A primate model of an intra-cortically controlled FES prosthesis for grasp

描述（由申请人提供）：当被问及时，大多数脊髓损伤（SCI）四肢瘫痪患者报告说，恢复使用双手的能力比任何其他失去的功能更重要。 功能性电刺激（FES）是一项了不起的技术，可用于使瘫痪患者的肌肉收缩。 FES已被用于恢复瘫痪患者的抓握能力。 FES用于恢复灵巧手运动的主要限制是不能以足够的力和特异性激活肌肉，以及瘫痪患者可以产生的控制信号的不足。 脑机接口（BMI）可以提供必要的控制信号。 BMI已经到达神经工程奋进治疗瘫痪患者的最前沿。 然而，尽管BMI技术取得了显著的进步，但实际上目前所有的应用都局限于在一个单一的、受约束的环境中每天进行几个小时的会话。 目前的BMI只能通过机器人或肢体外骨骼来恢复运动，没有一个能提供明确的力量控制。 这些限制最终将限制患者完全适应这项技术的能力，限制他们在白天或晚上的任何时候使用这项技术，并将其应用于广泛的行为。 通过将BMI技术与FES相结合，我们相信我们可以克服这些限制。 我们已经证明了一个独特的BMI使用外周神经阻滞麻痹猴子的手作为SCI模型：我们使用从皮层记录中提取的预期肌肉活动的信息，以产生一个FES控制信号，使猴子重新获得自愿控制他们的手腕和手。 我们建议使用BMI控制的FES模型来恢复猴子受试者长达一个月的全天候手部使用。 我们将开发自适应的，状态依赖的解码器，旨在扩大运动行为的范围，FES BMI将是有用的。 我们将通过使用新型电极进行神经记录和外周神经刺激，提高我们从大脑获得的信息质量和激活肌肉的有效性。 最后，我们将开发一种持久的外周神经阻滞，导致长达一个月的瘫痪。 我们将通过遥测技术记录，以控制完全植入的神经肌肉刺激器，这将使我们有前所未有的机会研究BMI神经假体的长期适应性。 我们将在猴子的自然笼子行为和更受约束的实验室环境中研究这种适应所导致的行为改善。 我们将研究猴子的适应性和自适应算法之间的相互作用。 这项工作将提供有关成年哺乳动物大脑适应能力的重要基本信息，BMI暴露可以“拯救”在瘫痪反应中经历适应不良变化的皮层的程度，以及长期练习改善BMI表现的程度。

DESCRIPTION (provided by applicant): When asked, most spinal cords injured (SCI) patients suffering tetraplegia report that regaining the ability to use their hands would be more important than any other lost function. Functional Electrical Stimulation (FES) is a remarkable technology that can be used to cause the muscles of a paralyzed patient to contract. FES has been used to restore grasping to paralyzed patients. The primary limitations of FES for the restoration of dexterous hand movements are the inability to activate muscles with adequate force and specificity, and the inadequacy of the control signals that the paralyzed patient can generate. The Brain Machine Interface (BMI) may provide the necessary control signal. BMIs have reached the forefront of the neural engineering endeavor to treat patients suffering from paralysis. Yet despite remarkable BMI technology advances, virtually all current applications are limited to daily, several-hour sessions in a single, constrained setting. Current BMIs that restore movement do so only through a robot or limb exoskeleton, and none provides explicit control of force. These constraints will ultimately limit patients' ability to adapt fully to the technology, to use it readily at any time of the day or night, and to apply it to a broad range of behaviors. By coupling BMI technology to FES, we believe we can overcome these limitations. We have demonstrated a unique BMI using a peripheral nerve block to paralyze a monkey's hand as a model for SCI: We use information about intended muscle activity extracted from cortical recordings to produce an FES control signals that allows the monkeys to regain voluntary control of their wrist and hand. We propose to use this BMI-controlled FES model to restore round-the-clock hand use to monkey subjects for month-long periods of time. We will develop adaptive, state-dependent decoders designed to broaden the range of motor behaviors for which the FES BMI will be useful. We will improve both the quality of information we can obtain from the brain and the effectiveness with which we can activate muscles by using new types of electrodes for neural recording and peripheral nerve stimulation. Finally, we will develop a long-lasting peripheral nerve block to cause month-long paralysis. We will record telemetrically, to control a fully implanted neuromuscular stimulator that will allow us an unprecedented opportunity to study long-term adaptation to a BMI neuroprosthesis. We will study the behavioral improvement that results from this adaptation both in the monkey's natural home-cage behaviors and in the more constrained lab setting. We will study the interaction between the monkey's adaptation and the adaptive algorithms. This work will provide important basic information about the adaptive capability of the adult, mammalian brain, the extent to which BMI exposure can "rescue" cortex that undergoes maladaptive changes in response to paralysis, and the extent to which long- term practice improves BMI performance.