Intuitive, complete neural control of tablet computers for communication

项目摘要 传统的辅助和替代通信（AAC）设备，用于患有 严重的语言和运动障碍（SSMI）依赖于残余运动功能，固有地 限制了通信吞吐量。商用AAC解决方案需要每天 护理人员设置，需要经常由精通技术的护理人员进行频繁的重新校准， 不能在黑暗的照明条件下使用，并可能阻碍或疲劳重要的剩余 物理能力。此外，对于因运动障碍而进行性运动功能障碍的人， 肌萎缩侧索硬化症（ALS），即使是最精心设计的AAC设备最终将 因为动作变得不可靠而失败。对于脑干中风、ALS和其他 导致闭锁综合征（LIS）或SSMI的疾病，脑机接口（BCI）保持 承诺是一种不依赖于言语或自愿的沟通方式 运动在之前NIDCD支持的研究中，我们的BrainGate研究团队提供了早期 证明了一个强大的皮质内脑机接口（iBCI）的原理， 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，通过想象自己的运动进行交流 手臂拟议的NIDCD U01临床研究将进一步开发和测试 完全植入式iBCI，可提供强大、直观的工业级通信控制 为LIS或SSMI患者提供的应用程序。通过利用正在进行的试验性临床试验， 研究BrainGate系统，我们的目标是（1）提高的鲁棒性和准确性， 神经驱动的点和点击，部分通过翻译的神经活动， 人的前运动区和运动区皮层，（2）扩大输入的维数到平板电脑 计算机通过神经活动可用，允许预期的手势命令控制 在触摸屏平板电脑上的通信应用程序，以及（3）严格比较 试验用BrainGate系统对试验受试者传统AAC的性能 系统的通信能力、信息吞吐量、用户偏好 和成果衡量标准。通过将六名个人参与者的反馈与 瘫痪，这项可行性试验将优化一个强大的iBCI通信，并将建立 完全植入、始终可用的iBCI后续关键试验所需的指标 SSMI患者的通信系统。

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.