第七个颈椎至第一胸廓（C7-T1），赋予了他关键的掌握能力，操作和释放对象。这是我们在瘫痪的人类中使用皮层内记录的信号成功控制肌肉激活的知识的首次证明。这些结果对于发展神经假体技术对全世界生活麻痹的人们具有重要意义。

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  • 来源
    《Nature》 |2016年第7602期|247-250|共4页
  • 作者

    Bouton Chad E.; Shaikhouni Ammar; Annetta Nicholas V.; Bockbrader Marcia A.; Friedenberg David A.; Nielson Dylan M.; Sharma Gaurav; Sederberg Per B.; Glenn Bradley C.; Mysiw W. Jerry; Morgan Austin G.; Deogaonkar Milind; Rezai Ali R.;

  • 作者单位

    Battelle Mem Inst, Med Devices & Neuromodulat, 505 King Ave, Columbus, OH 43201 USA|Feinstein Inst Med Res, 350 Community Dr, Manhasset, NY 11030 USA;

    Ohio State Univ, Ctr Neuromodulat, Columbus, OH 43210 USA|Ohio State Univ, Dept Neurol Surg, Columbus, OH 43210 USA;

    Battelle Mem Inst, Med Devices & Neuromodulat, 505 King Ave, Columbus, OH 43201 USA;

    Ohio State Univ, Ctr Neuromodulat, Columbus, OH 43210 USA|Ohio State Univ, Dept Phys Med & Rehabil, Columbus, OH 43210 USA;

    Battelle Mem Inst, Adv Analyt & Hlth Res, 505 King Ave, Columbus, OH 43201 USA;

    Ohio State Univ, Ctr Neuromodulat, Columbus, OH 43210 USA|Ohio State Univ, Dept Neurol Surg, Columbus, OH 43210 USA;

    Battelle Mem Inst, Med Devices & Neuromodulat, 505 King Ave, Columbus, OH 43201 USA;

    Ohio State Univ, Ctr Neuromodulat, Columbus, OH 43210 USA|Ohio State Univ, Dept Psychol, Columbus, OH 43210 USA;

    Battelle Mem Inst, Energy Syst, 505 King Ave, Columbus, OH 43201 USA;

    Ohio State Univ, Ctr Neuromodulat, Columbus, OH 43210 USA|Ohio State Univ, Dept Phys Med & Rehabil, Columbus, OH 43210 USA;

    Battelle Mem Inst, Med Devices & Neuromodulat, 505 King Ave, Columbus, OH 43201 USA;

    Ohio State Univ, Ctr Neuromodulat, Columbus, OH 43210 USA|Ohio State Univ, Dept Neurol Surg, Columbus, OH 43210 USA;

    Ohio State Univ, Ctr Neuromodulat, Columbus, OH 43210 USA|Ohio State Univ, Dept Neurol Surg, Columbus, OH 43210 USA;

  • 收录信息 美国《科学引文索引》(SCI);美国《工程索引》(EI);美国《生物学医学文摘》(MEDLINE);美国《化学文摘》(CA);
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