Implantable brain–computer interface for neuroprosthetic-enabled volitional hand grasp restoration in spinal cord injury

Author:

Cajigas Iahn1ORCID,Davis Kevin C2,Meschede-Krasa Benyamin345,Prins Noeline W26,Gallo Sebastian2,Naeem Jasim Ahmad2,Palermo Anne7,Wilson Audrey8,Guerra Santiago2,Parks Brandon A2,Zimmerman Lauren2,Gant Katie8,Levi Allan D18,Dietrich W Dalton128,Fisher Letitia8,Vanni Steven18,Tauber John Michael35,Garwood Indie C35,Abel John H345,Brown Emery N345,Ivan Michael E1,Prasad Abhishek28,Jagid Jonathan18

Affiliation:

1. Department of Neurological Surgery, University of Miami, Miami, FL 33136, USA

2. Department of Biomedical Engineering, University of Miami, Miami, FL 33146, USA

3. Department of Brain and Cognitive Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA

4. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA

5. Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA

6. Department of Electrical and Information Engineering, Faculty of Engineering, University of Ruhuna, Hapugala, Galle 80000, Sri Lanka

7. Department of Physical Therapy, University of Miami, Miami, FL 33146, USA

8. Miami Project to Cure Paralysis, University of Miami, Miami, FL 33136, USA

Abstract

Abstract Loss of hand function after cervical spinal cord injury severely impairs functional independence. We describe a method for restoring volitional control of hand grasp in one 21-year-old male subject with complete cervical quadriplegia (C5 American Spinal Injury Association Impairment Scale A) using a portable fully implanted brain–computer interface within the home environment. The brain–computer interface consists of subdural surface electrodes placed over the dominant-hand motor cortex and connects to a transmitter implanted subcutaneously below the clavicle, which allows continuous reading of the electrocorticographic activity. Movement-intent was used to trigger functional electrical stimulation of the dominant hand during an initial 29-weeks laboratory study and subsequently via a mechanical hand orthosis during in-home use. Movement-intent information could be decoded consistently throughout the 29-weeks in-laboratory study with a mean accuracy of 89.0% (range 78–93.3%). Improvements were observed in both the speed and accuracy of various upper extremity tasks, including lifting small objects and transferring objects to specific targets. At-home decoding accuracy during open-loop trials reached an accuracy of 91.3% (range 80–98.95%) and an accuracy of 88.3% (range 77.6–95.5%) during closed-loop trials. Importantly, the temporal stability of both the functional outcomes and decoder metrics were not explored in this study. A fully implanted brain–computer interface can be safely used to reliably decode movement-intent from motor cortex, allowing for accurate volitional control of hand grasp.

Funder

Miami Project to Cure Paralysis

Medtronic

National Institutes of Health/National Institute of Neurological Disorders and Stroke

National Institutes of Health

National Institutes of Health/National Institute of Aging

Publisher

Oxford University Press (OUP)

Subject

General Earth and Planetary Sciences,General Environmental Science

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