A Brain-Machine Interface to Facilitate Motor Recovery from Incomplete SCI

 描述（由申请人提供）：最近的研究表明，神经可塑性在神经损伤后的功能恢复中起着至关重要的作用。以持续性外周神经刺激（PNS）为形式的感觉输入可以上调神经可塑性变化，从而加速运动功能的恢复。此外，我们的初步数据表明，运动功能可以大大增强时，PNS运动训练之前交付。在PNS期间，受试者保持清醒，但不积极参与任何任务。本项目的目的是测试PNS在不完全脊髓损伤受试者中是否可以加速运动功能的恢复，当PNS以闭环方式输送时：即，只有在受试者自愿的情况下才能这么做这种短暂的PNS递送将由脑机接口（BMI）触发，该脑机接口（BMI）从脑电图（EEG）感觉运动（“mu”）节律的抑制中检测移动意图，这可能随着实际或想象的运动努力而发生。来自同步PNS与意图移动的有益效果的证据可以帮助优化时间依赖性神经可塑性，这对运动学习至关重要。这项建议的具体目标如下：1.开发BMI，用于以来自连续EEG测量的最小延迟准确地检测移动意图，并且响应于移动意图短暂地触发闭环PNS;以及2.测试闭环PNS可以比开环（预编程）PNS或假PNS更好地促进运动神经可塑性的假设，如运动诱发电位振幅和运动表现的渐进性增加所反映的。迄今为止，还没有研究对神经损伤患者进行闭环PNS。PNS技术和方案的完善，包括BMI将大大有助于科学和临床护理，因此具有很高的转化潜力的神经康复。

 DESCRIPTION (provided by applicant): Recent research suggests that neuroplasticity plays a crucial role in functional recovery after neurological injury. Sensory input in the form of sustaind peripheral nerve stimulation (PNS) can up-modulate neuroplastic change and thereby accelerate recovery of motor function. Furthermore, our preliminary data demonstrate that motor function can be substantially enhanced when PNS is delivered prior to motor training. During PNS, subjects remain awake but not actively engaged in any task. The objective of this project is to test whether PNS in subjects with incomplete spinal cord injury can accelerate recovery of motor function when PNS is delivered in closed-loop: i.e., only in response to subject's volition. This brief PNS delivery will be triggered by a brain-machine interface (BMI) that detects intent-to-move from suppression of the electroencephalogram (EEG) sensorimotor ("mu") rhythm, which can occur with actual or imagined movement effort. Evidence of a beneficial effect from synchronizing PNS with intent-to-move could help optimize timing- dependent neuroplasticity, which is critical for motor learning. This proposal has the following specific aims: 1. Develop a BMI for accurately detecting intent-to-move with minimal latency from continuous EEG measurements, and briefly triggering closed-loop PNS in response to intent-to-move; and 2. Test the hypothesis that closed-loop PNS can promote motor neuroplasticity better than open-loop (pre-programmed) PNS or sham PNS, as reflected by progressive increase in motor-evoked potential amplitude and motor performance. No study to date has investigated closed-loop PNS in individuals with neurological injuries. Refinement of PNS techniques and protocols that incorporate BMIs will contribute enormously to science and clinical care and therefore have high translational potential for neurorehabilitation.