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Fifer MS, McMullen DP, Osborn LE, Thomas TM, Christie B, Nickl RW, Candrea DN, Pohlmeyer EA, Thompson MC, Anaya MA, Schellekens W, Ramsey NF, Bensmaia SJ, Anderson WS, Wester BA, Crone NE, Celnik PA, Cantarero GL, Tenore FV. Intracortical Somatosensory Stimulation to Elicit Fingertip Sensations in an Individual With Spinal Cord Injury. Neurology 2022; 98:e679-e687. [PMID: 34880087 PMCID: PMC8865889 DOI: 10.1212/wnl.0000000000013173] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/19/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The restoration of touch to fingers and fingertips is critical to achieving dexterous neuroprosthetic control for individuals with sensorimotor dysfunction. However, localized fingertip sensations have not been evoked via intracortical microstimulation (ICMS). METHODS Using a novel intraoperative mapping approach, we implanted electrode arrays in the finger areas of left and right somatosensory cortex and delivered ICMS over a 2-year period in a human participant with spinal cord injury. RESULTS Stimulation evoked tactile sensations in 8 fingers, including fingertips, spanning both hands. Evoked percepts followed expected somatotopic arrangements. The subject was able to reliably identify up to 7 finger-specific sites spanning both hands in a finger discrimination task. The size of the evoked percepts was on average 33% larger than a finger pad, as assessed via manual markings of a hand image. The size of the evoked percepts increased modestly with increased stimulation intensity, growing 21% as pulse amplitude increased from 20 to 80 µA. Detection thresholds were estimated on a subset of electrodes, with estimates of 9.2 to 35 µA observed, roughly consistent with prior studies. DISCUSSION These results suggest that ICMS can enable the delivery of consistent and localized fingertip sensations during object manipulation by neuroprostheses for individuals with somatosensory deficits. CLINICALTRIALSGOV IDENTIFIER NCT03161067.
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Affiliation(s)
- Matthew S Fifer
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL.
| | - David P McMullen
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Luke E Osborn
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Tessy M Thomas
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Breanne Christie
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Robert W Nickl
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Daniel N Candrea
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Eric A Pohlmeyer
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Margaret C Thompson
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Manuel A Anaya
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Wouter Schellekens
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Nick F Ramsey
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Sliman J Bensmaia
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - William S Anderson
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Brock A Wester
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Nathan E Crone
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Pablo A Celnik
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Gabriela L Cantarero
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Francesco V Tenore
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
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