Brain-Computer Interface Implant for Severe Communication Disability

项目摘要/摘要 闭锁综合征(LIS)患者认知功能完好，但无法活动或交流，除非 通过眨眼或有限的(垂直)眼球运动。对于许多遭受这种困境的患者来说， 自我发起的交流不再可能，他们无法开始对话，提出问题， 或者引起护理者的注意。这些LIS患者没有其他与家人或朋友互动的方式 缺乏隐私和任何程度的独立性。最近，一种脑机接口(BCI)设备被 成功植入一名晚期肌萎缩侧索硬化症锁定患者。通过调节她的大脑信号，这位患者 能够选择字母和拼写单词。突破性的是，第一次，BCI系统 性能良好，无需专家即可在家中使用。这篇文章发表在《新闻》杂志上。 《英格兰医学杂志》。然而，拼写的速度只有每分钟2个字符，这显然需要 有待改进。在乌得勒支大学医学中心之间的这项合作早期可行性研究中 (荷兰)、约翰·霍普金斯大学(巴尔的摩)和 美敦力(明尼阿波利斯)，我们将使用显著改进的植入设备版本来更快地开发 和更多功能的家庭使用的脑机接口控制技术。这项研究的总体目标是：1)证明 该BCI的基本功能可推广到其他LIS患者(AIM1)，以及2)扩展电流 通过3个途径的研究实现脑机接口能力，旨在实现A)多维项目选择 (Avenue‘多选’)允许患者在多个菜单选项中进行选择，B)2D光标控制 (Avenue‘导航’)这将允许点击使用计算机，类似于眼睛追踪器 眼球运动正常的用户，以及C)通过语音合成器发声(大街上的“说”) (AIM2)，这将极大地提高沟通和生活质量。共有9名LIS患者将 每次参加一年，在此期间和之后，他们可以继续在家里使用BCI系统。一个 另外16名因无关诊断目的(癫痫手术)而植入电极网的患者将 包括用于开发高级解码算法，利用临床256声道记录 系统。这项研究将论证为LIS患者提供另一种治疗方法的可行性 通信，从而将人类神经科学的当前艺术状态转移到临床领域 治疗严重的沟通障碍。

PROJECT SUMMARY / ABSTRACT Patients with Locked-In Syndrome (LIS) are cognitively intact but unable to move or communicate except through eye blinks or limited (vertical) eye movements. For many patients suffering from this predicament, self-initiated communication is no longer possible, and they are unable to start a conversation, ask a question, or draw caregiver attention. Having no other means of interacting with family or friends, these LIS patients lack privacy and any degree of independence. Recently, a Brain-Computer Interface (BCI) device was successfully implanted in a locked-in patient with late stage ALS. By modulating her brain signals, this patient was able to select letters and spell words. The breakthrough was that, for the first time, a BCI system performed well enough to enable use at home without the need for experts. This was published in the New England Journal of Medicine. Yet, the rate of spelling was only 2 characters per minute, which clearly needs to be improved. In this collaborative early-feasibility study between the University Medical Center Utrecht (The Netherlands), the Johns Hopkins University (Baltimore), and the Neuromodulation Research unit of Medtronic (Minneapolis), we will use a significantly improved version of the implant device to develop faster and more versatile BCI control techniques for home use. The overall goal of the research is 1) to prove that the basic functionality of this BCI is generalizable to other patients with LIS (AIM1), and 2) to expand current BCI capabilities through research along 3 avenues aiming to achieve A) multidimensional item selection (avenue ‘Multiselect’) that would allow patients to choose among multiple menu options, B) 2D cursor control (avenue ‘Navigate’) that would allow point-and-click use of a computer, similar to that of eye trackers for users with normal eye movements, and C) vocalization through a speech synthesizer (avenue ‘Speak’) (AIM2), which would greatly enhance communication and quality of life. A total of nine LIS patients will participate for one year each, during and after which they may continue to use the BCI system at home. An additional 16 patients with electrode grids implanted for unrelated diagnostic purposes (epilepsy surgery) will be included for the development of advanced decoding algorithms, utilizing clinical 256-channel recording systems. The study will demonstrate the feasibility of providing LIS patients with an alternative means of communication, thereby moving the current state of the art in human neuroscience to the realm of clinical treatment for severe communication disorders.