Intracortical Somatosensory Stimulation to Elicit Fingertip Sensations in an Individual With Spinal Cord Injury
Intracortical Somatosensory Stimulation to Elicit Fingertip Sensations in an Individual With Spinal Cord Injury
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DOI：
10.1212/wnl.0000000000013173
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发表时间：
2022-02-15
期刊：
影响因子：
9.9
通讯作者：
Tenore, Francesco, V
中科院分区：
文献类型：
--
作者：
Fifer, Matthew Stephen;McMullen, David P.;Tenore, Francesco, V
背景和目的恢复手指和指尖的触觉对于感觉运动功能障碍患者实现灵巧的神经假体控制至关重要。然而，局部指尖的感觉还没有引起通过皮层内微刺激（ICMS）。方法使用一种新的术中标测方法，我们在左侧和右侧体感皮层的手指区域植入电极阵列，并在2年内为脊髓损伤的人类参与者提供ICMS。结果刺激引起包括指尖在内的8个手指的触觉感觉，跨越双手。诱发知觉遵循预期的躯体位置安排。受试者能够在手指辨别任务中可靠地识别多达7个跨越双手的手指特异性位点。诱发感知的大小平均比手指垫大33%，通过手动标记的手图像进行评估。随着刺激强度的增加，诱发感知的大小适度增加，当脉冲幅度从20 μ A增加到80 μ A时，诱发感知的大小增加了21%。在一个电极子集上估计检测阈值，观察到的估计值为9.2至35 μ A，与先前的研究大致一致。讨论这些结果表明，ICMS可以使一致的和本地化的指尖感觉，在对象操作过程中的神经假体与体感缺陷的个人。ClinicalTrials.gov标识符NCT 03161067。
Background and Objectives The restoration of touch to fingers and fingertips is critical to achieving dexterous neuroprosthetic control for individuals with sensorimotor dysfunction. However, localized fingertip sensations have not been evoked via intracortical microstimulation (ICMS). Methods Using a novel intraoperative mapping approach, we implanted electrode arrays in the finger areas of left and right somatosensory cortex and delivered ICMS over a 2-year period in a human participant with spinal cord injury. Results Stimulation evoked tactile sensations in 8 fingers, including fingertips, spanning both hands. Evoked percepts followed expected somatotopic arrangements. The subject was able to reliably identify up to 7 finger-specific sites spanning both hands in a finger discrimination task. The size of the evoked percepts was on average 33% larger than a finger pad, as assessed via manual markings of a hand image. The size of the evoked percepts increased modestly with increased stimulation intensity, growing 21% as pulse amplitude increased from 20 to 80 mu A. Detection thresholds were estimated on a subset of electrodes, with estimates of 9.2 to 35 mu A observed, roughly consistent with prior studies. Discussion These results suggest that ICMS can enable the delivery of consistent and localized fingertip sensations during object manipulation by neuroprostheses for individuals with somatosensory deficits. ClinicalTrials.gov Identifier NCT03161067.