Restoring High Dimensional Hand Function to Persons with Chronic High Tetraplegia

帮助慢性高位四肢瘫痪患者恢复高维手部功能

• 批准号: 9906766
• 负责人: ABIDEMI BOLU AJIBOYE
• 金额: --
• 依托单位: LOUIS STOKES CLEVELAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9906766
• 关键词: Activities of Daily Living; Amputation; Area; Brain; Caring; Cervical; Cervical spinal cord injury; Chronic; Clinical; Clinical Trials; Clinical assessments; Complex; Computers; Development; Digit structure; Dimensions; Electric Stimulation; Electrodes; Enrollment; Fingers; Hand; Hand functions; Implant; Implanted Electrodes; Individual; Injury; Intuition; Methods; Microelectrodes; Motion; Motor; Movement; Muscle; Nervous System Trauma; Outcome Measure; Paralysed; Participant; Pattern; Performance; Persons; Population; Prosthesis; Quadriplegia; Quality of life; Research; Series; Signal Transduction; Source; Speed; Spinal cord injury; System; Technology; Testing; Thumb structure; Time; Universities; Veterans; Volition; Work; arm; arm movement; base; brain computer interface; clinical trial participant; clinically relevant; cortex mapping; dexterity; finger movement; flexibility; functional electrical stimulation; functional gain; functional independence; grasp; hand grasp; high dimensionality; indexing; innovation; insight; nervous system disorder; neuroprosthesis; novel; primary outcome; prosthetic hand; relating to nervous system; response; restoration; robotic device; satisfaction; success; virtual

The current proposal aims to develop a physical neuroprosthesis system, directly controlled by cortical signals, to restore high-dimension hand functionality to Veterans with chronic tetraplegia resulting from high cervical spinal cord injury (SCI). This unique approach combines an intracortical brain-computer-interface (iBCI) that captures a user’s volitionally intended movements, with a percutaneous functional electrical stimulation (FES) system for activation of paralyzed muscles. While there exist research efforts to use BCIs to control the motion of simple computer cursors and robotic devices, the present proposal will investigate the possibility of restoring high-dimensional multi-grasp control of one’s own paralyzed hand. When realized, this system will enable Veterans with high cervical SCI to cortically command more hand grasp patterns than is realized by current FES neuroprosthetic systems, thereby allowing them to carry out a larger range of everyday grasping tasks. Dexterous hand function is a critical component to being able to perform the object manipulations necessary for successfully completing a wide variety of everyday reaching-and-grasping tasks. For example, the hand grasp required to pick up small flat objects differs from that required to interact with larger cylindrical objects, which differs from the hand grasp required for pointing tasks (e.g. pushing a button). Current clinically relevant neuroprosthetic systems implement one or at most two preprogrammed hand grasp patterns that the user can switch between, though usually not seamlessly. A hand grasp neuroprosthesis that allows users a larger variety of hand grasp patterns by allowing for independent thumb and index finger control, as well as possibly a larger set of switchable preprogrammed grasp patterns, will likely prove functionally advantageous over current clinically available systems. Currently available systems are partly limited in the scope of functionality due to the lack of available signals for commanding the multiple dimensions necessary for increased grasp flexibility. Recording of brain signals directly related to hand function, through an intracortical brain-computer-interface (iBCI) may allow for a richer source of signals for commanding higher dimensions of hand function. This proposal will thus investigate using iBCIs as a command source for implementing a high-dimensional FES hand neuroprostheses, by investigating 1) the possibility of commanding multiple hand grasp types from cortical activity, and 2) the possibility of commanding individual thumb and index movements from cortical activity, thereby allowing the user greater flexibility in creating their own hand grasps. The proposed work will engage Veterans and other participants enrolled in the BrainGate2 Pilot Clinical Trial. As part of the BrainGate2 Pilot Clinical Trial, these participants will already have received a) two intracortical microelectrodes implanted into motor cortical areas controlling arm and hand movements, and b) a percutaneous FES system consisting of small fine-wire electrodes implanted into various muscles of the arm and hand to restore reaching and grasping function through electrical stimulation. Thus this proposal will allow for direct testing of control concepts in Veterans with paralysis. When successful, the proposed work will 1) result in a brain-controlled highly dexterous hand neuroprosthesis for paralyzed Veterans, and 2) offer quantitative insight about the long term potential of iBCIs for commanding complex neuroprosthetic hand function for Veterans considering an intracortical implant for functional grasp restoration after neurological injury or disease.

目前的提案旨在开发一种由皮质信号直接控制的物理神经假体系统， 为患有高颈椎导致的慢性四肢瘫痪的退伍军人恢复高维手部功能 脊髓损伤（SCI）。这种独特的方法结合了皮质内脑机接口（iBCI）， 通过经皮功能性电刺激 (FES) 捕捉用户的有意运动 激活瘫痪肌肉的系统。虽然存在使用 BCI 来控制运动的研究工作 简单的计算机光标和机器人设备，目前的提案将研究恢复的可能性 对自己瘫痪的手进行高维多抓控制。实现后，该系统将启用 患有高位颈椎 SCI 的退伍军人皮质控制的手握模式比当前 FES 实现的要多 神经假体系统，从而使它们能够执行更广泛的日常抓取任务。 灵巧的手功能是能够执行所需的物体操作的关键组成部分 成功完成各种日常抓取和抓取任务。例如，手抓 拾取小型扁平物体所需的能力不同于与较大圆柱形物体相互作用所需的能力，这 与指点任务（例如按下按钮）所需的手部抓握不同。目前临床相关 神经假体系统实现一种或最多两种预编程的手部抓握模式，用户可以 之间进行切换，尽管通常不是无缝的。手抓式神经假体为用户提供更多选择 通过允许独立的拇指和食指控制以及可能更大的手部抓握模式 一组可切换的预编程抓取模式，可能会证明比当前的功能更具优势 临床上可用的系统。由于以下原因，当前可用的系统在功能范围上受到部分限制： 缺乏可用的信号来指挥提高抓取灵活性所需的多个维度。 通过皮质内脑机接口记录与手部功能直接相关的大脑信号 (iBCI) 可以提供更丰富的信号源来指挥更高维度的手部功能。这个提议 因此，我们将研究使用 iBCIs 作为实现高维 FES 手的命令源 神经假体，通过研究 1）从皮质控制多种手部抓握类型的可能性 活动，以及 2）通过皮质活动指挥个体拇指和食指运动的可能性， 从而使用户能够更灵活地创建自己的抓握方式。 拟议的工作将吸引退伍军人和参加 BrainGate2 试点临床试验的其他参与者。作为 作为 BrainGate2 试点临床试验的一部分，这些参与者将已经接受了 a) 两次皮质内注射 植入运动皮质区域的微电极控制手臂和手的运动，b）经皮 FES 系统由植入手臂和手部各种肌肉的小型细线电极组成， 通过电刺激恢复伸手和抓握功能。因此，该提案将允许直接 对瘫痪退伍军人的控制概念进行测试。如果成功，拟议的工作将 1) 产生 为瘫痪退伍军人提供大脑控制的高度灵巧的手部神经假体，2) 提供定量洞察 关于 iBCIs 在指挥退伍军人复杂神经假手功能方面的长期潜力 考虑在神经损伤或疾病后使用皮质内植入物来恢复功能性抓握。