Motor neuroprosthesis implanted with neurointerventional surgery improves capacity for activities of daily living tasks in severe paralysis: first in-human experience.
Motor neuroprosthesis implanted with neurointerventional surgery improves capacity for activities of daily living tasks in severe paralysis: first in-human experience.
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神经介入手术植入运动神经假体改善严重瘫痪患者的日常生活活动能力：首次人体经验。
DOI：
10.1136/neurintsurg-2020-016862
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发表时间：
2021-03
影响因子：
4.8
通讯作者：
Opie NL
中科院分区：
文献类型：
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作者：
Oxley TJ;Yoo PE;Rind GS;Ronayne SM;Lee CMS;Bird C;Hampshire V;Sharma RP;Morokoff A;Williams DL;MacIsaac C;Howard ME;Irving L;Vrljic I;Williams C;John SE;Weissenborn F;Dazenko M;Balabanski AH;Friedenberg D;Burkitt AN;Wong YT;Drummond KJ;Desmond P;Weber D;Denison T;Hochberg LR;Mathers S;O'Brien TJ;May CN;Mocco J;Grayden DB;Campbell BCV;Mitchell P;Opie NL
植入式脑机接口（BCIs）作为运动神经假体，有可能恢复控制数字设备的自主运动冲动，并改善因大脑、脊髓、周围神经或肌肉功能障碍而严重瘫痪的患者的功能独立性。然而，迄今为止的报告临床转化有限。两名患有肌萎缩侧索硬化症 (ALS) 的参与者在一项单臂、开放标签、前瞻性、早期可行性研究中接受了植入。采用微创神经介入手术，将新型血管内 Stentrode BCI 植入邻近初级运动皮层的上矢状窦。参与者接受了机器学习辅助培训，使用与尝试的运动相关的无线传输的皮层电图信号来控制多个鼠标单击动作，包括缩放和左键单击。与用于光标导航的眼动仪结合使用，参与者实现了 Windows 10 操作系统控制，以执行工具性日常生活活动 (IADL) 任务。参与者 1 从第 86 天开始无监督家庭使用，参与者 2 从第 71 天开始。参与者 1 的打字任务平均点击选择准确度为 92.63%（100.00%、87.50%–100.00%）（试验平均值（中位数，Q1–Q3）），率为 13.81（13.44， 10.96–16.09) 每分钟正确字符数 (CCPM)，禁用预测文本。参与者 2 在 CCPM 20.10 (17.73, 12.27–26.50) 时的平均点击选择准确度为 93.18% (100.00%, 88.19%–100.00%)。两名参与者都完成了 IADL 任务，包括短信、在线购物和独立管理财务。我们描述了微创、完全植入、无线、可移动运动神经假体的首次人体体验，该假体使用血管内支架电极阵列传输来自运动皮层的皮层电图信号，以对两名上肢弛缓性瘫痪的参与者进行数字设备的多重命令控制。
Implantable 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. Two 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. Unsupervised 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. We 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.
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影响因子：
9.9
作者：
Gallegos-Ayala G;Furdea A;Takano K;Ruf CA;Flor H;Birbaumer N
通讯作者：
Birbaumer N
影响因子：
5.7
作者：
Yanagisawa, Takufumi;Hirata, Masayuki;Yoshimine, Toshiki
通讯作者：
Yoshimine, Toshiki
影响因子：
4.6
作者：
Opie, Nicholas Lachlan;van der Nagel, Nicole R.;Oxley, Thomas J.
通讯作者：
Oxley, Thomas J.
影响因子：
64.8
作者：
Hochberg, Leigh R.;Serruya, Mijail D.;Donoghue, John P.
通讯作者：
Donoghue, John P.
DOI：
10.1056/nejmoa1608085
发表时间：
2016-11-24
期刊：
The New England journal of medicine
影响因子：
--
作者：
Vansteensel MJ;Pels EGM;Bleichner MG;Branco MP;Denison T;Freudenburg ZV;Gosselaar P;Leinders S;Ottens TH;Van Den Boom MA;Van Rijen PC;Aarnoutse EJ;Ramsey NF
通讯作者：
Ramsey NF