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|Title:||Motor neuroprosthesis implanted with neurointerventional surgery improves capacity for activities of daily living tasks in severe paralysis: first in-human experience.||Austin Authors:||Oxley, Thomas J;Yoo, Peter E;Rind, Gil S;Ronayne, Stephen M;Lee, C M Sarah;Bird, Christin;Hampshire, Victoria;Sharma, Rahul P;Morokoff, Andrew;Williams, Daryl L;MacIsaac, Christopher;Howard, Mark E ;Irving, Lou;Vrljic, Ivan;Williams, Cameron;John, Sam E;Weissenborn, Frank;Dazenko, Madeleine;Balabanski, Anna H;Friedenberg, David;Burkitt, Anthony N;Wong, Yan T;Drummond, Katharine J;Desmond, Patricia;Weber, Douglas;Denison, Timothy;Hochberg, Leigh R;Mathers, Susan;O'Brien, Terence J;May, Clive N;Mocco, J;Grayden, David B;Campbell, Bruce C V;Mitchell, Peter;Opie, Nicholas L||Affiliation:||Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia. Synchron, Inc, Campbell, California, USA..
Department of Electrical and Computer Systems Engineering, Monash University, Clayton, Victoria, Australia
Medicine, University of Melbourne, Parkville, Victoria, Australia
Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
Neurology, Melbourne Health, Parkville, Victoria, Australia
Synchron, Inc, Campbell, California, USA
Institute of Biomedical Engineering, Oxford University, Oxford, Oxfordshire, UK..
Neurology, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
Neurosurgery, Melbourne Health, Parkville, Victoria, Australia
Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
Radiology, Melbourne Health, Parkville, Victoria, Australia
Respiratory Medicine, Melbourne Health, Parkville, Victoria, Australia
Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
Intensive Care Unit, Melbourne Health, Parkville, Victoria, Australia
Anaesthesia, Melbourne Health, Parkville, Victoria, Australia
Synchron, Inc, Campbell, California, USA..
Interventional Cardiology, Cardiovascular Medicine Faculty, Stanford University, Stanford, California, USA..
Battelle Memorial Institute, Columbus, Ohio, USA..
Department of Mechanical Engineering and Neuroscience Institute, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA..
Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Harvard University, Cambridge, Massachusetts, USA..
Neurosurgery, The Mount Sinai Health System, New York, New York, USA..
|Issue Date:||28-Oct-2020||metadata.dc.date:||2020||Publication information:||Journal of neurointerventional surgery 2020; online first: 28 October||Abstract:||Implantable brain-computer interfaces (BCIs), functioning as motor neuroprostheses, have the potential to restore voluntary motor impulses to control digital devices and improve functional independence in patients with severe paralysis due to brain, spinal cord, peripheral nerve or muscle dysfunction. However, reports to date have had limited clinical translation. Two participants with amyotrophic lateral sclerosis (ALS) underwent implant in a single-arm, open-label, prospective, early feasibility study. Using a minimally invasive neurointervention procedure, a novel endovascular Stentrode BCI was implanted in the superior sagittal sinus adjacent to primary motor cortex. The participants undertook machine-learning-assisted training to use wirelessly transmitted electrocorticography signal associated with attempted movements to control multiple mouse-click actions, including zoom and left-click. Used in combination with an eye-tracker for cursor navigation, participants achieved Windows 10 operating system control to conduct instrumental activities of daily living (IADL) tasks. Unsupervised home use commenced from day 86 onwards for participant 1, and day 71 for participant 2. Participant 1 achieved a typing task average click selection accuracy of 92.63% (100.00%, 87.50%-100.00%) (trial mean (median, Q1-Q3)) at a rate of 13.81 (13.44, 10.96-16.09) correct characters per minute (CCPM) with predictive text disabled. Participant 2 achieved an average click selection accuracy of 93.18% (100.00%, 88.19%-100.00%) at 20.10 (17.73, 12.27-26.50) CCPM. Completion of IADL tasks including text messaging, online shopping and managing finances independently was demonstrated in both participants. We describe the first-in-human experience of a minimally invasive, fully implanted, wireless, ambulatory motor neuroprosthesis using an endovascular stent-electrode array to transmit electrocorticography signals from the motor cortex for multiple command control of digital devices in two participants with flaccid upper limb paralysis.||URI:||https://ahro.austin.org.au/austinjspui/handle/1/25216||DOI:||10.1136/neurintsurg-2020-016862||ORCID:||0000-0001-7772-1496||PubMed URL:||33115813||Type:||Journal Article||Subjects:||brain
|Appears in Collections:||Journal articles|
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