Restoring Communication with an Intracortical Neural Interface System

描述（由申请人提供）：脑干中风和肌萎缩侧索硬化症可导致毁灭性的残疾，部分原因是沟通障碍和行动不便。在最严重的情况下，患者会变得闭锁——清醒和警觉，但无法移动、控制环境或寻求帮助。在这些疾病中，以及其他神经系统疾病和损伤中，运动的愿望或意图保持完整，但大脑的运动中心与它们在脑干或脊髓中的目标“断开”，导致瘫痪。开发和测试一种技术，使患有严重瘫痪或闭锁综合症的人能够独立可靠地交流，这将彻底改变辅助技术和神经工程领域，并将是在瘫痪疾病或受伤后重新实现肢体运动的关键步骤。基于来自四肢瘫痪和交流受限的参与者的令人鼓舞的初步发现，这项拟议的转化研究将寻求进一步开发一种神经接口系统，该系统可以记录大脑信号，并允许瘫痪的人通过想象自己瘫痪的手臂或手的运动来控制通信软件。最多5名脑干中风或ALS患者将接受96微电极阵列（4x4毫米），该阵列将记录运动皮层中神经元群的单个和总活动。除了进一步评估这种植入医疗设备的安全性外，这项研究还将支持开发可靠的神经解码算法，使瘫痪患者能够使用与自然运动相关的皮层信号来驱动通信设备，以进行语音合成和改善环境控制。

DESCRIPTION (provided by applicant): Brainstem stroke and amyotrophic lateral sclerosis can lead to devastating disability, resulting in part from communication impairment and immobility. In the most severe cases, patients become locked-in - awake and alert, but unable to move, control their environment, or ask for help. In these disorders, as well as other neurologic diseases and injuries, the desire or intention to move remains fully intact, but the motor centers of the brain are "disconnected" from their targets in the brainstem or spinal cord, resulting in paralysis. The development and testing of a technology that enables someone with severe paralysis or locked-in syndrome to communicate independently and reliably would revolutionize the fields of assistive technology and neuroengineering, and would be critical steps toward re-enabling limb movement after paralyzing disease or injury. Based on encouraging preliminary findings from participants with tetraplegia and limited communication, this proposed translational research will seek to further develop a neural interface system that can record brain signals and permit persons with paralysis to control communication software, simply by imagining the movement of their own paralyzed arm or hand. Up to five participants with brainstem stroke or ALS will receive a 96-microelectrode array (4x4 mm) which will record the individual and summed activities of ensembles of neurons in the motor cortex. In addition to further assessing the safety of this implanted medical device, this research will support the development of reliable neural decoding algorithms that permit persons with paralysis to use their natural movement-related cortical signals to drive a communication device for speech synthesis and improved environmental control.