Closed-loop cortical control of virtual reach and posture using Cartesian and joint velocity commands.

OBJECTIVE: Brain-computer interfaces (BCIs) are a promising technology for the restoration of function to people with paralysis, especially for controlling coordinated reaching. Typical BCI studies decode Cartesian endpoint velocities as commands, but human arm movements might be better controlled in a joint-based coordinate frame, which may match underlying movement encoding in the motor cortex. A better understanding of BCI controlled reaching by people with paralysis may lead to performance improvements in brain-controlled assistive devices. APPROACH: Two intracortical BCI participants in the BrainGate2 pilot clinical trial performed a visual 3D endpoint virtual reality reaching task using two decoders: Cartesian and joint velocity. Task performance metrics (i.e. success rate and path efficiency) and single feature and population tuning were compared across the two decoder conditions. The participants also demonstrated the first BCI control of a fourth dimension of reaching, the arm's swivel angle, in a 4D posture matching task. MAIN RESULTS: Both users achieved significantly higher success rates using Cartesian velocity control, and joint controlled trajectories were more variable and significantly more curved. Neural tuning analyses showed that most single feature activity was best described by a Cartesian kinematic encoding model, and population analyses revealed only slight differences in aggregate activity between the decoder conditions. Simulations of a BCI user reproduced trajectory features seen during closed-loop joint control when assuming only Cartesian-tuned features passed through a joint decoder. With minimal training, both participants controlled the virtual arm's swivel angle to complete a 4D posture matching task, and achieved significantly higher success using a Cartesian + swivel velocity decoder compared to a joint velocity decoder. SIGNIFICANCE: These results suggest that Cartesian velocity command interfaces may provide better BCI control of arm movements than other kinematic variables, even in 4D posture tasks with swivel angle targets.

Signal processing methods for reducing artifacts in microelectrode brain recordings caused by functional electrical stimulation.

OBJECTIVE: Functional electrical stimulation (FES) is a promising technology for restoring movement to paralyzed limbs. Intracortical brain-computer interfaces (iBCIs) have enabled intuitive control over virtual and robotic movements, and more recently over upper extremity FES neuroprostheses. However, electrical stimulation of muscles creates artifacts in intracortical microelectrode recordings that could degrade iBCI performance. Here, we investigate methods for reducing the cortically recorded artifacts that result from peripheral electrical stimulation. APPROACH: One participant in the BrainGate2 pilot clinical trial had two intracortical microelectrode arrays placed in the motor cortex, and thirty-six stimulating intramuscular electrodes placed in the muscles of the contralateral limb. We characterized intracortically recorded electrical artifacts during both intramuscular and surface stimulation. We compared the performance of three artifact reduction methods: blanking, common average reference (CAR) and linear regression reference (LRR), which creates channel-specific reference signals, composed of weighted sums of other channels. MAIN RESULTS: Electrical artifacts resulting from surface stimulation were 175 × larger than baseline neural recordings (which were 110 µV peak-to-peak), while intramuscular stimulation artifacts were only 4 × larger. The artifact waveforms were highly consistent across electrodes within each array. Application of LRR reduced artifact magnitudes to less than 10 µV and largely preserved the original neural feature values used for decoding. Unmitigated stimulation artifacts decreased iBCI decoding performance, but performance was almost completely recovered using LRR, which outperformed CAR and blanking and extracted useful neural information during stimulation artifact periods. SIGNIFICANCE: The LRR method was effective at reducing electrical artifacts resulting from both intramuscular and surface FES, and almost completely restored iBCI decoding performance (>90% recovery for surface stimulation and full recovery for intramuscular stimulation). The results demonstrate that FES-induced artifacts can be easily mitigated in FES + iBCI systems by using LRR for artifact reduction, and suggest that the LRR method may also be useful in other noise reduction applications.

A transducer to measure isometric elbow moments.

OBJECTIVE: The purpose of this study was to design and implement a transducer to measure accurately the isometric elbow moments produced by individuals with tetraplegia. DESIGN: The device needed to be insensitive to off-axis moments and proximal joint motions and be capable of being used over a wide range of elbow and shoulder positions in an outpatient clinic setting. BACKGROUND: Measurement of the smaller isometric moments produced by individuals with tetraplegia is especially sensitive to the errors that can be introduced by inaccurate lever arm determination, off-axis loads, and proximal joint motions. Devices traditionally utilized for quantifying isometric strength are difficult to implement for the spinal cord injured population. METHODS: The elbow moment transducer consists of two four-bar parallelogram linkages joined by a lockable pivot. Strain gauges mounted on one beam of the parallelogram produce an output proportional to the elbow moment. RESULTS: Calibration of the device indicates that it accurately quantifies isometric elbow moments over a range that is appropriate for evaluating elbow extension strength in individuals with tetraplegia. CONCLUSIONS: A device was developed and implemented that accurately quantifies isometric elbow moments over a range that is appropriate for evaluating elbow extension strength in individuals with tetraplegia. RELEVANCE: The ability to quantitatively evaluate elbow strength in persons with tetraplegia is useful for understanding and improving the clinical outcomes of rehabilitative interventions that involve the elbow.

A neuroprosthesis for high tetraplegia.

BACKGROUND: This case report describes a neuroprosthesis that restored shoulder and elbow function in a 23-year-old man with chronic C3 complete tetraplegia. Before implementation of the neuroprosthesis, electrodiagnostic testing revealed denervation from C5 to T1, with the greatest degree of denervation in the C8 and T1 myotomes. Thirteen percutaneous intramuscular electrodes were implanted into muscles acting on the shoulder and elbow of one upper limb. Before functional testing, the subject underwent a conditioning regimen to maximize the strength and endurance of the implanted muscles. RESULTS: After completion of the 8-week exercise regimen, stimulated active range of motion against gravity included 60 degrees of shoulder abduction, 45 degrees of shoulder flexion, 10 degrees of shoulder external rotation with the shoulder passively abducted to 90 degrees, and 110 degrees of elbow flexion. Stimulated elbow extension lacked 20 degrees of full extension with gravity eliminated. After system setup, the subject was able to pick up mashed potatoes on a plate with a utensil and bring them to his mouth using the neuroprosthesis and a balanced forearm orthosis. A switch mounted on the headrest of the subject's wheelchair and a position sensor mounted on the contralateral shoulder allowed the subject to control movement of his upper limb.

An analysis of the input-output properties of neuroprosthetic hand grasps.

We measured the input-output properties of the hand grasps of 14 individuals with tetraplegia at the C5/C6 level who had received an implanted upper limb neuroprosthesis. The data provide a quantitative description of grasp-opening and grasp-force control with neuroprosthetic hand grasp systems. Static properties were estimated by slowly ramping the command (input) from 0 to 100%. A hand-held sensor monitored the outputs: grasp force and grasp opening. Trials were performed at different wrist positions, with two different-sized objects being held, and with both grasp modes (lateral and palmar grasps). Larger forces were produced when grasping larger objects, and greater opening was achieved with the wrist in flexion. Although active grasp force increased with wrist extension, it was not significant statistically. Lateral grasp produced larger forces than the palmar grasp. The command range can be divided into a portion that controls grasp opening and a portion that controls grasp force. The portion controlling force increased with spacer size, but did not depend significantly on grasp mode or wrist position. The force-command relationships were more linear than the position-command relationships. Grasp opening decreased significantly over a one-year period, while no significant change in grasp force was observed. These quantitative descriptions of neuroprosthetic hand grasps under varying conditions provide useful information about output capabilities that can be used to gauge the effectiveness of different control schemes and to design future control systems.

Electrically stimulated elbow extension in persons with C5/C6 tetraplegia: a functional and physiological evaluation.

OBJECTIVE: To measure the effect of electrically stimulated triceps on elbow extension strength, range of motion, and the performance of overhead reaching tasks. SETTING: Clinical research laboratory. PARTICIPANTS: Four individuals with spinal cord injuries at the C5 or C6 motor level. INTERVENTIONS: The participants, who already had an implanted upper extremity neuroprosthesis, were provided with elbow extension through functional electrical stimulation (FES) of the triceps brachii. MAIN OUTCOME MEASURES: Comparisons of stimulated elbow extension to voluntary elbow extension: (1) evaluations of impairment such as range of motion and strength; (2) performance of a set of functional overhead reaching tasks that required elbow extension; (3) a usage survey (conducted by telephone) to examine use of triceps stimulation in the home and community. RESULTS: All participants achieved greater range of motion and strength of elbow extension with stimulated triceps versus without. Overall functional task performance improved in 100% of the tasks tested for all but one participant, who showed improvement in 60% of the tasks. Participants reported using the triceps in at least one activity for at least 90% of the days the neuroprosthesis was donned.

An elbow extension neuroprosthesis for individuals with tetraplegia.

Functional electrical stimulation (FES) of the triceps to restore control of elbow extension was integrated into a portable hand grasp neuroprosthesis for use by people with cervical level spinal cord injury. An accelerometer mounted on the upper arm activated triceps stimulation when the arm was raised above a predetermined threshold angle. Elbow posture was controlled by the subjects voluntarily flexing to counteract the stimulated elbow extension. The elbow moments created by the stimulated triceps were at least 4 N.m, which was sufficient to extend the arm against gravity. Electrical stimulation of the triceps increased the range of locations and orientations in the workspace over which subjects could grasp and move objects. In addition, object acquisition speed was increased. Thus elbow extension enhances a person's ability to grasp and manipulate objects in an unstructured environment.

Instrumented objects for quantitative evaluation of hand grasp.

Two instrumented objects have been developed for quantitative assessment of functional tasks performed with the hand. These objects are useful for assessing neuroprosthetic hand grasp systems, and may also be useful in evaluating a variety of other upper limb disabilities and rehabilitation techniques. One object monitors grasp forced and object orientation during palmar prehension, allowing simulation of a drinking task or of manipulating a book. The second object monitors grasp force during lateral prehension for simulating eating or writing tasks. The two objects provide tools to analyze how a subject uses a hand grasp neuroprosthesis to perform activities of daily living. The objects will also be useful in comparing different methods of controlling the neuroprosthesis and in evaluating future changes in the neuroprosthetic system. Assessment trials with these two instrumented objects were performed quickly in an outpatient clinic setting.