Nicholas V. Annetta

Restoring cortical control of functional movement in a human with quadriplegia

Millions of people worldwide suffer from diseases that lead to paralysis through disruption of signal pathways between the brain and the muscles. Neuroprosthetic devices are designed to restore lost function and could be used to form an electronic ‘neural bypass’ to circumvent disconnected pathways in the nervous system. It has previously been shown that intracortically recorded signals can be decoded to extract information related to motion, allowing non-human primates and paralysed humans to control computers and robotic arms through imagined movements. In non-human primates, these types of signal have also been used to drive activation of chemically paralysed arm muscles. Here we show that intracortically recorded signals can be linked in real-time to muscle activation to restore movement in a paralysed human. We used a chronically implanted intracortical microelectrode array to record multiunit activity from the motor cortex in a study participant with quadriplegia from cervical spinal cord injury. We applied machine-learning algorithms to decode the neuronal activity and control activation of the participant’s forearm muscles through a custom-built high-resolution neuromuscular electrical stimulation system. The system provided isolated finger movements and the participant achieved continuous cortical control of six different wrist and hand motions. Furthermore, he was able to use the system to complete functional tasks relevant to daily living. Clinical assessment showed that, when using the system, his motor impairment improved from the fifth to the sixth cervical (C5–C6) to the seventh cervical to first thoracic (C7–T1) level unilaterally, conferring on him the critical abilities to grasp, manipulate, and release objects. This is the first demonstration to our knowledge of successful control of muscle activation using intracortically recorded signals in a paralysed human. These results have significant implications in advancing neuroprosthetic technology for people worldwide living with the effects of paralysis.

Using an Artificial Neural Bypass to Restore Cortical Control of Rhythmic Movements in a Human with Quadriplegia

Neuroprosthetic technology has been used to restore cortical control of discrete (non-rhythmic) hand movements in a paralyzed person. However, cortical control of rhythmic movements which originate in the brain but are coordinated by Central Pattern Generator (CPG) neural networks in the spinal cord has not been demonstrated previously. Here we show a demonstration of an artificial neural bypass technology that decodes cortical activity and emulates spinal cord CPG function allowing volitional rhythmic hand movement. The technology uses a combination of signals recorded from the brain, machine-learning algorithms to decode the signals, a numerical model of CPG network, and a neuromuscular electrical stimulation system to evoke rhythmic movements. Using the neural bypass, a quadriplegic participant was able to initiate, sustain, and switch between rhythmic and discrete finger movements, using his thoughts alone. These results have implications in advancing neuroprosthetic technology to restore complex movements in people living with paralysis.

Neuroprosthetic-enabled control of graded arm muscle contraction in a paralyzed human

Neuroprosthetics that combine a brain computer interface (BCI) with functional electrical stimulation (FES) can restore voluntary control of a patients’ own paralyzed limbs. To date, human studies have demonstrated an “all-or-none” type of control for a fixed number of pre-determined states, like hand-open and hand-closed. To be practical for everyday use, a BCI-FES system should enable smooth control of limb movements through a continuum of states and generate situationally appropriate, graded muscle contractions. Crucially, this functionality will allow users of BCI-FES neuroprosthetics to manipulate objects of different sizes and weights without dropping or crushing them. In this study, we present the first evidence that using a BCI-FES system, a human with tetraplegia can regain volitional, graded control of muscle contraction in his paralyzed limb. In addition, we show the critical ability of the system to generalize beyond training states and accurately generate wrist flexion states that are intermediate to training levels. These innovations provide the groundwork for enabling enhanced and more natural fine motor control of paralyzed limbs by BCI-FES neuroprosthetics.

Big data challenges in decoding cortical activity in a human with quadriplegia to inform a brain computer interface

Recent advances in Brain Computer Interfaces (BCIs) have created hope that one day paralyzed patients will be able to regain control of their paralyzed limbs. As part of an ongoing clinical study, we have implanted a 96-electrode Utah array in the motor cortex of a paralyzed human. The array generates almost 3 million data points from the brain every second. This presents several big data challenges towards developing algorithms that should not only process the data in real-time (for the BCI to be responsive) but are also robust to temporal variations and non-stationarities in the sensor data. We demonstrate an algorithmic approach to analyze such data and present a novel method to evaluate such algorithms. We present our methodology with examples of decoding human brain data in real-time to inform a BCI.Recent advances in Brain Computer Interfaces (BCIs) have created hope that one day paralyzed patients will be able to regain control of their paralyzed limbs. As part of an ongoing clinical study, we have implanted a 96-electrode Utah array in the motor cortex of a paralyzed human. The array generates almost 3 million data points from the brain every second. This presents several big data challenges towards developing algorithms that should not only process the data in real-time (for the BCI to be responsive) but are also robust to temporal variations and non-stationarities in the sensor data. We demonstrate an algorithmic approach to analyze such data and present a novel method to evaluate such algorithms. We present our methodology with examples of decoding human brain data in real-time to inform a BCI.

Dexterous Control of Seven Functional Hand Movements Using Cortically-Controlled Transcutaneous Muscle Stimulation in a Person With Tetraplegia

Individuals with tetraplegia identify restoration of hand function as a critical, unmet need to regain their independence and improve quality of life. Brain-Computer Interface (BCI)-controlled Functional Electrical Stimulation (FES) technology addresses this need by reconnecting the brain with paralyzed limbs to restore function. In this study, we quantified performance of an intuitive, cortically-controlled, transcutaneous FES system on standardized object manipulation tasks from the Grasp and Release Test (GRT). We found that a tetraplegic individual could use the system to control up to seven functional hand movements, each with >95% individual accuracy. He was able to select one movement from the possible seven movements available to him and use it to appropriately manipulate all GRT objects in real-time using naturalistic grasps. With the use of the system, the participant not only improved his GRT performance over his baseline, demonstrating an increase in number of transfers for all objects except the Block, but also significantly improved transfer times for the heaviest objects (videocassette (VHS), Can). Analysis of underlying motor cortex neural representations associated with the hand grasp states revealed an overlap or non-separability in neural activation patterns for similarly shaped objects that affected BCI-FES performance. These results suggest that motor cortex neural representations for functional grips are likely more related to hand shape and force required to hold objects, rather than to the objects themselves. These results, demonstrating multiple, naturalistic functional hand movements with the BCI-FES, constitute a further step toward translating BCI-FES technologies from research devices to clinical neuroprosthetics.

Advances in BCI: A Neural Bypass Technology to Reconnect the Brain to the Body

Millions of people worldwide suffer from diseases that lead to paralysis through disruption of signal pathways between the brain and the muscles. It has previously been shown that intracortically-recorded signals can be decoded to extract information related to movement, allowing non-human primates and paralyzed humans to control computers, wheelchairs and robotic arms through imagined movements. In non-human primates, these types of signals have also been used to drive activation of chemically paralyzed arm muscles. In an entirely novel application of brain computer interface (BCI) technology, we show that intracortically-recorded signals can be linked in real-time to muscle activation to restore functional wrist and finger movement in a paralyzed human. Our technology is designed to restore lost function and could be used to form an electronic ‘neural bypass’ to circumvent disconnected pathways in the nervous system.

Poster 253 Implanted Brain-Computer Interface Controlling a Neuroprosthetic for Increasing Upper Limb Function in a Human with Tetraparesis

ganglia calcifications with associated atrophy without evidence of acute stroke. Setting: Acute rehabilitation hospital. Results: We attempted to use computer programs on a portable device to help elicit communication with only mild improvement. Patient required moderate to max assist for scanning and selecting icons but did participate independently. His ability to answer biographical questions with simple yes/no gestures had an accuracy of about 70%. He only seemed to vocalize with family using single words or moans but that was heard by us on occasion, indicating severe dysarthria. Discussion: PPA is a rare neurologic condition that degenerates the language dominate hemisphere in the brain. Patient initially have deficits in word finding, word usage, and word comprehension. It can progress into cognitive decline as well. Intensive speech therapy needs to be initiated, along with assistive devices to help with communication. Conclusions: PPA is a unique condition and formal therapies are not yet well established. Technology and verbal exercises may help to slow the rapid progression of this disease. Level of Evidence: Level V

Solid state radiation measurement system for high flux applications

A solid state radiation measurement system was designed and developed to handle extremely high flux (approaching 0.9Mcps) and a large dynamic range. To achieve this the system utilizes a CdZnTe crystal that has undergone prior high flux testing with high bias to ensure it will not exhibit significant depolarization that will limit its ability to measure high flux. In addition, a preamplifier that produces a very narrow pulse (~125ns FWHM), was designed and a high speed ADC was used to digitize the pulse. A Field Programmable Gate Array (FPGA) was implemented that allowed for scalable (2 or more channels counting asynchronously), high speed (130 MHz) pulse analysis in real time. The FPGA uses a pulse recognition algorithm to recognize pulses, even those beginning to pile up onto one another. This system was tested with a high energy (511keV) source that had an activity exceeding 10Ci.