Development of Voice Neural Prosthesis Technology

描述(申请人提供)：在接受全喉切除术治疗晚期喉癌的患者中，约有一半依靠手持人工喉(EL)进行交流。不幸的是，使用一只手控制EL的需要在物理上是有限的，并且这些设备产生听起来非人类的语音，降低了可理解性和响度，并将不希望的注意力吸引到用户身上。该项目的主要目标是开发一种改进的人工电子喉通信系统，更接近正常的语音和语音产生。在喉切除术患者中，这将通过开发神经接口来实现，以提供对改进的EL声源的免提控制，即语音神经假体。我们将实施一项前瞻性的手术方案，以保留来自正常支配的带状肌和由喉返神经重新支配的带状肌的发声相关信号。这些信号将使用表面肌电电极进行检测，并将由基于DSP的系统进行处理，该系统将控制线性的免提EL换能器，以产生更多听起来更像人类的语音。将使用电生理和成像方法对喉切除术后的患者进行系统跟踪，以更好地了解潜在的解剖和生理因素如何影响神经假体声音的发育。将在手术标本中研究喉神经的形态，以帮助解释恢复的肌电信号。将采用手术后培训方案，以确保最大限度地熟练使用新系统，并正式评估培训在使用发声神经假体方面的作用。一个主要的目标是正式地比较使用两种不同的神经源的语音通信和传统的手动控制。此外，正在进行的迭代开发工作还将尝试使用更先进的信号处理方法，以进一步改进/优化系统性能接近单个患者正常语音产生的程度。从长远来看，一旦建立了基本的方法，我们计划将这项新技术的一些方面用于更广泛的喉切除人群，并作为未来努力开发更多手术假体/神经假体方法来进行语音和语言康复的基础。

DESCRIPTION (provided by applicant): About half of the patients who undergo total laryngectomy to treat advanced laryngeal cancer rely on a handheld artificial electrolarynx (EL) for communication. Unfortunately, the need to use one hand to control an EL is physically limiting, and these devices produce speech that sounds non-human, has reduced intelligibility and loudness, and draws undesirable attention to the user. The primary aim of this project is to develop an improved artificial electrolarynx communication system that more closely approximates normal voice and speech production. This will be accomplished in laryngectomy patients by developing a neural interface to provide hands-free control of an improved EL sound source, i.e., a voice neural prosthesis. We will carry out a prospective surgical protocol to preserve phonation-related signals from both normally innervated strap muscles and from strap muscles that have been reinnervated by the recurrent laryngeal nerve. The signals will be detected using surface EMG electrodes and will be processed by a DSP-based system that will control a linear, hands-free EL transducer to produce more human-sounding speech. Patients will be systematically followed post-laryngectomy using electrophysiological and imaging approaches to better understand how underlying anatomical and physiological factors influence the development of neural prosthetic voice. Laryngeal nerve morphology will be studied in surgical specimens to help interpret recovered EMG signals. A post-surgical training protocol will be employed to ensure development of maximum proficiency with the new system, and to formally assess the role of training in the use of a voice neural prosthesis. A main goal is to formally compare speech communication using the two different innervation sources and conventional manual control. In addition, an ongoing iterative development effort will also attempt to use more advanced signal processing approaches to further improve/optimize the degree to which system performance approximates normal speech production in individual patients. In the long-term, once the fundamental approaches have been established, we plan to utilize aspects of this new technology for a broader laryngectomy population, and as a foundation for future efforts to develop additional surgical-prosthetic/neuroprosthetic approaches to voice and speech rehabilitation.