Motor neuroprosthesis implanted with neurointerventional surgery improves capacity for activities of daily living tasks in severe paralysis: First in-human experience

Thumbnail Image
Citations
Web of Science:
4
Scopus:
138
Altmetric:
Altmetric::
Associated Records
Authors
Oxley, TJ; Yoo, PE; Rind, GS; Ronayne, SM; Lee, CMS; Bird, C; Hampshire, V; Sharma, RP; Morokoff, A; Williams, DL...
File Licence
Editors
Date
2021-02-01
Source Title
Journal of NeuroInterventional Surgery
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ PUBLISHING GROUP
Melbourne Authors
Burkitt, Anthony ORCID
 Grayden, David ORCID
 Oxley, Thomas ORCID
 O'Brien, Terence ORCID
 May, Clive ORCID
 Morokoff, Andrew ORCID
 Rind, Gil ORCID
 Opie, Nicholas ORCID
 Desmond, Patricia ORCID
 Campbell, Bruce ORCID
 Ronayne, Stephen ORCID
 Drummond, Katharine ORCID
 MacIsaac, Christopher
Howard, Mark ORCID
 John, Sam ORCID
 Mitchell, Peter
Yoo, Peter
Bird, Christin
Williams, Daryl ORCID
 Williams, Cameron ORCID
 Irving, Louis
Balabanski, Anna ORCID
Affiliation
Florey Department of Neuroscience and Mental Health
Medical Education
Biochemistry and Pharmacology
Biomedical Engineering
Medicine (Austin & Northern Health)
Medicine (RMH)
Surgery (RMH)
Radiology
Document Type
Journal Article
Subject Code
Citation
Oxley, T. J., Yoo, P. E., Rind, G. S., Ronayne, S. M., Lee, C. M. S., Bird, C., Hampshire, V., Sharma, R. P., Morokoff, A., Williams, D. L., MacIsaac, C., Howard, M. E., Irving, L., Vrljic, I., Williams, C., John, S. E., Weissenborn, F., Dazenko, M., Balabanski, A. H. ,... Opie, N. L. (2021). Motor neuroprosthesis implanted with neurointerventional surgery improves capacity for activities of daily living tasks in severe paralysis: First in-human experience. Journal of Neurointerventional Surgery, 13 (2), pp.102-108. https://doi.org/10.1136/neurintsurg-2020-016862.
Access Status
Open Access
URI
https://hdl.handle.net/11343/252257
DOI
10.1136/neurintsurg-2020-016862
Access URL
Open Access URL
Open Access at PMC
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7848062
Linked Resource URL
NHMRC Grant Code
NHMRC/1062532
 NHMRC/1138110
 NHMRC/1161108
ARC Grant Code
ARC/LP150100038
Description
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Notes
Terms of Use
Keywords
Publisher Licence
CC BY-NC
Publisher URL
https://doi.org/10.1136/neurintsurg-2020-016862
Collections
Florey Department of Neuroscience and Mental Health - Research Publications
Biochemistry and Pharmacology - Research Publications
Biomedical Engineering - Research Publications
Medical Education - Research Publications
Medicine (Austin & Northern Health) - Research Publications
Medicine (RMH) - Research Publications
Load more