Restoration of grasp following paralysis through brain-controlled stimulation of muscles.
Restoration of grasp following paralysis through brain-controlled stimulation of muscles.
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DOI：
10.1038/nature10987
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发表时间：
2012-05-17
期刊：
影响因子：
64.8
通讯作者：
Miller, L. E.
中科院分区：
文献类型：
--
作者：
Ethier, C.;Oby, E. R.;Bauman, M. J.;Miller, L. E.
脊髓损伤的患者缺乏大脑和脊髓回路之间的连接，这对随意运动至关重要。通过功能性电刺激（FES）实现肌肉收缩的临床系统已被证明可以有效地使四肢瘫痪患者重新控制手部运动，并在日常生活活动中实现更大程度的独立性。在典型的系统中，患者使用残余的近端肢体运动来触发预编程的刺激，该刺激导致瘫痪的肌肉收缩，从而允许使用一个或两个基本抓握。相反，我们在灵长类动物中开发了一种FES系统，该系统由永久植入大脑的微电极记录控制。我们通过注射局部麻醉剂阻断手肘的正中神经和尺神经来模拟C5-C6脊髓损伤引起的瘫痪的一些影响。然后，利用运动皮层中大约100个神经元的记录，我们预测了几块瘫痪肌肉的预期活动，并利用这些预测来控制对同一块肌肉的刺激强度。这个过程基本上绕过了脊髓，恢复了猴子对瘫痪肌肉的自主控制。这一成就代表了通过脑控FES恢复人类患者手部功能的重大进展。我们预计，在人类患者中，这种神经假体将允许比现有的FES系统更灵活和灵巧地使用手。
Patients with spinal cord injury lack the connections between brain and spinal cord circuits essential for voluntary movement. Clinical systems that achieve muscle contraction through functional electrical stimulation (FES) have proven to be effective in allowing patients with tetraplegia to regain control of hand movement and to achieve a greater measure of independence in activities of daily living . In typical systems, the patient uses residual proximal limb movements to trigger pre-programmed stimulation that causes the paralyzed muscles to contract, allowing use of one or two basic grasps. Instead, we have developed, in primates, an FES system that is controlled by recordings made from microelectrodes permanently implanted in the brain. We simulated some of the effects of the paralysis caused by C5-C6 spinal cord injury by injecting a local anesthetic to block the median and ulnar nerves at the elbow. Then, using recordings from approximately 100 neurons in the motor cortex, we predicted the intended activity of several of the paralyzed muscles, and used these predictions to control the intensity of stimulation of the same muscles. This process essentially bypassed the spinal cord, restoring to the monkeys voluntary control of their paralyzed muscles. This achievement represents a major advance toward similar restoration of hand function in human patients through brain-controlled FES. We anticipate that in human patients, this neuroprosthesis would allow much more flexible and dexterous use of the hand than is possible with existing FES systems.
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影响因子：
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作者：
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通讯作者：
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