Christine H Blabe

Clinical translation of a high-performance neural prosthesis

Neural prostheses have the potential to improve the quality of life of individuals with paralysis by directly mapping neural activity to limb- and computer-control signals. We translated a neural prosthetic system previously developed in animal model studies for use by two individuals with amyotrophic lateral sclerosis who had intracortical microelectrode arrays placed in motor cortex. Measured more than 1 year after implant, the neural cursor-control system showed the highest published performance achieved by a person to date, more than double that of previous pilot clinical trial participants.

Virtual typing by people with tetraplegia using a self-calibrating intracortical brain-computer interface

Individuals with tetraplegia are able to type self-paced for hours across multiple days using a self-calibrating point-and-click intracortical brain-computer interface. Prolonged typing with refined BCI The fact that the brain can be hooked up to a computer to allow paralyzed individuals to type is already a technological feat. But, these so-called brain-computer interface technologies can be tiring and burdensome for users, requiring frequent disruptions for recalibration when the decoded neural signals change. Jarosiewicz and colleagues therefore combined three calibration methods—retrospective target interference, velocity bias correction, and adaptive tracking of neural features—for seamless typing and stable neural control. This combination allowed two individuals with tetraplegia and with cortical microelectrode arrays to compose long texts at their own paces, with no need to interrupt typing for recalibration. Brain-computer interfaces (BCIs) promise to restore independence for people with severe motor disabilities by translating decoded neural activity directly into the control of a computer. However, recorded neural signals are not stationary (that is, can change over time), degrading the quality of decoding. Requiring users to pause what they are doing whenever signals change to perform decoder recalibration routines is time-consuming and impractical for everyday use of BCIs. We demonstrate that signal nonstationarity in an intracortical BCI can be mitigated automatically in software, enabling long periods (hours to days) of self-paced point-and-click typing by people with tetraplegia, without degradation in neural control. Three key innovations were included in our approach: tracking the statistics of the neural activity during self-timed pauses in neural control, velocity bias correction during neural control, and periodically recalibrating the decoder using data acquired during typing by mapping neural activity to movement intentions that are inferred retrospectively based on the user’s self-selected targets. These methods, which can be extended to a variety of neurally controlled applications, advance the potential for intracortical BCIs to help restore independent communication and assistive device control for people with paralysis.

Hand posture classification using electrocorticography signals in the gamma band over human sensorimotor brain areas

OBJECTIVE Brain-machine interface systems translate recorded neural signals into command signals for assistive technology. In individuals with upper limb amputation or cervical spinal cord injury, the restoration of a useful hand grasp could significantly improve daily function. We sought to determine if electrocorticographic (ECoG) signals contain sufficient information to select among multiple hand postures for a prosthetic hand, orthotic, or functional electrical stimulation system. APPROACH We recorded ECoG signals from subdural macro- and microelectrodes implanted in motor areas of three participants who were undergoing inpatient monitoring for diagnosis and treatment of intractable epilepsy. Participants performed five distinct isometric hand postures, as well as four distinct finger movements. Several control experiments were attempted in order to remove sensory information from the classification results. Online experiments were performed with two participants. MAIN RESULTS Classification rates were 68%, 84% and 81% for correct identification of 5 isometric hand postures offline. Using 3 potential controls for removing sensory signals, error rates were approximately doubled on average (2.1×). A similar increase in errors (2.6×) was noted when the participant was asked to make simultaneous wrist movements along with the hand postures. In online experiments, fist versus rest was successfully classified on 97% of trials; the classification output drove a prosthetic hand. Online classification performance for a larger number of hand postures remained above chance, but substantially below offline performance. In addition, the long integration windows used would preclude the use of decoded signals for control of a BCI system. SIGNIFICANCE These results suggest that ECoG is a plausible source of command signals for prosthetic grasp selection. Overall, avenues remain for improvement through better electrode designs and placement, better participant training, and characterization of non-stationarities such that ECoG could be a viable signal source for grasp control for amputees or individuals with paralysis.

High performance communication by people with paralysis using an intracortical brain-computer interface

Brain-computer interfaces (BCIs) have the potential to restore communication for people with tetraplegia and anarthria by translating neural activity into control signals for assistive communication devices. While previous pre-clinical and clinical studies have demonstrated promising proofs-of-concept (Serruya et al., 2002; Simeral et al., 2011; Bacher et al., 2015; Nuyujukian et al., 2015; Aflalo et al., 2015; Gilja et al., 2015; Jarosiewicz et al., 2015; Wolpaw et al., 1998; Hwang et al., 2012; Spüler et al., 2012; Leuthardt et al., 2004; Taylor et al., 2002; Schalk et al., 2008; Moran, 2010; Brunner et al., 2011; Wang et al., 2013; Townsend and Platsko, 2016; Vansteensel et al., 2016; Nuyujukian et al., 2016; Carmena et al., 2003; Musallam et al., 2004; Santhanam et al., 2006; Hochberg et al., 2006; Ganguly et al., 2011; O’Doherty et al., 2011; Gilja et al., 2012), the performance of human clinical BCI systems is not yet high enough to support widespread adoption by people with physical limitations of speech. Here we report a high-performance intracortical BCI (iBCI) for communication, which was tested by three clinical trial participants with paralysis. The system leveraged advances in decoder design developed in prior pre-clinical and clinical studies (Gilja et al., 2015; Kao et al., 2016; Gilja et al., 2012). For all three participants, performance exceeded previous iBCIs (Bacher et al., 2015; Jarosiewicz et al., 2015) as measured by typing rate (by a factor of 1.4–4.2) and information throughput (by a factor of 2.2–4.0). This high level of performance demonstrates the potential utility of iBCIs as powerful assistive communication devices for people with limited motor function. Clinical Trial No: NCT00912041 DOI: http://dx.doi.org/10.7554/eLife.18554.001

Neural population dynamics in human motor cortex during movements in people with ALS

The prevailing view of motor cortex holds that motor cortical neural activity represents muscle or movement parameters. However, recent studies in non-human primates have shown that neural activity does not simply represent muscle or movement parameters; instead, its temporal structure is well-described by a dynamical system where activity during movement evolves lawfully from an initial pre-movement state. In this study, we analyze neuronal ensemble activity in motor cortex in two clinical trial participants diagnosed with Amyotrophic Lateral Sclerosis (ALS). We find that activity in human motor cortex has similar dynamical structure to that of non-human primates, indicating that human motor cortex contains a similar underlying dynamical system for movement generation. Clinical trial registration: NCT00912041. DOI: http://dx.doi.org/10.7554/eLife.07436.001

Rapid calibration of an intracortical brain-computer interface for people with tetraplegia

OBJECTIVE Brain-computer interfaces (BCIs) can enable individuals with tetraplegia to communicate and control external devices. Though much progress has been made in improving the speed and robustness of neural control provided by intracortical BCIs, little research has been devoted to minimizing the amount of time spent on decoder calibration. APPROACH We investigated the amount of time users needed to calibrate decoders and achieve performance saturation using two markedly different decoding algorithms: the steady-state Kalman filter, and a novel technique using Gaussian process regression (GP-DKF). MAIN RESULTS Three people with tetraplegia gained rapid closed-loop neural cursor control and peak, plateaued decoder performance within 3 min of initializing calibration. We also show that a BCI-naïve user (T5) was able to rapidly attain closed-loop neural cursor control with the GP-DKF using self-selected movement imagery on his first-ever day of closed-loop BCI use, acquiring a target 37 s after initiating calibration. SIGNIFICANCE These results demonstrate the potential for an intracortical BCI to be used immediately after deployment by people with paralysis, without the need for user learning or extensive system calibration.

Feasibility of Automatic Error Detect-and-Undo System in Human Intracortical Brain–Computer Interfaces

Objective: Brain–computer interfaces (BCIs) aim to help people with impaired movement ability by directly translating their movement intentions into command signals for assistive technologies. Despite large performance improvements over the last two decades, BCI systems still make errors that need to be corrected manually by the user. This decreases system performance and is also frustrating for the user. The deleterious effects of errors could be mitigated if the system automatically detected when the user perceives that an error was made and automatically intervened with a corrective action; thus, sparing users from having to make the correction themselves. Our previous preclinical work with monkeys demonstrated that task-outcome correlates exist in motor cortical spiking activity and can be utilized to improve BCI performance. Here, we asked if these signals also exist in the human hand area of motor cortex, and whether they can be decoded with high accuracy. Methods: We analyzed posthoc the intracortical neural activity of two BrainGate2 clinical trial participants who were neurally controlling a computer cursor to perform a grid target selection task and a keyboard-typing task. Results: Our key findings are that: 1) there exists a putative outcome error signal reflected in both the action potentials and local field potentials of the human hand area of motor cortex, and 2) target selection outcomes can be classified with high accuracy (70–85%) of errors successfully detected with minimal (0–3%) misclassifications of success trials, based on neural activity alone. Significance: These offline results suggest that it will be possible to improve the performance of clinical intracortical BCIs by incorporating a real-time error detect-and-undo system alongside the decoding of movement intention.