PHOSPHENES PRODUCED BY ELECTRICAL-STIMULATION OF HUMAN OCCIPITAL CORTEX, AND THEIR APPLICATION TO DEVELOPMENT OF A PROSTHESIS FOR BLIND
PHOSPHENES PRODUCED BY ELECTRICAL-STIMULATION OF HUMAN OCCIPITAL CORTEX, AND THEIR APPLICATION TO DEVELOPMENT OF A PROSTHESIS FOR BLIND
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DOI：
10.1113/jphysiol.1974.sp010766
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发表时间：
1974-01-01
影响因子：
5.5
通讯作者：
MLADEJOVSKY, MG
中科院分区：
文献类型：
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作者：
DOBELLE, WH;MLADEJOVSKY, MG
1. 为了探索盲人视觉假体的可行性，在接受其他枕叶手术的清醒志愿者身上进行一系列手术过程中，人类视觉皮层受到刺激。2.地区编号17 似乎是此类刺激最有效的位点，至少对于视力正常或最近患有偏盲的患者而言是如此。3。电极尺寸和配置的变化，或者刺激参数的变化，对主观感觉影响很小。4．阈值确实根据参数而变化，但与电极尺寸无关，并且已经研究了这些影响。5。疼痛效应与刺激硬脑膜有关，但与距距动脉和相关血管无关。6。刺激单个电极通常会产生一个光幻视，其大小范围从像“天空中的星星”这样的微小点状感觉到一臂距离的大硬币。尽管测试了许多患者、电极和刺激参数组合，但尚未报告非常大的细长光幻视，就像布林德利的第二个患者所看到的那样。这些大的光幻视可能是长期失明的结果。7。明显高于阈值的刺激可能会产生第二个共轭光视，围绕水平子午线反转。8。单个电极的刺激也可能产生多个无差别阈值的光幻视。9．色彩效果和/或光幻视闪烁可能会发生，也可能不会发生。同一患者的不同点的情况可能有所不同。10。连续刺激 10-15 秒后幻视会消失。11。在我们的绘图技术的精度范围内，所有光幻视都与自愿眼球运动成比例地移动。12。通过改变脉冲幅度可以轻松实现亮度调制。13．光幻视在视野中的位置仅与基于显示视野到皮层的投影的经典图的预期大致一致。14。患者通常可以辨别由 1 mm2 电极在 3 mm 中心产生的光幻视，尽管这似乎接近分辨率的极限。15。已识别出由四个电极产生的多达四个光幻视的图案。然而，已经报道了各种复杂的相互作用。16。多个光幻视是共面的，尽管患者无法估计它们的距离。17。光幻视在刺激开始时立即出现，在刺激停止后立即消失。18．未来的工作必须集中在盲人志愿者身上，探索长期失明后产生的主观感觉可能存在的差异，并探索更复杂的模式呈现，这需要与任何特定患者一起花费大量时间。
1. To explore the feasibility of a visual prosthesis for the blind, human visual cortex has been stimulated during a series of surgical procedures on conscious volunteers undergoing other occipital lobe surgery.2. Area no. 17 seems the most effective locus for such stimulation, at least in sighted or recently hemianopic patients.3. Changes in electrode size and configuration, or in stimulus parameters, have little effect on subjective sensation.4. Thresholds do vary depending on parameters, but not electrode size, and these effects have been studied.5. Painful effects are associated with stimulation of the dura, but not of the calcarine artery and associated vessels.6. Stimulation of a single electrode usually produces one phosphene, whose size ranges from tiny punctate sensations like ‘a star in the sky’ up to a large coin at arm's length. Very large elongated phosphenes, like those seen by Brindley's second patient, have not been reported despite the number of patients, electrodes, and combinations of stimulus parameters tested. These large phosphenes may be an effect of prolonged blindness.7. Stimulation substantially above threshold may produce a second conjugate phosphene, inverted about the horizontal meridian.8. Stimulation of a single electrode may also produce multiple phosphenes with no differential threshold.9. Chromatic effects and/or phosphene flicker may, or may not occur. This can vary from point to point on the same patient.10. Phosphenes fade after 10–15 sec of continuous stimulation.11. All phosphenes move proportionately with voluntary eye movements, within the accuracy of our mapping techniques.12. Brightness modulation can easily be achieved by changing pulse amplitude.13. The position of phosphenes in the visual field corresponds only roughly with expectations based on classical maps showing the projection of the visual field onto the cortex.14. Patients can usually discriminate phosphenes produced by 1 mm2electrodes on 3 mm centres, although this seems to be close to the limit of resolution.15. Patterns of up to four phosphenes produced by four electrodes have been recognized. However, a variety of complex interactions have been reported.16. Multiple phosphenes are co‐planar, although patients are unable to estimate their distance.17. Phosphenes appear immediately when stimulation is begun, and disappear immediately upon cessation of stimulation.18. Future work must concentrate on blind volunteers to explore possible differences in subjective sensation produced after prolonged blindness, and to explore more complex pattern presentation which requires substantial periods of time with any given patient.