Development and Translational Assesment of a Tongue-Based Assistive Neuro-Technol

摘要/摘要：针对严重神经系统疾病患者的基于舌头的辅助神经技术（ANT）的开发和转化评估。超过200万美国人因事故、暴力行为和神经系统疾病而瘫痪。例如，严重脊髓损伤（SCI）病例每年增加11000例，使人口增加25万。可悲的是，55%的脊髓损伤患者年龄在16到30岁之间，他们将需要终身的特殊护理服务，目前每年的费用约为40亿美元。这些人中大约有一半是四肢瘫痪者，如果没有持续的帮助，他们很难完成日常任务。辅助神经技术（ANT）帮助这些人沟通他们的意图并有效地控制他们的环境，减轻了接受持续帮助的需要，从而减轻了家庭成员的负担，并降低了医疗保健和辅助生活成本。一种名为“舌头驱动系统”（TDS）的新型ANT，可以让严重残疾的人仅靠舌头运动就能进入周围的环境。人类的舌头天生就有能力进行复杂的控制和操纵任务，具有许多自由度。它可以在口腔内快速准确地移动，这样尖端就可以接触到每一颗牙齿。大脑和舌头之间的直接连接通常可以使它免受损伤，即使在严重的SCIs中也是如此。与大脑不同，舌头是可以接近的，它在口腔内的位置提供了一定程度的隐私。TDS由一个小扁豆大小的磁性示踪剂组成，通过粘合、植入或穿刺的方式附着在舌头上。该示踪剂在口腔内部和周围产生磁场，该磁场由安装在无线耳机上的磁传感器阵列检测到。舌头运动引起的磁场变化会被无线发送到用户携带的超移动电脑或智能手机上，这些电脑会处理并将舌头的每次运动转化为用户定义的特定功能。一旦一个残疾人“被允许”使用计算机设备，他/她几乎可以做任何一个健全的人用该设备能做的事情。这包括通信、教育、培训、娱乐和控制其他设备，如电动轮椅（PWC）、辅助机器人操纵器和局域网（LAN）上的其他家庭/办公设备。甚至个人自己的自然或假肢也可以通过功能性电刺激（FES）来操纵运动。该项目旨在改进和增强TDS技术，包括由最终目标用户（严重残疾的个人）进行评估，他们是指出任何新ANT的优点和可能缺点的最佳专家。它还探讨了基于语言的舌头运动作为一种直观的方式来获得使用这种新颖的ANT技能。这些努力应该有助于使舌驱动系统更普遍的使用可行。健康相关性：重度神经障碍患者基于舌头的辅助神经技术（ANT）的开发和转化评估舌头驱动系统（TDS）是一种辅助神经技术，它允许完全瘫痪的用户利用他们的舌头运动来访问计算机和控制轮椅。我们进一步发展TDS，并对严重残疾的个体进行评估。

DESCRIPTION (provided by the applicant): Research Area: Developing and validating assistive neuro-technologies: 06-NS-104 Abstract/summary: Development and Translational Assessment of a Tongue-Based Assistive Neuro-Technology (ANT) for Individuals with Severe Neurological Disorders More than two million Americans suffer from paralysis as a result of accidents, acts of violence, and neurological diseases. For instance, 11,000 cases of severe spinal cord injury (SCI) add every year to a population of a quarter of a million. Sadly, 55% of the SCI victims are between 16 and 30 years old, who will need lifelong special care services that currently cost about $4 billion each year. About half of these individuals are tetraplegics, who find it extremely difficult to carry out everyday tasks without continuous help. Assistive Neuro-Technologies (ANT) help these individuals communicate their intentions and effectively control their environments, easing the need for receiving continuous help, thus reducing the burden on family members, and lowering healthcare and assisted-living costs. A new ANT, called the Tongue Drive System (TDS), enables individuals with severe disability access their environment with nothing but their tongue motion. The human tongue is inherently capable of sophisticated control and manipulation tasks with many degrees of freedom. It can move rapidly and accurately within the mouth such that the tip can touch every single tooth. The direct connection between the brain and the tongue generally allows it to escape damage even in severe SCIs. Unlike the brain, the tongue is accessible, and its location inside the mouth affords a degree of privacy. TDS consists of a magnetic tracer, the size of a lentil, attached to the tongue by gluing, implantation, or piercing. The tracer generates a magnetic field inside and around the mouth that is detected by an array of magnetic sensors mounted on a wireless headset. Tongue-movement-induced changes in the magnetic field are sent wirelessly to an ultra-mobile computer or smartphone, carried by the user, which processes and translates every tongue motion to a particular user-defined function. Once an individual with disability is "enabled" to access a computing device, he/she can nearly do everything that an able-bodied individual can do with that device. This includes communicating, education, training, entertainment, and controlling other devices such as powered wheelchairs (PWC), assistive robotic manipulators, and other home/office appliances on a local area network (LAN). Even the individual's own natural or prosthetic limbs can be manipulated to move by functional electrical stimulation (FES). This project is intended to refine and enhance the TDS technology, including its evaluation by the ultimate intended users, individuals with severe disabilities, who are the best experts for indicating the benefits and possible shortcomings of any new ANT. It also explores speech-based tongue movements as an intuitive way of acquiring skills in using this novel ANT. These efforts should help make the Tongue Drive System viable for more general use. Research Area: Developing and validating assistive neuro-technologies: 06-NS-104 Health Relevance: Development and Translational Assessment of a Tongue-Based Assistive Neuro- Technology (ANT) for Individuals with Severe Neurological Disorders Tongue Drive System (TDS) is an assistive neuro-technology, which allows completely paralyzed users utilize their tongue motion to access computers and control wheelchairs. We further develop TDS and evaluate it by individuals with severe disabilities.