Sensory Augmentation, Restoration, and Modulation Using a Spinal Neuroprosthesis

项目摘要 物理世界包含着涵盖整个电磁频谱的信号，但人类 对世界的感知仅限于我们的五种感官。为了增强我们的感官，首先必须发展 可以有效地将高带宽信息传输到大脑的方法。研究人员正在研究大脑- 机器接口已经成功地从大脑中提取运动信号来控制外部设备。 然而，增强、恢复或调节感官知觉的方法目前是有限的。缺乏实时 来自脑机接口或神经假体装置的感觉反馈阻止最佳运动控制， 从而限制了感觉运动康复。由于改变生活的伤害和障碍而导致的感觉丧失会影响 数百万美国人的生活质量。因此，模仿感觉信号并将它们直接与 大脑是一个未满足的临床需求。本项目提出了一种新型的脊髓感觉神经假体接口 使用感觉脊髓刺激（SSCS），能够增强、恢复和调节感觉 感知。这种彻底创新的方法有可能影响广泛的神经系统疾病 通过解决感官恢复，并允许探索人类感官知觉的极限。预处理 在啮齿动物和恒河猴身上的临床实验证明，动物学会了探测和辨别 由SSCS引起的人工感觉。为了实现SSCS技术的临床转化，该提案涉及 在接受脊髓刺激器植入治疗的患者中进行的可行性研究， 慢性疼痛首先，SSCS诱导的感觉知觉阈值之间的关系， 差异，并建立刺激参数（目标1）。第二，人类受试者将接受训练， 检测和区分信号强度的变化和非原生信号的方向，例如红外、UV 光，磁场等使用SSCS诱导的感知觉，最终受试者将学会使用这些 新的感知能力，导航空间环境与非本地信号线索（目标2）。第三，降低 截肢者受试者将学习直观地感知他们的假肢的运动和位置， 通过使用SSCS的实时闭环感觉反馈的运动（目标3）。该项目具有创新性，因为 它在一个新的环境中使用FDA批准的技术（脊髓刺激），所有这些都不会改变患者的 标准治疗增强、恢复和调节感知的能力将是前所未有的。 在感觉神经修复学领域的发展。成功执行拟议目标不仅会启动 这是一个新的增强研究路线，但它也将展示SSCS可以广泛应用于 由于神经障碍和损伤而患有感觉缺陷的患者的康复。

Project Summary The physical world contains signals encompassing the entire electromagnetic spectrum, and yet human perception of the world is limited to our five senses. To augment our senses, it is essential to first develop methods that can effectively transmit high-bandwidth information to the brain. Researchers working on brain- machine interfaces have successfully extracted movement signals from the brain to control external devices. Yet, methods that augment, restore, or modulate sensory perception are currently limited. Lack of real-time sensory feedback from a brain-machine interface or neuroprosthetic device prevents optimal motor control and thus limits sensorimotor rehabilitation. Loss of sensation due to life-altering injuries and disorders affects the quality of life of millions of Americans. Thus, methods that mimic sensory signals and interface them directly with the brain are an unmet clinical need. This project proposes a novel spinal sensory neuroprosthetic interface using sensory spinal cord stimulation (SSCS) with the ability to augment, restore, and modulate sensory perceptions. This radically innovative approach has the potential to impact a wide array of neurological conditions by addressing sensory restoration and allows for the exploration of the limits of human sensory perception. Pre- clinical experiments in rodents and rhesus monkeys demonstrated that animals learn to detect and discriminate artificial sensations induced by SSCS. To achieve clinical translation of SSCS technology, this proposal involves a feasibility study, conducted in patients undergoing spinal cord stimulator implantation for the treatment of chronic pain. First, the relationship between SSCS-induced sensory perceptual thresholds, just-noticeable differences, and stimulation parameters will be established (Goal 1). Second, human subjects will be trained to detect and discriminate variations in signal intensity and orientation of non-native signals such as infrared, UV light, magnetic fields, etc. using SSCS-induced perceptual sense, and ultimately subjects will learn to use these novel perceptual abilities to navigate a spatial environment with non-native signal cues (Goal 2). Third, lower limb amputee subjects will learn to intuitively perceive movement and location of their prosthetic limbs during locomotion via real-time closed loop sensory feedback using SSCS (Goal 3). This project is innovative because it uses FDA-approved technology (spinal cord stimulation) in a new context, all without changing the patient’s standard-of-care. The ability to augment, restore, and modulate perceptions will be an unprecedented development in the field of sensory neuroprosthetics. Successful execution of proposed goals will not only launch a new line of augmentation research, but it will also showcase that SSCS can be widely applicable in the rehabilitation of patients suffering from sensory deficits due to neurological disorders and injuries.