TY - JOUR
T1 - High-performance neuroprosthetic control by an individual with tetraplegia
AU - Collinger, Jennifer L.
AU - Wodlinger, Brian
AU - Downey, John E.
AU - Wang, Wei
AU - Tyler-Kabara, Elizabeth C.
AU - Weber, Douglas J.
AU - McMorland, Angus J.C.
AU - Velliste, Meel
AU - Boninger, Michael L.
AU - Schwartz, Andrew B.
N1 - Funding Information:
This study is funded by the Defense Advanced Research Projects Agency's (Arlington, VA, USA) Revolutionizing Prosthetics programme (contract number N66001-10-C-4056) , National Institutes of Health , (Bethesda, MD, USA, grant 8KL2TR000146-07) , Office of Research and Development, Rehabilitation Research and Development Service, Department of Veterans Affairs (Washington, DC, USA, grant numbers B6789C, B7143R, and RX720) , and UPMC Rehabilitation Institute (Pittsburgh, PA, USA). This study was done under an investigational device exemption granted by the US Food and Drug Administration. We thank Jan Scheuermann for her extraordinary commitment and effort in relation to this study and insightful discussions with the study team; Karina Palko for her participation as an honorary research team member and support of the study; the clinicians and researchers at the University of Pittsburgh and UPMC including Joseph Ricker for the presurgical neuropsychological screening, Richard Barbara (both Physical Medicine and Rehabilitation) for providing psychological monitoring throughout the study, Ferenc Gyulai (Anesthesiology) for directing general anaesthesia for the implantation surgery, and Elizabeth Skidmore (Occupational Therapy) for advice about functional assessments of the prosthetic limb; Ramana Vinjamuri and Robin Ashmore for technical and software development efforts, Stephen Foldes for assistance with presurgical neuroimaging, Elke Brown (all four Physical Medicine and Rehabilitation) for assistance with brain–machine-interface testing sessions, Samuel Clanton (School of Medicine) who developed a prototype-system for high-dimensional decoding and participant training that was adapted for this experiment, Elizabeth Harchick for assistance with presurgical neuroimaging, recruitment, and regulatory compliance, and Alisha Shane-Cuniff (both Physical Medicine and Rehabilitation) for coordination of the data and safety monitoring board (DSMB); the University of Pittsburgh Clinical and Translational Science Institute and the Office of Investigator-Sponsored Investigational New Drugs and Investigational Device Exemption support for assistance with protocol development and regulatory reporting and compliance; the volunteer members of the DSMB for their continued monitoring of this study; the Johns Hopkins University Applied Physics Laboratory (Laurel, MD, USA) and Blackrock Microsystems (Salt Lake City, UT, USA) for coordination efforts and technical support in relation to this project. The views expressed herein are those of the authors and do not represent the official policy or position of the Department of Veterans Affairs, Department of Defense, or US Government.
PY - 2013/2
Y1 - 2013/2
N2 - Background Paralysis or amputation of an arm results in the loss of the ability to orient the hand and grasp, manipulate, and carry objects, functions that are essential for activities of daily living. Brain-machine interfaces could provide a solution to restoring many of these lost functions. We therefore tested whether an individual with tetraplegia could rapidly achieve neurological control of a high-performance prosthetic limb using this type of an interface. Methods We implanted two 96-channel intracortical microelectrodes in the motor cortex of a 52-year-old individual with tetraplegia. Brain-machine-interface training was done for 13 weeks with the goal of controlling an anthropomorphic prosthetic limb with seven degrees of freedom (three-dimensional translation, three-dimensional orientation, one-dimensional grasping). The participant's ability to control the prosthetic limb was assessed with clinical measures of upper limb function. This study is registered with ClinicalTrials.gov, NCT01364480. Findings The participant was able to move the prosthetic limb freely in the three-dimensional workspace on the second day of training. After 13 weeks, robust seven-dimensional movements were performed routinely. Mean success rate on target-based reaching tasks was 91 6% (SD 4 4) versus median chance level 6 2% (95% CI 2 0-15 3). Improvements were seen in completion time (decreased from a mean of 148 s [SD 60] to 112 s [6]) and path efficiency (increased from 0 30 [0 04] to 0 38 [0 02]). The participant was also able to use the prosthetic limb to do skilful and coordinated reach and grasp movements that resulted in clinically significant gains in tests of upper limb function. No adverse events were reported. Interpretation With continued development of neuroprosthetic limbs, individuals with long-term paralysis could recover the natural and intuitive command signals for hand placement, orientation, and reaching, allowing them to perform activities of daily living.
AB - Background Paralysis or amputation of an arm results in the loss of the ability to orient the hand and grasp, manipulate, and carry objects, functions that are essential for activities of daily living. Brain-machine interfaces could provide a solution to restoring many of these lost functions. We therefore tested whether an individual with tetraplegia could rapidly achieve neurological control of a high-performance prosthetic limb using this type of an interface. Methods We implanted two 96-channel intracortical microelectrodes in the motor cortex of a 52-year-old individual with tetraplegia. Brain-machine-interface training was done for 13 weeks with the goal of controlling an anthropomorphic prosthetic limb with seven degrees of freedom (three-dimensional translation, three-dimensional orientation, one-dimensional grasping). The participant's ability to control the prosthetic limb was assessed with clinical measures of upper limb function. This study is registered with ClinicalTrials.gov, NCT01364480. Findings The participant was able to move the prosthetic limb freely in the three-dimensional workspace on the second day of training. After 13 weeks, robust seven-dimensional movements were performed routinely. Mean success rate on target-based reaching tasks was 91 6% (SD 4 4) versus median chance level 6 2% (95% CI 2 0-15 3). Improvements were seen in completion time (decreased from a mean of 148 s [SD 60] to 112 s [6]) and path efficiency (increased from 0 30 [0 04] to 0 38 [0 02]). The participant was also able to use the prosthetic limb to do skilful and coordinated reach and grasp movements that resulted in clinically significant gains in tests of upper limb function. No adverse events were reported. Interpretation With continued development of neuroprosthetic limbs, individuals with long-term paralysis could recover the natural and intuitive command signals for hand placement, orientation, and reaching, allowing them to perform activities of daily living.
UR - http://www.scopus.com/inward/record.url?scp=84873710744&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(12)61816-9
DO - 10.1016/S0140-6736(12)61816-9
M3 - Article
C2 - 23253623
AN - SCOPUS:84873710744
VL - 381
SP - 557
EP - 564
JO - The Lancet
JF - The Lancet
SN - 0140-6736
IS - 9866
ER -