A Vision for the Blind

Survey of electrically evoked responses in the retina - stimulus preferences and oscillation among neurons

Electrical stimulation is an important tool in neuroscience research and clinically. In the retina, extensive work has revealed how the retinal ganglion cells respond to extracellular electrical stimulation. But little is known about the responses of other neuronal types, and more generally, how the network responds to stimulation. We conducted a survey of electrically evoked responses, over a range of pulse amplitudes and pulse widths, for 21 cell types spanning the inner two layers of the rabbit retina. It revealed: (i) the evoked responses of some neurons were charge insensitive; (ii) pulse-width sensitivity varied between cell types, allowing preferential recruitment of cell types; and (iii) 10-20 Hz damped oscillations across retinal layers. These oscillations were generated by reciprocal excitatory / inhibitory synapses, at locations as early as the cone-horizontal-cell synapses. These results illustrate at cellular resolution how a network responds to extracellular stimulation, and could inform the development of bioelectronic implants for treating blindness.

Bioinspired Ferroelectric Polymer Arrays as Photodetectors with Signal Transmissible to Neuron Cells

A bioinspired photodetector with signal transmissible to neuron cells is fabricated. Photoisomerization of the dye molecules embedded in the ferroelectric polymer membrane achieves electric polarization change under visible light. The photodetector realizes high sensitivity, color recognition, transient response, and 3D visual detection with resolution of 25 000 PPI, and, impressively, directly transduces the signal to neuron cells.

Providing power for miniaturized medical implants: triplet sensitization of semiconductor surfaces

Here, we recognize the growing significance of miniaturized devices as medical diagnostic tools and highlight the need to provide a convenient means of powering such instruments when implanted into the body. One of the most promising approaches to this end involves using a light-collection facility to absorb incident white light and transfer the photonic energy to a tiny semiconductor embedded on the device. Although fluorescent organic molecules offer strong potential as modules for such solar collectors, we emphasize the promise offered by transition metal complexes. Thus, an extended series of binuclear Ru(II)/Os(II) poly(pyridine) complexes has been shown to be highly promising sensitizers for amorphous silicon solar cells. These materials absorb a high fraction of visible light while the Ru(II)-based units possess triplet energies that are comparable to those of the naphthalene-based bridge. The metal complex injects a triplet exciton into the bridge and this, in turn, is trapped by the Os(II)-based terminal. The result is extremely efficacious triplet-energy transfer; at room temperature the rate of energy transfer is independent of distance over some 6 nm and only weakly dependent on temperature.

Photodiode circuits for retinal prostheses

Photodiode circuits show promise for the development of high-resolution retinal prostheses. While several of these systems have been constructed and some even implanted in humans, existing descriptions of the complex optoelectronic interaction between light, photodiode, and the electrode/electrolyte load are limited. This study examines this interaction in depth with theoretical calculations and experimental measurements. Actively biased photoconductive and passive photovoltaic circuits are investigated, with the photovoltaic circuits consisting of one or more diodes connected in series, and the photoconductive circuits consisting of a single diode in series with a pulsed bias voltage. Circuit behavior and charge injection levels were markedly different for platinum and sputtered iridium-oxide film (SIROF) electrodes. Photovoltaic circuits were able to deliver 0.038 mC/cm(2) (0.75 nC/phase) per photodiode with 50- μm platinum electrodes, and 0.54-mC/cm(2) (11 nC/phase) per photodiode with 50-μ m SIROF electrodes driven with 0.5-ms pulses of light at 25 Hz. The same pulses applied to photoconductive circuits with the same electrodes were able to deliver charge injections as high as 0.38 and 7.6 mC/cm(2) (7.5 and 150 nC/phase), respectively. We demonstrate photovoltaic stimulation of rabbit retina in-vitro, with 0.5-ms pulses of 905-nm light using peak irradiance of 1 mW/mm(2). Based on the experimental data, we derive electrochemical and optical safety limits for pixel density and charge injection in various circuits. While photoconductive circuits offer smaller pixels, photovoltaic systems do not require an external bias voltage. Both classes of circuits show promise for the development of high-resolution optoelectronic retinal prostheses.

Throwing a glance at the neural code: rapid information transmission in the visual system

Our visual system can operate at fascinating speeds. Psychophysical experiments teach us that the processing of complex natural images and visual object recognition require a mere split second. Even in everyday life, our gaze seldom rests for long on any particular spot of the visual scene before a sudden movement of the eyes or the head shifts it to a new location. These observations challenge our understanding of how neurons in the visual system of the brain represent, process, and transmit the relevant visual information quickly enough. This article argues that the speed of visual processing provides an adjuvant framework for studying the neural code in the visual system. In the retina, which constitutes the first stage of visual processing, recent experiments have highlighted response features that allow for particularly rapid information transmission. This sets the stage for discussing some of the fundamental questions in the research of neural coding. How do downstream brain regions read out signals from the retina and combine them with intrinsic signals that accompany eye movements? And, how do the neural response features ultimately affect perception and behavior?

A suprachoroidal electrical retinal stimulator design for long-term animal experiments and in vivo assessment of its feasibility and biocompatibility in rabbits

This article reports on a retinal stimulation system for long-term use in animal electrical stimulation experiments. The presented system consisted of an implantable stimulator which provided continuous electrical stimulation, and an external component which provided preset stimulation patterns and power to the implanted stimulator via a paired radio frequency (RF) coil. A rechargeable internal battery and a parameter memory component were introduced to the implanted retinal stimulator. As a result, the external component was not necessary during the stimulation mode. The inductive coil pair was used to pass the parameter data and to recharge the battery. A switch circuit was used to separate the stimulation mode from the battery recharging mode. The implantable stimulator was implemented with IC chips and the electronics, except for the stimulation electrodes, were hermetically packaged in a biocompatible metal case. A polyimide-based gold electrode array was used. Surgical implantation into rabbits was performed to verify the functionality and safety of this newly designed system. The electrodes were implanted in the suprachoroidal space. Evoked cortical potentials were recorded during electrical stimulation of the retina. Long-term follow-up using OCT showed no chorioretinal abnormality after implantation of the electrodes.

Neurotrophic factors and neural prostheses: potential clinical applications based upon findings in the auditory system

Spiral ganglion neurons (SGNs) are the target cells of the cochlear implant, a neural prosthesis designed to provide important auditory cues to severely or profoundly deaf patients. The ongoing degeneration of SGNs that occurs following a sensorineural hearing loss is, therefore, considered a limiting factor in cochlear implant efficacy. We review neurobiological techniques aimed at preventing SGN degeneration using exogenous delivery of neurotrophic factors. Application of these proteins prevents SGN degeneration and can enhance neurite outgrowth. Furthermore, chronic electrical stimulation of SGNs increases neurotrophic factor-induced survival and is correlated with functional benefits. The application of neurotrophic factors has the potential to enhance the benefits that patients can derive from cochlear implants; moreover, these techniques may be relevant for use with neural prostheses in other neurological conditions.

Primate reaching cued by multichannel spatiotemporal cortical microstimulation

Both humans and animals can discriminate signals delivered to sensory areas of their brains using electrical microstimulation. This opens the possibility of creating an artificial sensory channel that could be implemented in neuroprosthetic devices. Although microstimulation delivered through multiple implanted electrodes could be beneficial for this purpose, appropriate microstimulation protocols have not been developed. Here, we report a series of experiments in which owl monkeys performed reaching movements guided by spatiotemporal patterns of cortical microstimulation delivered to primary somatosensory cortex through chronically implanted multielectrode arrays. The monkeys learned to discriminate microstimulation patterns, and their ability to learn new patterns and new behavioral rules improved during several months of testing. Significantly, information was conveyed to the brain through the interplay of microstimulation patterns delivered to multiple electrodes and the temporal order in which these electrodes were stimulated. This suggests multichannel microstimulation as a viable means of sensorizing neural prostheses.

Prosthetic interfaces with the visual system: biological issues

The design of effective visual prostheses for the blind represents a challenge for biomedical engineers and neuroscientists. Significant progress has been made in the miniaturization and processing power of prosthesis electronics; however development lags in the design and construction of effective machine-brain interfaces with visual system neurons. This review summarizes what has been learned about stimulating neurons in the human and primate retina, lateral geniculate nucleus and visual cortex. Each level of the visual system presents unique challenges for neural interface design. Blind patients with the retinal degenerative disease retinitis pigmentosa (RP) are a common population in clinical trials of visual prostheses. The visual performance abilities of normals and RP patients are compared. To generate pattern vision in blind patients, the visual prosthetic interface must effectively stimulate the retinotopically organized neurons in the central visual field to elicit patterned visual percepts. The development of more biologically compatible methods of stimulating visual system neurons is critical to the development of finer spatial percepts. Prosthesis electrode arrays need to adapt to different optimal stimulus locations, stimulus patterns, and patient disease states.

Safety and effectiveness considerations for clinical studies of visual prosthetic devices

With the advent of new designs of visual prostheses for the blind, FDA is faced with developing guidance for evaluating their engineering, safety and patient performance. Visual prostheses are considered significant risk medical devices, and their use in human clinical trials must be approved by FDA under an investigation device exemption (IDE). This paper contains a series of test topics and design issues that sponsors should consider in order to assess the safety and efficacy of their device. The IDE application includes a series of pre-clinical and clinical data sections. The pre-clinical section documents laboratory, animal and bench top performance tests of visual prostheses safety and reliability to support a human clinical trial. The materials used in constructing the implant should be biocompatible, sterile, corrosion resistant, and able to withstand any forces exerted on it during normal patient use. The clinical data section is composed of items related to patient-related evaluation of device performance. This section documents the implantation procedure, trial design, statistical analysis and how visual performance is assessed. Similar to cochlear implants, a visual prosthesis is expected to last in the body for many years, and good pre-clinical and clinical testing will help ensure its safety, durability and effectiveness.

'Who is the ideal candidate?': decisions and issues relating to visual neuroprosthesis development, patient testing and neuroplasticity

Appropriate delivery of electrical stimulation to intact visual structures can evoke patterned sensations of light in individuals who have been blind for many years. This pivotal finding has lent credibility to the concept of restoring functional vision by artificial means. As numerous groups worldwide pursue human clinical testing with visual prosthetic devices, it is becoming increasingly clear that there remains a considerable gap between the challenges of prosthetic device development and the rehabilitative strategies needed to implement this new technology in patients. An important area of future work will be the development of appropriate pre- and post-implantation measures of performance and establishing candidate selection criteria in order to quantify technical advances, guide future device design and optimize therapeutic success. We propose that the selection of an 'ideal' candidate should also be considered within the context of the variable neuroplastic changes that follow vision loss. Specifically, an understanding of the adaptive and compensatory changes that occur within the brain could assist in guiding the development of post-implantation rehabilitative strategies and optimize behavioral outcomes.

Experimental implantation of epiretinal retina implants (EPI-RET) with an IOL-type receiver unit

The purpose of this paper is to investigate the surgical feasibility of implantation and long-term structural outcome of retina implant devices with an anterior IOL receiver, a connecting microcable and posterior segment epiretinal microcontacts. Implantation of epiretinal retina (EPI-RET) implants was performed as a one-step surgical procedure including phacoemulsification and pars plana vitrectomy in two adult rabbits. Implants were mechanically stabilized in an anterior position by the lens capsule and in the posterior segment by microtacks with a soft contact collar. Follow-up (6 and 9 months) included regular clinical examination, anterior and posterior segment photography and finally pathohistological evaluation. Implantation was uneventful in case 1 and complicated by vitreous space haemorrhage in case 2. At the end of follow-up, the retina was partially detached in animal 1 and subtotally detached in animal 2. Common features of tissue reaction in both cases were the formation of cyclitic membranes extending around and posterior to the anterior IOL receiver. In addition to that severe proliferations developed around microcables, microcontacts and microtacks forming a tissue capsule around posterior segment foreign materials. Retinal areas in contact to implant devices presented a severe structural damage and disorganization. Results of this preliminary trial suggest that the application of epiretinal prostheses with large diameter IOL receivers may be a critical issue and can give rise to an unfavourable outcome. Further systematic investigation ought to be performed involving a larger number of animals, modified implants and perhaps other species.