Intuitive, complete neural control of tablet computers for communication

项目摘要 适用于以下人群的传统增强和替代通信(AAC)设备 严重的言语和运动障碍(SSMI)天生依赖于残存的运动功能 限制通信吞吐量。商用AAC解决方案需要每天 护理员设置，通常需要技术精通的护理员频繁地重新校准，通常 不能在黑暗的光线条件下使用，并会阻碍或疲劳重要的残留 身体能力。此外，对于因以下原因导致进行性运动功能障碍的人 肌萎缩侧索硬化症(ALS)，即使是设计最好的AAC设备最终也会 由于机芯变得不可靠而失败。适用于脑干中风、肌萎缩侧索硬化症和其他 导致闭锁综合征(LIS)或SSMI的疾病，脑-计算机接口(BCI) 承诺作为一种实现沟通的方法，不依赖于言语或自愿 有动静。在之前由NIDCD支持的研究中，我们的BrainGate研究团队很早就提供了 强大的大脑皮质内脑机接口(IBCI)解码原理的证明 运动意图直接来自大脑活动。这项技术使人们能够控制 计算机屏幕上的光标，用于简单地通过想象他们自己的动作来进行交流 手臂。拟议的NIDCD U01临床研究将进一步开发和测试 完全植入IBCI，可提供对工业级通信的强大、直观控制 为LIS或SSMI患者提供的应用程序。通过利用正在进行的试点临床试验 研究中的BrainGate系统，我们的目标是(1)提高健壮性和准确性 神经驱动的点击式点击，部分是通过将神经元活动从 人类运动前期和运动皮质，(2)将输入维度扩展到平板电脑 通过神经活动获得计算机，允许预期的手势命令控制 触屏平板电脑上的通信应用程序，以及(3)严格比较 研究性脑门系统对受试者常规AAC的作用 关于通信能力、信息吞吐量、用户偏好的系统 和结果衡量标准。通过将六名个体参与者的反馈与 瘫痪，这项可行性试验将优化强大的IBCI通信，并将建立 对完全植入、始终可用的IBCI进行后续关键试验所需的指标 SSMI患者的通讯系统。

Project Summary Conventional augmentative and alternative communication (AAC) devices for people with severe speech and motor impairments (SSMI) rely on residual motor function, inherently limiting communication throughput. Commercially available AAC solutions require daily caregiver setup, need frequent recalibration often from a technically savvy caregiver, are often unable to be used in dark lighting conditions, and can encumber or fatigue important remaining physical abilities. Furthermore, for people with progressive motor dysfunction due to amyotrophic lateral sclerosis (ALS), even the most well-designed AAC devices will eventually fail as movements become unreliable. For people with brainstem stroke, ALS, and other disorders causing locked-in syndrome (LIS) or SSMI, brain-computer interfaces (BCIs) hold promise as a method of enabling communication that does not rely upon speech or voluntary movement. In prior NIDCD-supported research, our BrainGate research team provided early proofs of principle of a powerful intracortical brain-computer interface (iBCI) that decodes movement intentions directly from brain activity. This technology has allowed people to control a cursor on a computer screen for communication simply by imagining movements of their own arm. The proposed NIDCD U01 clinical research will further the development and testing of a fully implanted iBCI that could provide robust, intuitive control of industry-grade communication apps for people with LIS or SSMI. By leveraging the ongoing pilot clinical trials of the investigational BrainGate system, we aim to (1) improve the robustness and accuracy of neurally actuated point-and click, in part through the translation of neuronal activity from human premotor and motor cortex, (2) expand the number of input dimensions to tablet computers available via neural activity, allowing intended hand gesture commands to control communication apps on touch-screen tablet computers, and (3) rigorously compare the performance of the investigational BrainGate system to trial participants’ conventional AAC systems with respect to communication competence, information throughput, user preference and outcomes measures. By incorporating the feedback of six individual participants with paralysis, this feasibility trial will optimize a powerful iBCI for communication and will establish the metrics needed for a subsequent pivotal trial of a fully implanted, always-available iBCI communication system for people with SSMI.