neuroprosthesis

神经假体
  • 文章类型: Journal Article
    功能性电刺激(FES)是一种常见的神经运动干预措施,其中电诱发背屈肌收缩有助于步行过程中的足部清除。最近出现了前屈神经刺激来辅助和再训练步态推进;然而,在地面行走过程中,安全有效地协调背屈和足屈神经刺激一直难以捉摸,限制推进神经假体利用跑步机行走。我们提出了一种地面推进神经假体,自适应地协调,循序渐进,对背屈肌和足底屈肌的神经刺激。在中风后的10个人中,我们评估了不同发病时间给予的足底屈肌神经刺激的即时效果,和保持无辅助步行(NCT06459401)。不同个体的首选发病时间不同。个性化调谐导致麻痹性推进峰值显着增加10%(Δ:1.41±1.52%BW),麻痹性屈肌功率增加8%(Δ:0.27±0.23W/kg),与无人行走相比。会后无辅助步行速度,弱推进峰值,和推进对称性都显著提高了9%(0.14±0.09m/s),28%(2.24±3.00%BW),和12%(4.5±6.0%),分别,与会前测量相比。在这里,我们证明了地上推进神经假体可以在中风恢复的慢性阶段提高地上行走速度和推进对称性。未来的研究应包括一个对照组,以检查与单独的步态训练相比,通过推进神经假体增强的步态训练的功效。
    Functional electrical stimulation (FES) is a common neuromotor intervention whereby electrically evoked dorsiflexor muscle contractions assist foot clearance during walking. Plantarflexor neurostimulation has recently emerged to assist and retrain gait propulsion; however, safe and effective coordination of dorsiflexor and plantarflexor neurostimulation during overground walking has been elusive, restricting propulsion neuroprostheses to harnessed treadmill walking. We present an overground propulsion neuroprosthesis that adaptively coordinates, on a step-by-step basis, neurostimulation to the dorsiflexors and plantarflexors. In 10 individuals post-stroke, we evaluate the immediate effects of plantarflexor neurostimulation delivered with different onset timings, and retention to unassisted walking (NCT06459401). Preferred onset timing differed across individuals. Individualized tuning resulted in a significant 10% increase in paretic propulsion peak (Δ: 1.41 ± 1.52%BW) and an 8% increase in paretic plantarflexor power (Δ: 0.27 ± 0.23 W/kg), compared to unassisted walking. Post-session unassisted walking speed, paretic propulsion peak, and propulsion symmetry all significantly improved by 9% (0.14 ± 0.09 m/s), 28% (2.24 ± 3.00%BW), and 12% (4.5 ± 6.0%), respectively, compared to pre-session measurements. Here we show that an overground propulsion neuroprosthesis can improve overground walking speed and propulsion symmetry in the chronic phase of stroke recovery. Future studies should include a control group to examine the efficacy of gait training augmented by the propulsion neuroprosthesis compared to gait training alone.
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  • 文章类型: Journal Article
    背景:植入式迷走神经刺激是心脏移植后恢复自主性心血管功能的一种有前途的方法。为了成功治疗,系统应当具有多个电极以递送精确的刺激和复杂的神经调制模式。
    方法:本文介绍了一种可植入的多通道刺激系统,用于猪的迷走神经-心脏神经调节研究。该系统包括经皮连接到外部可穿戴控制器的有源电极阵列植入物。有源电极阵列植入物具有安装在陶瓷衬底上的集成刺激器ASIC,所述陶瓷衬底经由微铆钉结合连接到内部电极阵列。植入物是有机硅封装的,用于生物相容性和植入寿命。刺激参数通过蓝牙遥测链路远程传输。
    结果:封装的有源电极阵列植入物的尺寸为8mm×10mm×3mm。刺激器ASIC具有10位电流幅度分辨率和16个独立的输出通道,每个能够提供高达550µA的刺激电流和20V的最大电压。在70°C下对有源电极阵列植入物进行7天的体外加速寿命测试,而性能没有下降。持续刺激超过2小时后,植入物的表面温度变化小于0.5°C。此外,在雄性哥廷根小型猪的坐骨神经上进行的体内测试表明,植入物可以有效地引起EMG反应,随着刺激幅度的增加,EMG反应逐渐增强。
    结论:多通道刺激器适用于长期植入。它显示出作为动物模型中迷走神经-心脏神经调节研究的有用工具的潜力,可在心脏移植后恢复自主神经心血管功能。
    BACKGROUND: Implantable vagus nerve stimulation is a promising approach for restoring autonomic cardiovascular functions after heart transplantation. For successful treatment a system should have multiple electrodes to deliver precise stimulation and complex neuromodulation patterns.
    METHODS: This paper presents an implantable multi-channel stimulation system for vagal-cardiac neuromodulation studies in swine species. The system comprises an active electrode array implant percutaneously connected to an external wearable controller. The active electrode array implant has an integrated stimulator ASIC mounted on a ceramic substrate connected to an intraneural electrode array via micro-rivet bonding. The implant is silicone encapsulated for biocompatibility and implanted lifetime. The stimulation parameters are remotely transmitted via a Bluetooth telemetry link.
    RESULTS: The size of the encapsulated active electrode array implant is 8 mm × 10 mm × 3 mm. The stimulator ASIC has 10-bit current amplitude resolution and 16 independent output channels, each capable of delivering up to 550 µA stimulus current and a maximum voltage of 20 V. The active electrode array implant was subjected to in vitro accelerated lifetime testing at 70 °C for 7 days with no degradation in performance. After over 2 h continuous stimulation, the surface temperature change of the implant was less than 0.5 °C. In addition, in vivo testing on the sciatic nerve of a male Göttingen minipig demonstrated that the implant could effectively elicit an EMG response that grew progressively stronger on increasing the amplitude of the stimulation.
    CONCLUSIONS: The multi-channel stimulator is suitable for long term implantation. It shows potential as a useful tool in vagal-cardiac neuromodulation studies in animal models for restoring autonomic cardiovascular functions after heart transplantation.
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  • 文章类型: Journal Article
    目的:我们打算长期恢复躯体感觉,并通过一种新颖的方法为肢体缺失的患者提供高保真的肌电控制,分布式,高通道计数,植入系统。
    方法:我们开发了植入式体感神经电刺激和感应(iSens®)系统,可通过多达64、96或128个电极触点支持周围神经刺激,并从16、8或0个双极部位进行肌电记录,分别。可充电中央设备具有Bluetooth®无线遥测,可与外部设备进行通信,并可连接多达四个植入卫星刺激或记录设备的有线连接。我们表征了刺激,录音,电池运行时,和无线性能,并完成了安全测试,以支持其在人体试验中的使用。
    结果:刺激器在一系列参数中按预期运行,并且可以调度多个异步,交错脉冲序列受总电荷输送限制。当距离ImA刺激源10cm时,在盐水中记录的信号显示可忽略的刺激伪影。在盐水躯干体模中,无线遥测范围超过1m(取决于方向和方向)。带宽支持刺激命令和数据特征的100Hz双向更新速率或流式选择全带宽肌电信号。初步的人类首次数据验证了台架测试结果。
    结论:我们开发了,tested,并在临床上实施了先进的,模块化,完全植入的外周刺激和感知系统,用于体感恢复和肌电控制。电极类型和数量的模块化,包括分布式传感和刺激,支持各种各样的应用;iSens®是一个灵活的平台,使周围神经调节应用到临床现实。
    结果:政府IDNCT04430218。 .
    Objective. We intend to chronically restore somatosensation and provide high-fidelity myoelectric control for those with limb loss via a novel, distributed, high-channel-count, implanted system.Approach.We have developed the implanted Somatosensory Electrical Neurostimulation and Sensing (iSens®) system to support peripheral nerve stimulation through up to 64, 96, or 128 electrode contacts with myoelectric recording from 16, 8, or 0 bipolar sites, respectively. The rechargeable central device has Bluetooth® wireless telemetry to communicate to external devices and wired connections for up to four implanted satellite stimulation or recording devices. We characterized the stimulation, recording, battery runtime, and wireless performance and completed safety testing to support its use in human trials.Results.The stimulator operates as expected across a range of parameters and can schedule multiple asynchronous, interleaved pulse trains subject to total charge delivery limits. Recorded signals in saline show negligible stimulus artifact when 10 cm from a 1 mA stimulating source. The wireless telemetry range exceeds 1 m (direction and orientation dependent) in a saline torso phantom. The bandwidth supports 100 Hz bidirectional update rates of stimulation commands and data features or streaming select full bandwidth myoelectric signals. Preliminary first-in-human data validates the bench testing result.Significance.We developed, tested, and clinically implemented an advanced, modular, fully implanted peripheral stimulation and sensing system for somatosensory restoration and myoelectric control. The modularity in electrode type and number, including distributed sensing and stimulation, supports a wide variety of applications; iSens® is a flexible platform to bring peripheral neuromodulation applications to clinical reality. ClinicalTrials.gov ID NCT04430218.
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  • 文章类型: Journal Article
    脑机接口(BCI)可以帮助患有严重神经功能缺损的患者与外界交流。根据从无节制行为大鼠的初级体感皮层(S1)记录的微脑电图(µECoG)数据,这项研究试图通过使用机器学习算法来解码心理物理检测任务中的杠杆按压。
    将16通道Pt-Ir微电极阵列植入两只大鼠的S1上,在振动触觉是/否检测任务期间记录和µECoG。对于这项任务,训练大鼠在检测到振动触觉刺激时按右杠杆,在检测不到时按左杠杆。通过时频方法离线分析多通道µECoG数据,并在每次试验中将其特征用于杠杆压力机的二进制分类。这样测试了几种机器学习算法。
    两种大鼠的心理物理敏感性(A\')相似且较低(0.58)。大鼠2(B\'\':-0.11)的右杠杆偏倚高于大鼠1(B\'\':-0.01)。使用所有测试的算法,可以预测杠杆压力机的精度超过66%,支持向量机的平均准确率最高(78%)。
    根据最近的研究,感官反馈增加了BCI的益处。当前的概念验证研究表明,杠杆压力机可以从S1解码;因此,该区域将来可以用于双向BCI。
    UNASSIGNED: Brain-computer interfaces (BCIs) may help patients with severe neurological deficits communicate with the external world. Based on microelectrocorticography (µECoG) data recorded from the primary somatosensory cortex (S1) of unrestrained behaving rats, this study attempts to decode lever presses in a psychophysical detection task by using machine learning algorithms.
    UNASSIGNED: 16-channel Pt-Ir microelectrode arrays were implanted on the S1 of two rats, and µECoG was recorded during a vibrotactile yes/no detection task. For this task, the rats were trained to press the right lever when they detected the vibrotactile stimulus and the left lever when they did not. The multichannel µECoG data was analysed offline by time-frequency methods and its features were used for binary classification of the lever press at each trial. Several machine learning algorithms were tested as such.
    UNASSIGNED: The psychophysical sensitivities (A\') were similar and low for both rats (0.58). Rat 2 (B\'\': -0.11) had higher bias for the right lever than Rat 1 (B\'\': - 0.01). The lever presses could be predicted with accuracies over 66% with all the tested algorithms, and the highest average accuracy (78%) was with the support vector machine.
    UNASSIGNED: According to the recent studies, sensory feedback increases the benefit of the BCIs. The current proof-of-concept study shows that lever presses can be decoded from the S1; therefore, this area may be utilised for a bidirectional BCI in the future.
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  • 文章类型: Journal Article
    目的:神经假体可以通过为脊髓损伤后运动功能丧失提供替代选择来改善生活质量,中风,和其他中枢神经系统疾病。这项研究的目的是分析我们的研究小组在25年内为瘫痪志愿者安装的植入式脉冲发生器的结果,以帮助下肢功能。具体来说,为了确定存活率和常见的故障模式,删除或修改的原因,以及可能对器件性能产生不利影响的因素或外部事件。
    方法:我们的植入式接收器-刺激器(IRS-8)和植入式刺激器-遥测仪(IST-12和IST-16)装置历史通过手术记录进行回顾性回顾,监管文件,以及1996年至2021年的制造记录。
    结果:在43名志愿者中植入的65个装置(64.6%)中,大部分仍在植入和操作。七个因感染而进行了外植体;七个有内部故障,六个被外部事件破坏了。在移植的22个设备中,已成功替换15个收件人以恢复增强的功能。没有败血症或重大健康并发症的实例。在此期间,所有93例IRS和IST下肢研究手术之后的5例感染表明,合并感染率为5.4%。Kaplan-Meier对植入日期和最近随访之间的技术故障的分析显示,十-,20年设备生存率为92%,84%,71%,分别。
    结论:故障发生率类似于,而感染率略高于,其他常见的植入式医疗设备。未来的调查将集中在预防感染上,根据接受者的人口统计数据修改技术,生活方式因素,和教育,并整合在其他应用中使用的运动神经假体的类似经验。
    OBJECTIVE: Neuroprosthetic devices can improve quality of life by providing an alternative option for motor function lost after spinal cord injury, stroke, and other central nervous system disorders. The objective of this study is to analyze the outcomes of implanted pulse generators that our research group installed in volunteers with paralysis to assist with lower extremity function over a 25-year period, specifically, to determine survival rates and common modes of malfunction, reasons for removal or revision, and precipitating factors or external events that may have adversely influenced device performance.
    METHODS: Our implantable receiver-stimulator (IRS-8) and implantable stimulator-telemeter (IST-12 and IST-16) device histories were retrospectively reviewed through surgical notes, regulatory documentation, and manufacturing records from 1996 to 2021.
    RESULTS: Most of the 65 devices (64.6%) implanted in 43 volunteers remain implanted and operational. Seven underwent explantation owing to infection; seven had internal failures, and six were physically broken by external events. Of the 22 devices explanted, 15 were successfully replaced to restore recipients\' enhanced functionality. There were no instances of sepsis or major health complications. The five infections that followed all 93 IRS and IST lower extremity research surgeries during this period indicate a pooled infection rate of 5.4%. The Kaplan-Meier analysis of technical malfunctions between the implant date and most recent follow-up shows five-, ten-, and 20-year device survival rates of 92%, 84%, and 71%, respectively.
    CONCLUSIONS: Incidence of malfunction is similar to, whereas infection rates are slightly higher than, other commonly implanted medical devices. Future investigations will focus on infection prevention, modifying techniques on the basis of recipient demographics, lifestyle factors, and education, and integrating similar experience of motor neuroprostheses used in other applications.
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  • 文章类型: Journal Article
    目的:为了确定神经接口的疗效-,包括脑机接口(BCI),通过常规和个体患者数据(IPD)荟萃分析基于神经康复,并评估与基于神经接口的神经康复的积极反应相关的临床参数。
    方法:PubMed,EMBASE,和截至2022年2月的Cochrane图书馆数据库进行了审查。
    方法:使用神经界面控制的物理效应子(FES和/或动力外骨骼)和报告的Fugl-Meyer评估-上肢(FMA-UE)评分进行研究。这项荟萃分析在PROSPERO上进行了前瞻性登记(#CRD42022312428)。遵循PRISMA指南。
    方法:合并FMA-UE评分的变化以估计平均效应大小。使用研究水平变量和IPD对临床参数和神经界面参数进行亚组分析。
    结果:纳入46项包含617名患者的研究。涉及214名患者的29项研究报告了IPD。FMA-UE得分平均增加5.23(95%CI:3.85至6.61)。使用运动尝试的系统比运动图像产生更大的FMA-UE增益,训练持续>4周和≤4周。关于IPD分析,超过MCID的平均改善时间为12周(95%CI:7至未达到).6个月时,58%的改善高于MCID(95%CI:41%至70%)。在单变量对数秩检验中,严重损害(p=0.042)和年龄>50岁(p=0.0022)的患者与未能改善超过MCID相关。然而,在多变量Cox分析中,这些因素仅有临界显著性(分别为HR0.15,p=0.08和HR0.47,p=0.06).
    结论:基于神经界面的运动康复可显著降低卒中后损害,但仍可在卒中后神经康复中得到更广泛的应用。
    OBJECTIVE: To determine the efficacy of neural interface-based neurorehabilitation, including brain-computer interface, through conventional and individual patient data (IPD) meta-analysis and to assess clinical parameters associated with positive response to neural interface-based neurorehabilitation.
    METHODS: PubMed, EMBASE, and Cochrane Library databases up to February 2022 were reviewed.
    METHODS: Studies using neural interface-controlled physical effectors (functional electrical stimulation and/or powered exoskeletons) and reported Fugl-Meyer Assessment-upper-extremity (FMA-UE) scores were identified. This meta-analysis was prospectively registered on PROSPERO (#CRD42022312428). PRISMA guidelines were followed.
    METHODS: Changes in FMA-UE scores were pooled to estimate the mean effect size. Subgroup analyses were performed on clinical parameters and neural interface parameters with both study-level variables and IPD.
    RESULTS: Forty-six studies containing 617 patients were included. Twenty-nine studies involving 214 patients reported IPD. FMA-UE scores increased by a mean of 5.23 (95% confidence interval [CI]: 3.85-6.61). Systems that used motor attempt resulted in greater FMA-UE gain than motor imagery, as did training lasting >4 vs ≤4 weeks. On IPD analysis, the mean time-to-improvement above minimal clinically important difference (MCID) was 12 weeks (95% CI: 7 to not reached). At 6 months, 58% improved above MCID (95% CI: 41%-70%). Patients with severe impairment (P=.042) and age >50 years (P=.0022) correlated with the failure to improve above the MCID on univariate log-rank tests. However, these factors were only borderline significant on multivariate Cox analysis (hazard ratio [HR] 0.15, P=.08 and HR 0.47, P=.06, respectively).
    CONCLUSIONS: Neural interface-based motor rehabilitation resulted in significant, although modest, reductions in poststroke impairment and should be considered for wider applications in stroke neurorehabilitation.
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  • 文章类型: Journal Article
    目的:感觉反馈对于有效控制脑机接口(BMI)和神经假体装置至关重要。脊髓刺激(SCS)被提议作为一种在啮齿动物中诱导人工感官知觉的技术,猴子,和人类。然而,为了充分发挥SCS作为感觉神经修复技术的潜力,有必要更好地了解SCS脉冲串参数变化对感官检测和辨别阈值的影响。 方法。在这里,我们调查了刺激周期是否会影响大鼠在不同频率下检测和区分SCS诱导的感知的能力。 主要结果。通过改变刺激脉冲间隔的变异系数(CV),我们表明,在较低的频率下,大鼠可以检测到较低振幅的高度非周期性SCS脉冲串(即,降低检测阈值)。此外,大鼠学会了区分周期性细微差异的刺激,与周期性刺激相比,高度非周期性刺激的明显差异(JND)较小。 意义。这些结果表明,SCS脉冲串的时间结构是神经假体应用中调节感觉反馈的不可或缺的参数。
    Objective.Sensory feedback is critical for effectively controlling brain-machine interfaces and neuroprosthetic devices. Spinal cord stimulation (SCS) is proposed as a technique to induce artificial sensory perceptions in rodents, monkeys, and humans. However, to realize the full potential of SCS as a sensory neuroprosthetic technology, a better understanding of the effect of SCS pulse train parameter changes on sensory detection and discrimination thresholds is necessary.Approach.Here we investigated whether stimulation periodicity impacts rats\' ability to detect and discriminate SCS-induced perceptions at different frequencies.Main results.By varying the coefficient of variation (CV) of interstimulus pulse interval, we showed that at lower frequencies, rats could detect highly aperiodic SCS pulse trains at lower amplitudes (i.e. decreased detection thresholds). Furthermore, rats learned to discriminate stimuli with subtle differences in periodicity, and the just-noticeable differences from a highly aperiodic stimulus were smaller than those from a periodic stimulus.Significance.These results demonstrate that the temporal structure of an SCS pulse train is an integral parameter for modulating sensory feedback in neuroprosthetic applications.
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  • 文章类型: Review
    Bioprinting allows additive fabrication of bioengineered constructs with defined two- or three-dimensional organization using live cells, biopolymers and other materials. This article reviews main bioprinting technologies and their capabilities in clinical and experimental ophthalmology. Analysis of literature sources helped reveal and describe the main types of bioprinting technologies: inkjet, laser-assisted, and extrusion. Extrusion bioprinting is the most widely used method, providing the ability to use various types of bioinks and a wide range of cell concentrations. The following materials can be used as the base for bioinks: alginate, collagen, gelatin, hyaluronic acid, chitosan, fibrin, as well as their different combinations. These materials can be modified for best bioprinting properties by adding various functional groups. The major directions of application of bioprinting technologies in ophthalmology are tissue engineering for regenerative medicine and fabrication of model systems for fundamental and preclinical studies. Experiments in creating a bioprinted cornea are being conducted in the field of regenerative medicine. Furthermore, there are studies on fabricating retinal tissue equivalents, although tissue engineering of this structure is a task of great complexity. Model systems, which can be fabricated by bioprinting, are represented by tissue equivalents of ocular structures and the appendages of the eye, as well as by microphysiological organ-on-a-chip systems. Another promising application of bioprinting is fabrication of biocompatible implantable electrode arrays for visual neuroprostheses.
    Технология биопечати позволяет из живых клеток, биополимеров и иных материалов создавать аддитивным способом биоинженерные структуры с заданной двух- или трехмерной пространственной организацией. Цель данного обзора — дать краткую характеристику основных технологий биопечати и их возможностей в сфере клинической и экспериментальной офтальмологии. В ходе анализа литературных источников были выделены и описаны основные виды биопечати: струйная, лазерная и экструзионная. Экструзионная биопечать является самым распространенным вариантом, позволяющим использовать различные типы биочернил и широкий диапазон концентраций клеток. В качестве основы для биочернил могут использоваться такие материалы, как альгинат, коллаген, желатин, гиалуроновая кислота, хитозан, фибрин и их различные сочетания. Для получения биочернил с оптимальными для биопринтинга свойствами входящие в их состав материалы могут быть модифицированы путем добавления различных функциональных групп. Основные направления применения технологий биопечати в офтальмологии — создание тканеинженерных конструкций для регенеративной медицины, изготовление модельных систем для фундаментальных и доклинических исследований. В сфере регенеративной медицины ведутся эксперименты по созданию биопечатной роговицы. Кроме того, есть исследования по получению тканевых эквивалентов сетчатки, хотя тканевая инженерия данной структуры отличается большей сложностью. Модельные системы, которые могут быть изготовлены с применением биопринтинга, представлены как тканевыми эквивалентами различных структур глаза и его вспомогательного аппарата, так и микрофизиологическими системами «орган-на-чипе». Перспективным направлением применения биопечати может стать изготовление биосовместимых имплантируемых мультиэлектродных матриц для зрительных нейропротезов.
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  • 文章类型: Journal Article
    直接从大脑活动中解码语音的脑机接口(BCI)旨在恢复不会说话的瘫痪患者的交流。尽管最近取得了进展,语音的神经推理仍然不完善,限制语音BCI的能力,以实现诸如促进代理的流利对话之类的体验-也就是说,用户创作和传输表达其意图的消息的能力。这里,我们根据神经工程中现有和新兴的策略提出促进代理的建议。重点是快速实现,准确,和可靠的性能,同时确保在使用解码器时进行自愿控制,到底解码了什么,以及信息是如何表达的。此外,在受控实验环境中的神经科学进步,我们认为,平行的研究必须考虑如何将实验成功转化为现实世界的环境。虽然这样的研究最终需要来自潜在用户的输入,在这里,我们确定并描述了在现有辅助技术领域中受到人为因素工作启发的设计选择,它解决了未来现实世界语音BCI应用中可能出现的实际问题。
    Brain-computer interfaces (BCI) that directly decode speech from brain activity aim to restore communication in people with paralysis who cannot speak. Despite recent advances, neural inference of speech remains imperfect, limiting the ability for speech BCIs to enable experiences such as fluent conversation that promote agency - that is, the ability for users to author and transmit messages enacting their intentions. Here, we make recommendations for promoting agency based on existing and emerging strategies in neural engineering. The focus is on achieving fast, accurate, and reliable performance while ensuring volitional control over when a decoder is engaged, what exactly is decoded, and how messages are expressed. Additionally, alongside neuroscientific progress within controlled experimental settings, we argue that a parallel line of research must consider how to translate experimental successes into real-world environments. While such research will ultimately require input from prospective users, here we identify and describe design choices inspired by human-factors work conducted in existing fields of assistive technology, which address practical issues likely to emerge in future real-world speech BCI applications.
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  • 文章类型: Journal Article
    下肢失足患者跌倒的风险增加,部分原因是缺乏失足的感官反馈。通过直接与残留在残肢中的周围神经连接,可以恢复被认为源自失足的足底感觉。这反过来在改善步态和平衡方面显示出了希望。然而,目前还不清楚这些电引起的足底感觉是如何整合到人体的自然感觉运动控制反射中的。历史上,H反射已被用作研究感觉运动控制的模型。在脊髓内,输入的数组,包括足底皮肤感觉,整合以对H反射产生抑制和兴奋作用。
    在这项研究中,我们表征了电引起的足底感觉与这种内在反射机制之间的相互作用。参与者采用模仿步态周期特定阶段的姿势。在每个姿势中,我们电引起足底感觉,随后在存在和不存在这些感觉的情况下都会引起H反射。
    我们的发现表明,电引起的足底感觉在任何采用的姿势中都没有显着改变H反射的兴奋性。
    这表明下肢丧失的个体可以在行走过程中直接受益于电引起的足底感觉,而不会破坏调节反射反应的现有感觉信号通路。
    UNASSIGNED: Individuals with lower limb loss experience an increased risk of falls partly due to the lack of sensory feedback from their missing foot. It is possible to restore plantar sensation perceived as originating from the missing foot by directly interfacing with the peripheral nerves remaining in the residual limb, which in turn has shown promise in improving gait and balance. However, it is yet unclear how these electrically elicited plantar sensation are integrated into the body\'s natural sensorimotor control reflexes. Historically, the H-reflex has been used as a model for investigating sensorimotor control. Within the spinal cord, an array of inputs, including plantar cutaneous sensation, are integrated to produce inhibitory and excitatory effects on the H-reflex.
    UNASSIGNED: In this study, we characterized the interplay between electrically elicited plantar sensations and this intrinsic reflex mechanism. Participants adopted postures mimicking specific phases of the gait cycle. During each posture, we electrically elicited plantar sensation, and subsequently the H-reflex was evoked both in the presence and absence of these sensations.
    UNASSIGNED: Our findings indicated that electrically elicited plantar sensations did not significantly alter the H-reflex excitability across any of the adopted postures.
    UNASSIGNED: This suggests that individuals with lower limb loss can directly benefit from electrically elicited plantar sensation during walking without disrupting the existing sensory signaling pathways that modulate reflex responses.
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